Sedentary behavior, physical activity, and 24-hour behavior in pregnancy and offspring health: the Pregnancy 24/7 Offspring Study

久坐行为、体力活动和 24 小时行为对怀孕和后代健康的影响：怀孕 24/7 后代研究

• 批准号: 10654333
• 负责人: Bethany Barone Gibbs
• 金额: $ 70.27万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-17 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10654333
• 关键词: Address; Adult; Aging; Behavior; Behavior assessment; Birth; Blood Pressure; Blood Vessels; Body mass index; Breast Feeding; Cardiovascular Diseases; Cause of Death; Child; Child Health; Childhood; Cohort Studies; Data; Data Analyses; Development; Diet; Disease; Elderly; Enrollment; Epidemic; Fetal Growth; First Pregnancy Trimester; Future; Goals; Growth; Health; Home environment; Hour; Hypertension; Incidence; Intervention; Late pregnancy; Link; Longevity; Maternal Behavior; Maternal Exposure; Maternal Health; Measurement; Measures; Medical Records; Methods; Modeling; Monitor; National Heart, Lung, and Blood Institute; Obesity; Outcome; Participant; Pattern; Persons; Physical activity; Physiologic pulse; Physiological; Pregnancy; Pregnancy Trimesters; Pregnant Women; Prevention; Primary Prevention; Questionnaires; Research; Risk; Risk Factors; Risk Reduction; Role; Site; Sleep; Smoking; Statistical Methods; Time; Unhealthy Diet; United States; Visit; Woman; adverse pregnancy outcome; cardiovascular disorder risk; cardiovascular risk factor; clinically relevant; early childhood; early onset; fetal programming; gestational weight gain; in utero; interest; modifiable behavior; novel; obesity in children; obesity risk; observational cohort study; offspring; offspring obesity; poor sleep; post pregnancy; postnatal; prenatal; prenatal exposure; prepregnancy obesity; prevent; preventive intervention; primary outcome; prospective; response; sedentary lifestyle; theories; vigorous intensity

ABSTRACT Over the past three decades, there has been an alarming increase in the incidence of childhood obesity. Childhood obesity leads to early onset of cardiovascular risk factors, and both obesity and cardiovascular risk factors track into adulthood and contribute to the epidemic of cardiovascular disease (CVD). The Developmental Origins of Health and Disease theory posits that risk for obesity and CVD is, in part, programmed in utero. To prevent this early entrenchment into obesity and CVD, identification of modifiable maternal factors during pregnancy that later impact offspring risk in early childhood is essential. A surprising lack of research investigates the role of prenatal sedentary behavior (SED), moderate-to-vigorous-intensity physical activity (MVPA), and the novel 24-hour behavior paradigm (the composition of SED, physical activity, and sleep) on these adverse offspring outcomes. This is a critical research gap because there is strong physiological rationale that SED, MVPA, and 24-hour behavior in pregnancy could influence offspring health, and these behaviors are modifiable targets for intervention during pregnancy. The overall goal of this proposal is to examine the associations of SED (Aim 1) and MVPA (Aim 2) across pregnancy with offspring obesity risk and CVD risk through 24 months. We will also use novel statistical methods to determine the optimal 24-hour behavior compositions (Aim 3) during pregnancy associated with reduced risk of these adverse offspring outcomes. We can achieve these aims by leveraging our ongoing, multi-center cohort study Pregnancy 24/7 (R01 HL153095), where we are prospectively measuring SED, physical activity, and sleep in 500 women in each trimester of pregnancy using state-of-the-art monitors (activPAL3 micro and Actiwatch Spectrum Plus). Pregnancy 24/7 also assesses other relevant prenatal exposures that may associate with offspring obesity and CVD risk, i.e., pre-pregnancy obesity, gestational weight gain, diet, smoking, and adverse pregnancy outcomes. In direct response to the NHLBI’s Notice of Special Interest (NOT-HL-19-695), we propose to expand Pregnancy 24/7 by conducting a separate cohort study among the offspring of its participants. In the Offspring Study, we propose to combine maternal exposure data from Pregnancy 24/7 with new, comprehensive assessments of postnatal exposures, obesity, and CVD risk measures in the child through 24 months via medical record abstraction, questionnaires, and an in-person study visit at 24 months. We hypothesize that offspring of women with higher SED or lower MVPA across pregnancy will have more rapid increases in BMI Z-score (primary outcome), and greater adiposity, blood pressure, and pulse wave velocity through 24 months. Further, we hypothesize that statistically reallocating time in SED to physical activity, but not sleep (among adequate duration sleepers) will be associated with more optimal offspring outcomes. By combining prenatal and postnatal exposure data, our approach uniquely allows us to isolate the effects of pregnancy SED, MVPA, and 24-hr behavior on offspring obesity and CVD risk measures in early childhood. This project will inform critically needed primordial prevention interventions to decrease the risk of obesity and CVD.

抽象的 在过去的三十年中，儿童对象的发生率令人震惊。 儿童肥胖导致心血管危险因素早期发作，肥胖和心血管风险 导致成年期的因素并导致心血管疾病的流行（CVD）。发展 健康与疾病理论的起源认为，肥胖和CVD的风险部分在子宫内编程。到 防止这种早期侵犯肥胖和CVD，鉴定可修改的母亲因素 怀孕后来影响幼儿的后代风险至关重要。令人惊讶的缺乏研究调查 产前久坐行为（SED），中度到vig弱强度的体育活动（MVPA）和 新颖的24小时行为范式（SED的组成，体育锻炼和睡眠的组成） 后代结果。这是一个关键的研究差距，因为SED有强大的生理原理 MVPA和怀孕24小时的行为可能影响后代的健康，这些行为是可修改的 怀孕期间干预的目标。该提案的总体目标是检查SED的关联 （AIM 1）和MVPA（AIM 2）在怀孕期间，后代肥胖风险和CVD风险在24个月内。我们 还将使用新颖的统计方法来确定最佳的24小时行为组成（AIM 3） 与这些不良后代结果的风险降低有关的妊娠。我们可以通过 利用我们正在进行的多中心队列研究妊娠24/7（R01 HL153095） 使用最先进 监视器（ActivPal3 Micro和ActiWatch Spectrum Plus）。怀孕24/7还评估其他相关产前 可能与后代肥胖和CVD风险相关的暴露，即怀孕前肥胖症，妊娠体重 获得，饮食，吸烟和不良怀孕结果。直接回应NHLBI的特别通知 兴趣（非HL-19-695），我们提议通过在24/7全天候扩大怀孕 参与者的后代。在后代研究中，我们建议将物质暴露数据结合在一起 怀孕24/7，对产后暴露，肥胖和CVD风险测量的新，全面评估 在孩子到24个月的儿童中，通过医疗记录抽象，问卷调查和面对面的研究访问24 月份。我们假设在怀孕期间较高或较低MVPA的女性的后代将拥有 BMI Z分数（主要结果）以及更大的肥胖，血压和脉搏波的迅速增加 速度为24个月。此外，我们假设在统计上重新分配了体育锻炼的时间， 但是不睡觉（在足够的持续时间卧铺中）将与更最佳的后代结果相关。经过 结合产前和产后暴露数据，我们的方法独特地使我们能够隔离 孕期后代肥胖和CVD风险度量的怀孕，MVPA和24小时行为。这 项目将为迫切需要的原始预防干预措施提供信息，以降低肥胖和CVD的风险。