Pregnancy is a period of extreme change, as maternal physiology adapts rapidly to sustain a growing fetus. It is conventionally assumed that women’s physiology returns to its pre-pregnancy state within six months of giving birth, but the evidence for that is limited, and it remains somewhat controversial. Researchers at the University of Rochester Medical Center (URMC) are examining which metabolic changes of pregnancy may persist into the postpartum years and how this may contribute to an increased risk for later disease.
With a five-year, $2.6 million grant from the National Institutes of Health (NIH), researchers will conduct a longitudinal study that extends from early pregnancy until three years postpartum to better understand how changes during the perinatal period may identify mothers at risk for future cardiometabolic problems and the modifiable factors that can help reduce those risks.
Susan Groth, PhD, WHNP-BC, FAANP, associate professor of nursing at the UR School of Nursing, is the lead researcher among three principal investigators, which also includes Thomas O’Connor, PhD, professor of psychiatry in the UR School of Medicine and Dentistry, and Emily Barrett, PhD, associate professor at Rutgers University School of Public Health and adjunct professor in Obstetrics and Gynecology and Public Health Sciences at the University of Rochester School of Medicine and Dentistry.
This research leverages and capitalizes on the infrastructure already in place for an ongoing cohort of pregnant mothers. Examining the mother for an extended period of time – from early pregnancy until three years postpartum – is an innovative approach to gaining a better understanding of the physiological effects of pregnancy, both in the crucial period covered, as well as the length of time studied.
“What’s also unique about this research is we’re not just collecting weight and height,” said Groth, whose previous research focused on the long-term effects of weight gain among pregnant women on both mother and children. “Our study assesses weight gain and weight changes, but also moves beyond that to study more targeted physical measures such as body composition, as well as multiple biological markers throughout the study.”
Excess weight and obesity prior to pregnancy is a major public health concern in the U.S., with more than 50 percent of women entering pregnancy overweight or obese. Furthermore, nearly 50 percent of women gain more than the recommended amount of weight during pregnancy, which contributes to long-term weight retention. Unhealthy maternal weight and weight gain have been identified as key maternal-child health risks. Changes in weight, body composition, and obesity-related biomarkers across the pregnancy-postpartum period may be critical determinants of women’s future risk for chronic conditions such as type 2 diabetes and cardiovascular disease.
URMC researchers will collect biological and lifestyle data from postnatal visits with mothers at 6, 12, and 36 months. The extended follow-up period will provide investigators with critical information on changes in maternal biology in the perinatal period, combined with a greater understanding of the impact of such behaviors as breastfeeding, sleep, and physical activity. What they learn about key pathways or influencers of disease can help shape the development of future targeted interventions to help prevent the onset of those diseases.
“This work will shed light on risk that factors that we do not fully understand, potentially identifying future opportunities for targeted and personalized plans to prevent the development of cardiometabolic conditions in the future,” said Groth. “Our overarching hypothesis is that the changes in weight and obesity-related biomarkers across the pregnancy-postpartum period can be long-lasting and contribute to a postpartum profile that increases the mothers’ subsequent disease risk.”