Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Health Sciences, California State University Northridge, Northridge, CA, USA.
Int J Obes (Lond). 2022 Feb;46(2):366-373. doi: 10.1038/s41366-021-01009-8. Epub 2021 Oct 30.
BACKGROUND/OBJECTIVE: Prevalence of pre-pregnancy obesity and excessive gestational weight gain (GWG) are higher among women of color with low SES. Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis and its end-product, cortisol, during pregnancy is hypothesized to be associated with excessive GWG. However, past studies have produced inconsistent findings and often did not include health disparities populations. This study examined the association between pre-pregnancy body mass index (BMI), third trimester diurnal cortisol, and GWG in low-income, predominantly Hispanic women.
SUBJECTS/METHODS: The MADRES study is an ongoing prospective cohort study of primarily Hispanic, low-income pregnant women and their children in Los Angeles, California. Data from 176 participants were included in this study. Total cortisol secretion (area under the curve, AUC) was quantified using four salivary cortisol samples (awakening, 30 min after awakening, afternoon, and bedtime) that were collected at home on one day during the third trimester of pregnancy. Moderation of the association between total cortisol and GWG by pre-pregnancy BMI was tested using multiple linear regression with a multiplicative interaction term.
There was no association between total cortisol secretion and GWG overall (p = 0.82), but the association between total cortisol and GWG was stronger for women with class 1 pre-pregnancy obesity compared to women with normal pre-pregnancy BMI (interaction term p = 0.04).
Results suggest that obesity status before pregnancy may be exacerbating the physiological impact of cortisol on GWG.
背景/目的：社会经济地位较低的有色人种女性中，孕前肥胖和孕期体重过度增加（GWG）的发生率较高。怀孕期间下丘脑-垂体-肾上腺（HPA）轴及其终产物皮质醇的失调与 GWG 过多有关。然而，过去的研究得出的结果并不一致，而且往往不包括健康差异人群。本研究旨在探讨低社会经济地位、以西班牙裔为主的孕妇孕前体重指数（BMI）、孕晚期日间皮质醇与 GWG 之间的关系。
受试者/方法：MADRES 研究是一项正在进行的前瞻性队列研究，研究对象为加利福尼亚州洛杉矶的主要为西班牙裔、低收入的孕妇及其子女。本研究纳入了 176 名参与者的数据。通过在家中收集的四份唾液皮质醇样本（觉醒时、觉醒后 30 分钟、下午和睡前），定量测定总皮质醇分泌（曲线下面积，AUC）。使用多元线性回归和乘法交互项来检验总皮质醇与 GWG 之间的关系是否受孕前 BMI 的调节。
总皮质醇分泌与 GWG 总体之间无关联（p=0.82），但与正常孕前 BMI 相比，孕前肥胖的女性中，总皮质醇与 GWG 之间的关联更强（交互项 p=0.04）。
结果表明，孕前肥胖状况可能加剧了皮质醇对 GWG 的生理影响。
