Thursday, April 3, 2025
4/3/2025
Prenatal sleep and pathways to offspring cardiometabolic risk - Project Summary Cardiovascular disease (CVD) is the leading cause of death in the US, with significant disparities by socioeconomic status and race/ethnicity. The developmental origins of CVD begin early in life and even before birth. Despite the known importance of early life for CVD risk, the processes and pathways by which early life experiences shape CVD risk remain poorly understood. This proposal tests the hypothesis that prenatal sleep, which is highly integrated with circadian rhythms and influences numerous physiological systems during pregnancy, is an understudied pathway to poor child cardiovascular health. Existing evidence relying primarily on subjective sleep assessments demonstrates a correlation between prenatal sleep and offspring CVD risk. However, critical gaps in the literature that impede progress include: 1) lack of investigation of physiological pathways by which prenatal maternal sleep impacts offspring CVD risk, 2) absence of rigorous and objective measurements of prenatal sleep (e.g., actigraphy) longitudinally across pregnancy in the context of other measures of maternal health, and 3) lack of dense longitudinal follow-up of infant growth and development. This proposal investigates three key pathways that are both known to be impacted by prenatal sleep and linked to CVD risk will be examined: maternal biological processes (stress-mediating and inflammatory pathways), child biological processes (infant growth trajectories, adiposity) and child behavior (sleep, negative emotionality, self- regulation). To investigate these pathways, three aims will be tested. Aim 1 tests the hypothesis that prenatal maternal sleep trajectories predict prenatal maternal biological pathways that may influence offspring CVD risk, including increased circulating inflammatory biomarkers and altered diurnal salivary cortisol during each trimester of pregnancy. Aim 2 tests the hypothesis that prenatal maternal sleep trajectories predict offspring biological pathways to CVD risk, including accelerated offspring growth trajectories and greater body fat percentage through 6 months postnatal. Aim 3 tests the hypothesis that prenatal maternal sleep trajectories predict offspring behavioral contributors to CVD risk, including infant sleep, negative emotionality, and self-regulation. Aims will be evaluated in a sample of 300 primarily low-income and racially- and ethnically diverse English- and Spanish- speaking pregnant individuals from Denver Health Hospital Authority, a community safety-net hospital that serves the largest proportion of uninsured and Medicaid patients in the Denver area.
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