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Author ORCID Identifier

https://orcid.org/0009-0003-8035-4414

AccessType

Campus-Only Access for Five (5) Years

Document Type

dissertation

Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

Year Degree Awarded

2023

Month Degree Awarded

May

First Advisor

Lisa Chasan-Taber

Subject Categories

Epidemiology

Abstract

The increasing rates of gestational diabetes and maternal obesity is a major challenge to public health. They can result in long-term health consequences for both the woman and her offspring. In women these conditions can cause postpartum weight retention resulting in increased risk for type 2 diabetes and cardiovascular disease. In the offspring they can cause an increased risk of future obesity, type 2 diabetes, cardiovascular disease, and if the offspring is female increased risk of prepregnancy obesity and gestational diabetes, thus resulting in a vicious intergenerational cycle of obesity and diabetes that impacts population health. Lifestyle interventions involving diet and exercise during pregnancy could have an impact on adiposity in infants and on postpartum weight retention in women. Therefore, we assessed the impact of a culturally tailored Lifestyle on these outcomes using data from Proyecto Mamá and Estudió PARTO, two randomized controlled trials and evaluated the predictors of health behaviors in this high-risk group of pregnant Hispanic women.

Chapter 1 examined the effect of the Lifestyle Intervention in overweight or obese pregnant Hispanic women on the anthropometric measures of their offspring, including z-scores for birthweight for gestational age, weight for age, weight for length; body size (ponderal index: g/cm3) and sum and ratio of skinfolds thickness. We observed no significant difference in anthropometric measures of infants between study arms.

Chapter 2 evaluated the predictors of prenatal and postpartum health behaviors in Hispanic women with abnormal glucose tolerance in pregnancy. We found that normal BMI and low prenatal stress and anxiety are significant predictors of health behaviors.

Chapter 3 examined the effect of the Lifestyle Intervention on postpartum weight retention in Hispanic women with abnormal glucose tolerance in pregnancy. We did not observe any significant overall differences in weight change pattern between intervention arms and observed higher odds of meeting secondary postpartum weight reduction outcome at 12 months postpartum.

In conclusion, this Lifestyle Intervention did not affect the anthropometric measures of the offspring; increased the odds of meeting postpartum weight loss goals and established that selected psychosocial and medical factors were associated with health behaviors in this high-risk Hispanic population.

DOI

https://doi.org/10.7275/35077929

Available for download on Sunday, May 26, 2024

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