Longitudinal Changes in Weight and Biology in the Pregnancy-Postpartum Period and Subsequent Cardiometabolic Risk
|Dates:||4/1/2018 - 1/31/2023|
|Role:||Harriet Jones Kitzman, PhD, RN, FAAN : Co-Investigator|
|Principal Investigator:||Susan Groth, Thomas O’Connor and Emily Barrett|
To improve our understanding of the nature of biological changes in the pregnancy-postpartum period that may predict cardiometabolic risk, we propose a cost-efficient longitudinal study extending from the first trimester through 3 years postpartum that capitalizes on the infrastructure of an ongoing pregnancy cohort. Our aims include identification of maternal weight profiles in the pregnancy-postpartum period that predict adverse cardiometabolic risk; characterization of profiles of immune, endocrine and metabolic biomarkers in the pregnancy-postpartum period and determination of their association with cardiometabolic risk; and determination of how modifiable health behaviors predict weight and cardiometabolic risk in the postpartum period and/or moderate the association between postpartum weight retention and cardiometabolic risk. Poor prenatal health is a major public health concern in the U.S. Over 50% of U.S. women enter pregnancy overweight or obese and nearly 50% of women gain above the Institute of Medicine recommendations during pregnancy. Unhealthy maternal weight and weight gain have been identified as key maternal-child health risks in Healthy People 2020. These factors also lead to weight retention in the postpartum, a vicious cycle which may contribute to increasing baseline weight over successive pregnancies and, ultimately, elevated cardiometabolic risk. The physiological mechanisms underlying these relationships are poorly understood. By characterizing weight and obesity-related biomarker profiles during this important period, we may be able to identify key predictors of sustained cardiometabolic risk several years after pregnancy. Our data on modifiable health behaviors and lifestyle will be similarly valuable in identifying factors that may ameliorate or exacerbate cardiometabolic risks. Once these key pathways and behaviors are identified, it becomes possible to develop targeted, personalized interventions to address those specific pathways. For instance, if we find that a relationship between weight retention and adverse subsequent cardiometabolic profiles only among women who are sedentary, this would suggest that interventions to encourage physical activity are particularly important in the postpartum. The aims of the current study are highly relevant to the health promotion and illness prevention. Our study will provide valuable, clinically relevant, and actionable findings on how weight and physiological profiles during the perinatal period contribute to women’s cardiometabolic health.