Gestational weight gain and infant birthweight among Black women: Beyond individual-level factors

项目总结/摘要 孕期体重增加（GWG）可能是黑人实现最佳分娩结局的一个可补救因素。 妇女总体而言，黑人女性更容易肥胖（体重指数[BMI] ≥30 kg/m2）， 在怀孕期间获得最佳体重，与非妊娠期相比，分娩的婴儿出生体重较低， 西班牙裔白色和西班牙裔妇女。黑人妇女也更有可能居住在社区， 社会经济不利地位的程度（例如，贫困）、无序（例如，空置房屋）和犯罪，并有 与白人相比，进入超市和健康食品的机会有限。邻里环境 压力因素（社会经济劣势，混乱，犯罪，有限的食物可获得性）可能会增加 GWG不足或过多以及婴儿出生体重较低。然而，现有数据显示， 邻里环境压力源与GWG不足或过度和婴儿 出生体重数据来自参加NIH R 01研究的620名黑人孕妇。 炎症：早产的混合方法（R 01 MD 011575; PI Giescu，Co-I Misra） 将分析COVID-19大流行。女性在19-29岁时完成问卷调查并抽血 怀孕几周。邻里环境压力源和抑郁症状的测量， 产妇问卷和行政（例如，人口普查）数据。通过以下指标评估全身性炎症： 血浆细胞因子水平（白细胞介素[IL]-4，IL-6，IL-8，IL-10，肿瘤坏死因子[TNF-α]，干扰素γ [IFN-γ]）和C-反应蛋白[CRP]。将从病历中获取GWG和出生数据。目标 本研究的主要目的是：1）确定社区环境压力源与GWG的关系; （2）确定邻里环境应激源与婴儿出生体重相关的途径。 这是第一项同时考察感知和客观测量之间关系的研究 社区环境压力与GWG在一个大的队列怀孕的黑人妇女。邻域 获得健康和不健康的食品商店将被视为GWG的健康决定因素。为配合 国家护理研究所的优先事项，这项研究将确定社会和身体的决定因素， GWG和黑人妇女的婴儿出生体重。目标和具体目标与《公约》的 使命是促进和改善个人、家庭和社区的健康。博士后奖学金将 提供一个坚实的基础，在此基础上建立申请人的研究，以确保足够的GWG，并最终 改善黑人家庭的母婴健康。中央大学的研究环境 佛罗里达将支持申请人的发展成为一个独立的研究人员和护士科学家。结果 将告知未来的干预措施与先进的实践护士（执业护士，认证护士 助产士），以减少黑人妇女在GWG和婴儿出生体重方面的健康差距。

Project Summary/Abstract Gestational weight gain (GWG) may be a remediable factor in achieving optimal birth outcomes for Black women. Overall, Black women are more likely to be obese (body mass index [BMI] ≥30 kg/m2), at risk for not gaining optimal weight during pregnancy, and delivering an infant of lower birthweight compared with non- Hispanic white and Hispanic women. Black women are also more likely to reside in neighborhoods with higher levels of socioeconomic disadvantage (e.g., poverty), disorder (e.g., vacant housing) and crime, and have limited access to supermarkets and healthy food options compared with whites. Neighborhood environmental stressors (socioeconomic disadvantage, disorder, crime, limited food accessibility) may increase the risk for either inadequate or excessive GWG and lower infant birthweight. However, existing data show inconclusive associations of neighborhood environmental stressors with inadequate or excessive GWG and infant birthweight. Data from 620 pregnant Black women enrolled in the NIH R01 study Social stressors and inflammation: A mixed methods approach to preterm birth (R01MD011575; PI Giurgescu, Co-I Misra) prior to the COVID-19 pandemic will be analyzed. Women completed questionnaires and had blood drawn at 19-29 weeks gestation. Neighborhood environmental stressors and depressive symptoms were measured by maternal questionnaires and administrative (e.g., census) data. Systemic inflammation was assessed by plasma levels of cytokines (interleukin [IL]-4, IL-6, IL-8, IL-10, tumor necrosis factor [TNF-α], interferon gamma [IFN-γ]) and C-Reactive Protein [CRP]. GWG and birth data will be obtained from medical records. The aims of this study are to: 1) Determine the pathways by which neighborhood environmental stressors relate to GWG; and 2) Determine the pathways by which neighborhood environmental stressors relate to infant birthweight. This is the first study to simultaneously examine the relationship of perceived and objectively measured neighborhood environmental stressors with GWG in a large cohort of pregnant Black women. Neighborhood access to healthy and unhealthy food stores will be examined as a health determinant to GWG. In line with the National Institute of Nursing Research’s priorities, this study will identify social and physical determinants of GWG and infant birthweight among Black women. The objectives and specific aims are highly relevant to the mission to promote and improve health individuals, families, and communities. The postdoctoral fellowship will provide a strong foundation on which to build the applicant’s research to ensure adequate GWG and ultimately improve maternal and infant health among Black families. The research environment at University of Central Florida will support the applicant’s development into an independent researcher and nurse scientist. Results will inform future interventions with advanced practice nurses (nurse practitioners, certified nurse midwives) to reduce health disparities in GWG and infant birthweight among Black women.