Cardiovascular and Metabolic Risk in Women in the First Year Postpartum: Allostatic Load as a Function of Race, Ethnicity, and Poverty Status

Madeleine U. Shalowitz, Christine Dunkel Schetter, Marianne Messersmith Hillemeier, Vernon Chinchilli, Emma K. Adam, Calvin J. Hobel, Sharon Landesman Ramey, Maxine Reed Vance, Patricia O'Campo, John M. Thorp, Teresa E. Seeman, Tonse N.K. Raju

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective Allostatic load (AL) represents multisystem physiological wear-and-tear reflecting emerging chronic disease risk. We assessed AL during the first year postpartum in a diverse community sample with known health disparities. Study Design The Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network enrolled 2,448 predominantly low-income African-American, Latina, and White women immediately after delivery of liveborn infants at ≥20 weeks' gestation, following them over time with interviews, clinical measures, and biomarkers. AL at 6 and 12 months postpartum was measured by body mass index, waist:hip ratio, blood pressure, pulse, hemoglobin A1c, high-sensitive C-reactive protein, total cholesterol and high-density lipoprotein, and diurnal cortisol slope. Results Adverse AL health-risk profiles were significantly more prevalent among African-American women compared with non-Hispanic Whites, with Latinas intermediate. Breastfeeding was protective, particularly for White women. Complications of pregnancy were associated with higher AL, and disparities persisted or worsened through the first year postpartum. Conclusion Adverse AL profiles occurred in a substantial proportion of postpartum women, and disparities did not improve from birth to 1 year. Breastfeeding was protective for the mother.

Original languageEnglish (US)
Pages (from-to)1079-1089
Number of pages11
JournalAmerican Journal of Perinatology
Volume36
Issue number10
DOIs
StatePublished - Jan 1 2019

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Allostasis
Poverty
Postpartum Period
Breast Feeding
Hispanic Americans
African Americans
Community Networks
National Institute of Child Health and Human Development (U.S.)
Waist-Hip Ratio
Pregnancy Complications
Health
Tears
C-Reactive Protein
HDL Cholesterol
Hydrocortisone
Hemoglobins
Body Mass Index
Chronic Disease
Biomarkers
Mothers

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Shalowitz, Madeleine U. ; Schetter, Christine Dunkel ; Hillemeier, Marianne Messersmith ; Chinchilli, Vernon ; Adam, Emma K. ; Hobel, Calvin J. ; Ramey, Sharon Landesman ; Vance, Maxine Reed ; O'Campo, Patricia ; Thorp, John M. ; Seeman, Teresa E. ; Raju, Tonse N.K. / Cardiovascular and Metabolic Risk in Women in the First Year Postpartum : Allostatic Load as a Function of Race, Ethnicity, and Poverty Status. In: American Journal of Perinatology. 2019 ; Vol. 36, No. 10. pp. 1079-1089.
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title = "Cardiovascular and Metabolic Risk in Women in the First Year Postpartum: Allostatic Load as a Function of Race, Ethnicity, and Poverty Status",
abstract = "Objective Allostatic load (AL) represents multisystem physiological wear-and-tear reflecting emerging chronic disease risk. We assessed AL during the first year postpartum in a diverse community sample with known health disparities. Study Design The Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network enrolled 2,448 predominantly low-income African-American, Latina, and White women immediately after delivery of liveborn infants at ≥20 weeks' gestation, following them over time with interviews, clinical measures, and biomarkers. AL at 6 and 12 months postpartum was measured by body mass index, waist:hip ratio, blood pressure, pulse, hemoglobin A1c, high-sensitive C-reactive protein, total cholesterol and high-density lipoprotein, and diurnal cortisol slope. Results Adverse AL health-risk profiles were significantly more prevalent among African-American women compared with non-Hispanic Whites, with Latinas intermediate. Breastfeeding was protective, particularly for White women. Complications of pregnancy were associated with higher AL, and disparities persisted or worsened through the first year postpartum. Conclusion Adverse AL profiles occurred in a substantial proportion of postpartum women, and disparities did not improve from birth to 1 year. Breastfeeding was protective for the mother.",
author = "Shalowitz, {Madeleine U.} and Schetter, {Christine Dunkel} and Hillemeier, {Marianne Messersmith} and Vernon Chinchilli and Adam, {Emma K.} and Hobel, {Calvin J.} and Ramey, {Sharon Landesman} and Vance, {Maxine Reed} and Patricia O'Campo and Thorp, {John M.} and Seeman, {Teresa E.} and Raju, {Tonse N.K.}",
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Shalowitz, MU, Schetter, CD, Hillemeier, MM, Chinchilli, V, Adam, EK, Hobel, CJ, Ramey, SL, Vance, MR, O'Campo, P, Thorp, JM, Seeman, TE & Raju, TNK 2019, 'Cardiovascular and Metabolic Risk in Women in the First Year Postpartum: Allostatic Load as a Function of Race, Ethnicity, and Poverty Status', American Journal of Perinatology, vol. 36, no. 10, pp. 1079-1089. https://doi.org/10.1055/s-0038-1675618

