Xu, Jia
(2015)
Low birthweight delivery and long term maternal cardiovascular health.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Objective: The objective of this dissertation is to provide insights into potential underlying pathways linking a prior low-birth-weight (LBW) delivery to long term maternal cardiovascular health.
Methods: This dissertation comprises three individual studies. The first study evaluates blood pressure and hypertension in women who reported a prior preterm (PTB) or small-for-gestational-age (SGA) LBW delivery in the National Health and Nutrition Examination Survey 1999-2006 (n=6,307). The second study examines associations between PTB and maternal interleukin-6 (IL-6) and C-reactive protein (CRP) concentrations (n=361) eight years after delivery in the Women and Infant Study of Healthy Hearts study (WISH study). The third study is an exploratory study within the WISH study to examine the relations between a prior PTB and adiposity measures eight years after delivery. It also investigates how adiposity measures may contribute to the associations between a prior PTB and subsequent cardiometabolic and inflammatory risk factors.
Results: The major findings of the study are 1) there was a positive association between a preterm-LBW and hypertension (adjusted OR=1.39, 95% confidence interval (CI) 1.02-1.90). Non-Hispanic African American women had increased risk of hypertension following SGA-LBW delivery (adjusted OR=2.09, 95% CI 1.12-3.90); 2) women with a previous spontaneous PTB had higher IL-6 concentrations compared to women with term delivery (2.18 pg/ml vs. 1.82 pg/ml, p<0.05), after adjusting for potential confounding variables; 3) visceral adipose tissue (VAT) was higher in women with a prior PTB vs. term delivery among non-obese women after adjustment for body mass index (14.1±7.5 cm2, p=0.07). VAT may be a potential mediator of the association between PTB and elevated triglycerides later in life (95% confidence interval for the indirect effect of PTB on triglyceride through VAT: 0.0044, 0.1413).
Conclusion: This dissertation suggests that excess CVD risk may be detectable among women with a history of LBW at reproductive age. The potential mechanisms might involve vascular dysfunction, inflammation, adiposity, and alterations in lipids.
Public health significance: Women with a history of LBW should be encouraged to optimize their lifestyle in order to prevent future CVD and to evaluate and monitor cardiovascular risk factors (hypertension, obesity, inflammation, and dyslipidemia).
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
28 September 2015 |
| Date Type: |
Publication |
| Defense Date: |
29 July 2015 |
| Approval Date: |
28 September 2015 |
| Submission Date: |
20 July 2015 |
| Access Restriction: |
5 year -- Restrict access to University of Pittsburgh for a period of 5 years. |
| Number of Pages: |
114 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
dissertation for PhD degree at the department of Epidemiology at Graduate School of Public Health |
| Date Deposited: |
28 Sep 2015 19:50 |
| Last Modified: |
01 Sep 2020 05:15 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/25710 |
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