Intergenerational Obesity: Do Early Adversity and Pregnancy Explain Disparities?

项目总结/摘要 项目摘要。虽然遗传倾向肯定会导致肥胖，但现有的种族/民族 肥胖的差异在很大程度上仍然无法解释。妇女在怀孕期间患肥胖症的风险特别大。 生育;然而，怀孕前，怀孕期间和怀孕后体重增加之间的关系可能不同 黑人西班牙裔和非西班牙裔白色女性之间的差异母亲怀孕时肥胖和/或过度肥胖 怀孕期间体重增加也可能显着影响代谢的发展和编程， 对后代的影响-影响也可能因种族/族裔而异。因此，生育代表着 一个重要的发展窗口，在其中探索肥胖的种族/民族差异的起源-为 母亲和她们的孩子这个项目的目的是调查种族/民族的差异， 可能增加中年母亲BMI和肥胖的几个因素之间的影响和相互作用 在后代中：早期母体社会环境（例如，社会经济地位和家庭结构）、怀孕- 相关权重（例如，过度妊娠体重增加和产后体重保持），以及不利的孕产妇 童年经历（例如，家庭中的身体虐待、药物滥用或精神疾病）。美国1979 全国青年纵向调查（NLSY）及其对NLSY女性所生子女的伴随研究 为进行队列研究提供了有价值的数据集。这些备受尊敬的、具有全国代表性的 对大约4000名美国妇女及其子女的研究提供了一个评估平等的独特机会- 相关的体重，社会经济和心理因素，以及一代母亲及其 孩子这项建议的一个创新特点是收集关于孕产妇不良反应史的新数据， 2012年NLSY浪潮中的童年经历。我们将利用合作者的专业知识， 这些机构以前曾在其他研究项目上合作过，其专业知识涵盖了 围产期流行病学，营养和肥胖，神经生物学，健康差距，心理学，社会 流行病学和生物统计学。我们假设：1）调整孕前BMI和当前BMI后， 社会环境、妊娠期体重过度增加和产后体重保持将介导 早期社会劣势与中年BMI之间的关联，这种中介作用在黑人中更大。 2）在适应当前的社会环境后，母亲的早期社会环境和高体重 怀孕前、怀孕中和怀孕后，是后代肥胖的种族差异的途径。 增加;和3）母亲的童年不良经历的历史将解释很大一部分， 早期社会环境和妊娠体重增加与母亲和儿童BMI之间的关系， 适应当前社会环境。

Project Summary/Abstract Project Summary. While genetic predisposition certainly contributes to obesity, the existing racial/ethnic disparities in obesity remain largely unexplained. Women are at special risk for developing obesity during childbearing; however, the relationship between weight gain before, during and after pregnancy may differ between black, Hispanic, and non-Hispanic white women. Maternal obesity at conception and/or excessive weight gain during pregnancy may also significantly influence the development and programming of metabolic processes in offspring - impacts which may also vary by race/ethnicity. Therefore childbearing represents an important developmental window within which to explore the origins of racial/ethnic disparities in obesity - for both mothers and their children. The purpose of this project is to investigate racial/ethnic differences in the impact and interactions between several factors that may increase maternal BMI at mid-life as well as obesity in offspring: early maternal social environment (e.g., socioeconomic status and family structure), pregnancy- related weight (e.g., excessive gestational weight gain and postpartum weight retention), and adverse maternal childhood experiences (e.g., physical abuse, substance abuse or mental illness in the home). The U.S. 1979 National Longitudinal Survey of Youth (NLSY) and its companion study of children born to NLSY females provide a valuable data set to conduct a cohort study. These highly respected, nationally representative studies of approximately 4000 U.S. women and their children provide a unique opportunity to assess parity- related weight, socioeconomic and psychological factors, and BMI across one generation of mothers and their children. An innovative feature of this proposal is the collection of new data on history of maternal adverse childhood experiences in the 2012 wave of the NLSY. We will capitalize on expertise of collaborators from institutions that have worked together previously on other research projects and whose expertise spans the fields of perinatal epidemiology, nutrition and obesity, neurobiology, health disparities, psychology, social epidemiology and biostatistics. We hypothesize that: 1) after adjusting for pre-pregnancy BMI and current social environment, excessive gestational weight gain and postpartum weight retention will mediate the association between early social disadvantage and mid-life BMI and that this mediation will be larger for black women; 2) after adjusting for current social environment, a mother's early social environment and high weight before, during and after pregnancy represent pathways through which racial disparities in offspring obesity are increased; and 3) maternal history of childhood adverse experiences will explain a substantial portion of the association between early social environment and pregnancy weight gain with maternal and child BMI, adjusting for current social environment.