Kozai, Andrea
(2023)
Physical Activity, Sedentary Behavior, and Maternal Cardiovascular Health During Pregnancy: Impact on Placental Vascular Development.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Though adverse pregnancy outcomes are related to maternal health and behaviors during pregnancy and are associated with pathological changes in the placenta, the mechanistic origins of these relationships are unclear. An important limitation of previous research is the use of dichotomous outcomes of placental pathology that limit statistical approaches to analysis. This study aimed to describe the associations between physical activity (PA), sedentary behavior (SB), and maternal cardiovascular health (CVH) with a novel continuous measure of placental health. Methods: Participants (N=64) enrolled in cohort studies that prospectively measured PA and SB for one week during each trimester of pregnancy and co-enrolled in the Magee Obstetric Maternal & Infant Biobank to provide placenta tissue samples at delivery. CVH was assessed and quantified using the Life’s Essential 8 scoring framework set forth by the American Heart Association. Diet, sleep, and smoking were collected in each trimester via questionnaire. Blood pressure, gestational weight gain, one-hour glucose screen, and pre-pregnancy BMI were abstracted from the medical record. At delivery, placental villous tissue was collected, formalin-fixed, and paraffin-embedded. Tissue sections were stained with CD34 antibody. Whole-slide images were scanned and analyzed using Aperio ImageScope Positive Pixel Count software. Fetal vascular percentage (FV%) was quantified as the proportion of pixels positive for CD34 antigen. Associations between exposures and FV% were examined using linear regression, with covariate adjustment for maternal age and smoking as appropriate. Results: No significant associations were found between PA or SB and FV%, though associations approached significance for adjusted models of SB in the first trimester (β=0.73, p=0.128). Similarly, no significant associations between CVH scores and FV% were found either across gestation or within trimesters, though positive associations approached significance in several models (p<0.2). Higher diet score in the first trimester was significantly associated with greater FV% (β=1.0, p=0.018). No other component scores or continuous values of components were associated with FV%. Conclusions: Development of FV% in the placenta was not statistically associated with measures of PA, SB, or CVH. Associations approaching significance suggest repetition in a fully-powered study and that the novel FV% outcome may be a useful tool for further research.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
11 January 2023 |
| Date Type: |
Publication |
| Defense Date: |
18 October 2022 |
| Approval Date: |
11 January 2023 |
| Submission Date: |
12 December 2022 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
104 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Education > Health and Physical Activity |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
pregnancy
placenta
physical activity
sedentary behavior
cardiovascular health |
| Date Deposited: |
11 Jan 2023 19:25 |
| Last Modified: |
11 Jan 2023 19:25 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/43986 |
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