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

Citation

Shalowitz, Madeleine U.; Schetter, Christine Dunkel; Hillemeier, Marianne M.; Chinchilli, Vernon M.; Adam, Emma K.; Hobel, Calvin J.; Ramey, Sharon Landesman; Vance, Maxine Reed; O'Campo, Patricia; & Thorp, John M., Jr., et al. (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, 36(10), 1079-1089. PMCID: PMC6584076

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.
METHODS: 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.

URL

http://dx.doi.org/10.1055/s-0038-1675618

Reference Type

Journal Article

Year Published

2019

Journal Title

American Journal of Perinatology

Author(s)

Shalowitz, Madeleine U.
Schetter, Christine Dunkel
Hillemeier, Marianne M.
Chinchilli, Vernon M.
Adam, Emma K.
Hobel, Calvin J.
Ramey, Sharon Landesman
Vance, Maxine Reed
O'Campo, Patricia
Thorp, John M., Jr.
Seeman, Teresa E.
Raju, Tonse N. K., for the
Eunice Kennedy Shriver
National Institute of Child Human Development Community Child Health Network

PMCID

PMC6584076

ORCiD

Thorp - 0000-0002-9307-6690