Few modifiable risk factors for preterm birth (PTB) and intrauterine growth retardation (IUGR) have been identified. Poor cardiovascular health during the pregnancy can lead to preterm birth (PTB), but the effect of pre-pregnancy cardiovascular health on birth outcomes is not clear. Our long-term goal is to determine the causes of and ultimately develop interventions that can reduce the incidence of and disparities in PTB/IUGR. Our overall objective with this project is to determine the relationship between pre-pregnancy cardiovascular risk, from childhood through early adulthood, and birth outcomes. Our central hypothesis is that high cardiovascular risk across the lifespan predicts poor pregnancy outcome and partially accounts for racial disparities in these outcomes. We plan to take advantage of the data collected in the Bogalusa Heart Study, a long-running biracial (black/white) study of cardiovascular health in children and young adults. The study includes data on almost 6000 women, now in their late reproductive years. We propose to link to vital records data (estimated N=3980), interview participants about their pregnancy history (estimated N=3060), and request medical records for their pregnancies (estimated N=1330). We will then examine the relationship between cardiovascular disease (CVD) risk factors across the lifespan, birth outcomes, and pregnancy complications.
Our specific aims are 1. To determine the impact of mother's CVD risk factors (high blood pressure, dyslipidemia, hyperglycemia, hyperinsulinemia, obesity) in childhood and adolescence on birth outcomes of her babies (preterm birth (PTB) and intrauterine growth retardation (IUGR)) in a black and white population;2) To examine the relationship of longitudinal changes of mother's CVD risk factors from childhood to adulthood to birth outcomes in black and white individuals);3) To determine whether pre-pregnancy CVD risk factors are associated with pregnancy complications (gestational hypertension, gestational diabetes and pre-eclampsia), and whether this explains the relationship between pre-pregnancy cardiovascular risk and PTB/IUGR;4) To determine whether differences in CVD risk factors explain racial disparities in birth outcomes. The contribution of the proposed research is expected to be linking pre-pregnancy cardiovascular health across the life span with pregnancy outcomes. This will be significant because we will identify novel risk factors, timing, and subpopulations for interventions that could reduce the incidence of and disparities in PTB/IUGR. This proposal takes advantage of the unique opportunity to use 35 years of longitudinal research, beginning in childhood, in a biracial population.

Public Health Relevance

The proposed research will contribute to reducing an important public health problem, disparities in preterm birth and intrauterine growth retardation. By identifying risk factors over the life course (childhood, adolescence, and adulthood), it will be possible to develop interventions that improve both cardiovascular and reproductive health. This research will be significant because we will identify novel risk factors, timing, and subpopulations for interventions that could improve pregnancy outcome.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD069587-01A1
Application #
8245469
Study Section
Infectious Diseases, Reproductive Health, Asthma and Pulmonary Conditions Study Section (IRAP)
Program Officer
Reddy, Uma M
Project Start
2012-08-05
Project End
2016-06-30
Budget Start
2012-08-05
Budget End
2013-06-30
Support Year
1
Fiscal Year
2012
Total Cost
$525,461
Indirect Cost
$154,867
Name
Tulane University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
053785812
City
New Orleans
State
LA
Country
United States
Zip Code
70118
Harville, Emily W; Myers, Leann; Shu, Tian et al. (2018) Pre-pregnancy cardiovascular risk factors and racial disparities in birth outcomes: the Bogalusa Heart Study. BMC Pregnancy Childbirth 18:339
Wang, Yiping; Xiong, Xu; Bazzano, Lydia et al. (2018) Childhood cardiovascular health and subfertility: the Bogalusa Heart Study. Pediatr Res :
Harville, Emily W; Chen, Wei; Guralnik, Jack et al. (2018) Reproductive history and physical functioning in midlife: The Bogalusa Heart Study. Maturitas 109:26-31
Harville, Emily W; Jacobs, Marni; Shu, Tian et al. (2018) Feasibility of Linking Long-Term Cardiovascular Cohort Data to Offspring Birth Records: The Bogalusa Heart Study. Matern Child Health J 22:858-865
Wallace, Maeve E; Bazzano, Lydia; Zhang, Cuilin et al. (2018) Fasting glucose concentrations and associations with reproductive history over 40 years of follow-up. Gynecol Endocrinol 34:724-727
Jacobs, M B; Bazzano, L A; Pridjian, G et al. (2017) Childhood adiposity and fertility difficulties: the Bogalusa Heart Study. Pediatr Obes 12:477-484
Wallace, Maeve; Bazzano, Lydia; Chen, Wei et al. (2017) Maternal childhood cardiometabolic risk factors and pregnancy complications. Ann Epidemiol 27:429-434
Harville, E W; Chen, W; Bazzano, L et al. (2017) Indicators of fetal growth and adult liver enzymes: the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study. J Dev Orig Health Dis 8:226-235
Harville, Emily W; Jacobs, Marni B; Qi, Lu et al. (2017) Multigenerational Cardiometabolic Risk as a Predictor of Birth Outcomes: The Bogalusa Heart Study. J Pediatr 181:154-162.e1
Li, Shengxu; Xiong, Xu; Harville, Emily et al. (2016) Childhood Risk Factors and Pregnancy-Induced Hypertension: The Bogalusa Heart Study. Am J Hypertens 29:1206-11

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