Examining the Influence of Soc. Determinants of Health on Gestational WeightGain

几乎一半的美国育龄女性是超重或肥胖，其中 黑人女性和南方腹地居民。妊娠期体重增加与产后体重滞留 随着时间的推移而增加，导致母亲和母亲出现许多不利健康后果的风险更高 后代。因此，怀孕是了解和干预致病因素的关键时期。 GWG过多和随后增加的条件和疾病的风险，这对 少数族裔。OW/OB人群面临不良后果的最大风险，因此 最有可能受益并产生提供信息的结果；然而，关于什么是 影响GWG的因素最多。虽然选择个人特征解释了一些观察到的 尽管在结果上存在种族/族裔差异，但即使在控制个别因素时也存在巨大差异。 此外，肥胖与种族和复杂性之间的关系。以多决定因素框架为基础 关于产前健康，这项拟议的研究试图检查社会决定因素对 健康(例如，社会、文化和建筑环境)和人际特征(例如，年龄、种族) 年200对黑人和200对白人母婴的母体体重和短期健康结局 伯明翰，AL和杰克逊女士，进一步，我们寻求利用这些信息来通知社区驱动 促进这些社区卫生公平的方法。以下目标将通过一个 来自阿拉巴马大学伯明翰分校(UAB)、密西西比大学的跨学科团队 医学中心(UMMC)和杰克逊州立大学(JSU)：(1)比较社会性别差异 健康的决定因素；(2)比较GWG(主要结局)和产科并发症(例如， 妊娠期糖尿病/胰岛素抵抗、剖腹产、高血压疾病)、出生体重、脐血C-肽 注意力、婴儿体重和产后6个月体重减轻(次要结果)；(3)检查 中小学生个体因素与社会健康决定因素的关系 结果；以及(4)试点测试社区驱动的战略，以解决健康的社会决定因素。

Almost half of all US women of reproductive age are ovenweight (OW) or obese, with higher rates among black women and Deep South residents. Gestational weight gain (GWG) and retention of weight post-partum have increased over time, resulting in higher risk for numerous adverse health outcomes for mother and offspring. As such, pregnancy is a critical period for understanding and intervening on factors contributing to excess GWG and subsequent increased risk for conditions and diseases which disproportionately impact racial/ethnic minorities. The OW/OB population is at greatest risk for the adverse outcomes, and therefore most likely to benefit and yield informative results; however, there is a lack of definitive evidence about what factors most influence GWG. While select individual characteristics explain some of the observed racial/ethnic differences in outcomes, wide disparities exist even when controlling for individual factors. Further the relationship between obesity and race and complex. Grounded in a multideterminants framework of prenatal health, the proposed study seeks to examine the relative contribution of social determinants of health (e.g., social, cultural, and built environments) and interpersonal characteristics (e.g., age, race) on maternal GWG and short-term health outcomes of 200 black and 200 white mother-infant pairs in Birmingham, AL and Jackson, MS. Further, we seek to use this information to inform community-driven approaches to promote health equity in these communities. The following aims will be accomplised by a transdiciplinary team from the University of Alabama at Birmingham (UAB), the University of Mississippi Medical Center (UMMC), and Jackson State University (JSU): (1) compare racial differences in social determinants of health; (2) Compare GWG (primary outcome) and obstetric complica- tions (e.g., GDM/insulin resistance, C-section, hypertensive disorders), birth weight, umbilical cord blood c-peptide concentration, infant weight and postpartum weight loss at 6-months (secondary outcomes); (3) Examine the relationship between individual factors and social determinants of health on primary and secondary outcomes, and (4) pilot test community-driven strategies to address social determinants of health.