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Physical Activity, Sedentary Behavior, and Maternal Cardiovascular Health During Pregnancy: Impact on Placental Vascular Development

Kozai, Andrea (2023) Physical Activity, Sedentary Behavior, and Maternal Cardiovascular Health During Pregnancy: Impact on Placental Vascular Development. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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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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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Kozai, Andreaandrea.kozai@pitt.eduack720000-0001-8568-0911
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBarone Gibbs,
Committee MemberCatov,
Committee MemberParks, William
Committee MemberLane,
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


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