Using a 24-Hour Movement Framework to Improve Pregnancy Outcomes

项目摘要/摘要 母亲肥胖、妊娠期糖尿病和儿童肥胖是恶性循环的一部分。几乎一半的人 美国育龄女性超重或肥胖。超重和肥胖女性人数上升 患妊娠期糖尿病的可能性是正常体重女性的6倍。在宫内接触GDM的儿童有一 2型糖尿病的风险增加了8倍，肥胖的风险增加了2倍，延续了这个循环。不断增加的物理 怀孕期间的活动和睡眠可能有助于降低这些风险。这些行为是相互关联的：提高 一种(例如，获得更多的体力活动)可能会以牺牲另一种(例如，获得足够的睡眠)为代价。这个 理想的日常体力活动和睡眠模式，以预防妊娠并发症和随后的童年 肥胖的危险因素是未知的。尽管这些行为的本质是相互关联的，但之前对物理行为的研究 超重和肥胖孕妇在孕期的活动、久坐行为和睡眠 重点关注这些行为与围产期结局的个体关联。如何相互依存 24小时运动框架内体力活动、久坐行为和睡眠之间的关系 对围产期结局的影响尚不清楚。这个K99/R00独立之路奖的目标是 促进我转变为一名在24小时运动中拥有专业知识的独立研究员 孕期框架，以最终制定24小时活动的干预措施和准则 这一关键时期。在该奖项的导师(K99)阶段，我将继续进行分析方面的培训 加速计-测量的身体活动数据，睡眠的生理和测量，以及实用技能 在莫尼克博士的指导下进行研究，包括招募和保留 Hedderson(首席导师)，Kelley PetteGabriel博士(共同导师和加速度计专家-测量 24小时运动框架内的体力活动)和Rachel Manber博士(共同导师和专家 怀孕期间睡觉)。我在指导阶段的研究将1)评估24小时移动 怀孕早期的情况与妊娠晚期母体代谢生物标记物有关，2) 评估妊娠早期和晚期的24小时运动轨迹是否与分娩有关 超重和肥胖婴儿中儿童肥胖危险因素的研究 怀孕的女人。在本奖项的独立(R00)阶段，我将研究24- 妊娠期间的小时运动与糖耐量、出生体重和新生儿肥胖症的关系 创建一组超重和肥胖的孕妇，每天通过基于设备的身体测量 怀孕期间的活动、久坐行为和睡眠。这些培训和研究活动将为 我将成功申请R01拨款，以支持进一步调查24小时运动概况和 孕妇高危人群的妊娠结局。

PROJECT SUMMARY/ABSTRACT Maternal obesity, gestational diabetes, and childhood obesity are part of a vicious cycle. Almost half of all reproductive-aged women in the United States are overweight or obese. Overweight and obese women are up to 6 times more likely to develop GDM than normal weight women. Children exposed to GDM in utero have an 8-fold greater type 2 diabetes risk and a 2-fold greater obesity risk, perpetuating the cycle. Increasing physical activity and sleep during pregnancy may help mitigate these risks. These behaviors are interrelated: improving one (e.g. getting more physical activity) could occur at the expense of another (e.g. getting enough sleep). The ideal daily pattern of physical activity and sleep to prevent pregnancy complications and subsequent childhood obesity risk factors is unknown. Despite the interrelated nature of these behaviors, prior research on physical activity, sedentary behavior, and sleep during pregnancy in overweight and obese pregnanct women has focused on individual associations of these behaviors with perinatal outcomes. How the interdependent relationships between physical activity, sedentary behavior, and sleep within a 24-hour movement framework affect perinatal outcomes remains unclear. The goal of this K99/R00 Pathway to Independence Award is to facilitate my transition to becoming an independent researcher with expertise in the 24-hour movement framework during pregnancy to ultimately develop interventions and guidelines for 24-hour movement during this critical period. During the Mentored (K99) Phase of this award, I will pursue training in the analysis of accelerometer-measured physical activity data, the physiology and measurement of sleep, and practical skills in research study conduct, including recruitment and retention, under the mentorship of Dr. Monique Hedderson (Primary Mentor), Dr. Kelley Pettee Gabriel (Co-Mentor and expert in accelerometer-measured physical activity within a 24-hour movement framework), and Dr. Rachel Manber (Co-Mentor and expert in sleep during pregnancy). My research during the Mentored Phase will 1) assess whether 24-hour movement profiles during early pregnancy are associated with late pregnancy maternal metabolic biomarkers, and 2) assess whether 24-hour movement profiles during early and late pregnancy are associated with delivering infants with childhood obesity risk factors using data from an existing study among overweight and obese pregnant women. In the Independent (R00) Phase of this award, I will examine longitudinal relationships of 24- hour movement profiles during pregnancy with glucose tolerance, birthweight, and neonatal adiposity by creating a cohort of overweight and obese pregnant women with daily, device-based measurement of physical activity, sedentary behavior, and sleep across pregnancy. These training and research activities will prepare me to successfully compete for R01 funding to support further investigation of 24-hour movement profiles and pregnancy outcomes in high-risk populations of pregnant women.