Association of Discrimination Reported During Pregnancy with Cardiovascular Disease Risk in Mothers - PROJECT SUMMARY/ABSTRACT Cardiovascular disease (CVD) is the leading cause of death for women in the US. Pregnancy is a key sensitive period for CVD risk during which rapid maternal cardiovascular changes occur. According to the American Heart Association, cardiac-related adverse pregnancy outcomes (e.g., hypertensive disorders of pregnancy) significantly predict future maternal CVD risk. Psychosocial stressors, including discrimination during pregnancy, may have lasting implications for maternal CVD risk, as greater experiences of psychosocial stress prior to and during pregnancy are associated with adverse pregnancy outcomes. However, little research has examined the associations of experiences of discrimination during pregnancy with later maternal CVD risk. The proposed research examines associations of discrimination during pregnancy with maternal CVD risk at 3-4 years postpartum, and evaluates whether childhood experiences increase vulnerability to the effects of this association. This study uses a prospective longitudinal design including a population of at least 200 socioeconomically and racially/ethnically diverse mothers enrolled in an ongoing longitudinal study (R01MH109662, R01HL155744). Discrimination, ACEs, and PCEs were assessed during pregnancy, and maternal CVD risk is assessed in the lab at 3-4 years postpartum. This project has three aims: Aim 1: To test the hypothesis that greater discrimination during pregnancy is associated with greater overall maternal CVD risk (Framingham-based CVD risk prediction model) at 3-4 years postpartum. Aim 2: To test the hypothesis that greater discrimination during pregnancy is associated with increases in individual maternal CVD risk factors (BMI, waist circumference, body fat percentage, BP, and arterial stiffness) at 3-4 years postpartum. Aim 3 (Exploratory): To test the hypothesis that both higher adverse and fewer positive childhood experiences in mothers will increase vulnerability to the effect of discrimination during pregnancy on later maternal CVD risk at 3-4 years postpartum. During the fellowship period, the applicant will gain essential training at the University of Denver that supports her goal of becoming an independent NIH-funded researcher. The applicant’s goals include 1) increasing understanding of the perinatal period as a sensitive period for maternal health; 2) increasing conceptual/methodological knowledge of perinatal and maternal cardiovascular health; 3) developing expertise in the influences of stressors and resilience factors on biological and behavioral pathways to CVD risk; 4) developing advanced skills in statistical and longitudinal analysis; and 5) developing skills in grant-writing. The completion of these training objectives, along with the strong mentorship from project sponsor (Jenalee Doom, PhD), co-sponsor (Elysia Davis, PhD), and co- mentors (Josephine Chou, MD, Dana Dabelea, MD, PhD, Deborah Glueck, PhD, and Benjamin Hankin, PhD), will support this applicant’s goal of becoming an independent researcher.