Cardiovascular and Metabolic Risk in Women in the First Year Postpartum : Allostatic Load as a Function of Race, Ethnicity, and Poverty Status. / Shalowitz, Madeleine U.; Schetter, Christine Dunkel; Hillemeier, Marianne Messersmith; Chinchilli, Vernon; Adam, Emma K.; Hobel, Calvin J.; Ramey, Sharon Landesman; Vance, Maxine Reed; O'Campo, Patricia; Thorp, John M.; Seeman, Teresa E.; Raju, Tonse N.K.

In: American Journal of Perinatology, Vol. 36, No. 10, 01.01.2019, p. 1079-1089.

Research output: Contribution to journalArticle

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T1 - Cardiovascular and Metabolic Risk in Women in the First Year Postpartum

T2 - Allostatic Load as a Function of Race, Ethnicity, and Poverty Status

AU - Shalowitz, Madeleine U.

AU - Schetter, Christine Dunkel

AU - Hillemeier, Marianne Messersmith

AU - Chinchilli, Vernon

AU - Adam, Emma K.

AU - Hobel, Calvin J.

AU - Ramey, Sharon Landesman

AU - Vance, Maxine Reed

AU - O'Campo, Patricia

AU - Thorp, John M.

AU - Seeman, Teresa E.

AU - Raju, Tonse N.K.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective Allostatic load (AL) represents multisystem physiological wear-and-tear reflecting emerging chronic disease risk. We assessed AL during the first year postpartum in a diverse community sample with known health disparities. Study Design The Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network enrolled 2,448 predominantly low-income African-American, Latina, and White women immediately after delivery of liveborn infants at ≥20 weeks' gestation, following them over time with interviews, clinical measures, and biomarkers. AL at 6 and 12 months postpartum was measured by body mass index, waist:hip ratio, blood pressure, pulse, hemoglobin A1c, high-sensitive C-reactive protein, total cholesterol and high-density lipoprotein, and diurnal cortisol slope. Results Adverse AL health-risk profiles were significantly more prevalent among African-American women compared with non-Hispanic Whites, with Latinas intermediate. Breastfeeding was protective, particularly for White women. Complications of pregnancy were associated with higher AL, and disparities persisted or worsened through the first year postpartum. Conclusion Adverse AL profiles occurred in a substantial proportion of postpartum women, and disparities did not improve from birth to 1 year. Breastfeeding was protective for the mother.

AB - Objective Allostatic load (AL) represents multisystem physiological wear-and-tear reflecting emerging chronic disease risk. We assessed AL during the first year postpartum in a diverse community sample with known health disparities. Study Design The Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network enrolled 2,448 predominantly low-income African-American, Latina, and White women immediately after delivery of liveborn infants at ≥20 weeks' gestation, following them over time with interviews, clinical measures, and biomarkers. AL at 6 and 12 months postpartum was measured by body mass index, waist:hip ratio, blood pressure, pulse, hemoglobin A1c, high-sensitive C-reactive protein, total cholesterol and high-density lipoprotein, and diurnal cortisol slope. Results Adverse AL health-risk profiles were significantly more prevalent among African-American women compared with non-Hispanic Whites, with Latinas intermediate. Breastfeeding was protective, particularly for White women. Complications of pregnancy were associated with higher AL, and disparities persisted or worsened through the first year postpartum. Conclusion Adverse AL profiles occurred in a substantial proportion of postpartum women, and disparities did not improve from birth to 1 year. Breastfeeding was protective for the mother.

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