Madeleine U Shalowitz1,2, Christine Dunkel Schetter3, Marianne M Hillemeier4, Vernon M Chinchilli5, Emma K Adam6, Calvin J Hobel7, Sharon Landesman Ramey8,9, Maxine Reed Vance10, Patricia O'Campo11, John M Thorp12, Teresa E Seeman13,14, Tonse N K Raju. 1. Department of Pediatrics, NorthShore University HealthSystem Research Institute, Evanston, Illinois. 2. Department of Pediatrics, University of Chicago Pritzker School of Medicine, Chicago, Illinois. 3. Department of Psychology, University College of Los Angeles, Los Angeles, California. 4. Department of Health Policy and Administration, Pennsylvania State University, University Park, Pennsylvania. 5. Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. 6. School of Human Development and Social Policy, Northwestern University, Evanston, Illinois. 7. Department of Obstetrics, Gynecology, and Pediatrics, Cedars-Sinai Hospital, Los Angeles, California. 8. Department of Psychology, Virginia Technical Carilion School of Medicine and Research Institute, Roanoke, Virginia. 9. Department of Psychiatry, Virginia Technical Carilion School of Medicine and Research Institute, Roanoke, Virginia. 10. Baltimore Healthy Start, Baltimore, Maryland. 11. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 12. Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. 13. Department of Internal Medicine, UCLA Geffen School of Medicine, Los Angeles, California. 14. Department of Epidemiology, UCLA School of Public Health, Los Angeles, California.
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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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