Author ORCID Identifier
https://orcid.org/0000-0002-8807-7808
Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Epidemiology
First Advisor
Juan Lu
Second Advisor
Izzudin M Aris
Third Advisor
Niloofar Ramezani
Fourth Advisor
Kia Ling Kong
Fifth Advisor
Chrisa Arcan
Sixth Advisor
D'Arcy P Mays
Abstract
Overall Abstract
Background: Pediatric high blood pressure (BP) is a growing global concern, with 1 in 7 adolescents in the U.S. experiencing elevated BP or hypertension. Maternal lifestyle factors, including depressive symptoms, physically demanding work, and work hours during pregnancy, may influence offspring BP trajectories. However, prior studies often focus on single time points or specific age groups, limiting understanding of long-term effects. This study investigates the associations between maternal depressive symptoms, physically demanding work-related factors, and work hours before, during, and after pregnancy with offspring systolic blood pressure (SBP) trajectories from early childhood to adolescence.
Methods: We utilized data from Project Viva, a longitudinal birth cohort study in Boston, Massachusetts, recruited in 1999–2002. Offspring SBP was measured at multiple time points, and SBP Z-scores were calculated by sex, age, and height. Linear spline mixed-effects models assessed associations between maternal depression, maternal physical work demands, maternal work hours duration before, during and after pregnancy and SBP trajectories, adjusting for covariates.
Results: Maternal depressive symptoms during the prenatal, postpartum, and perinatal periods were not significantly associated with changes in offspring SBP z-scores from early childhood to adolescence. Non-significant associations were consistent across all models and age-specific analyses. Moderate physical work during mid-pregnancy was associated with a higher rate of SBP Z-score change from mid-childhood to adolescence (β = 1.36, 95% CI: 0.11, 2.62). Prolonged standing (>5 hours/day) during mid-pregnancy was associated with increased SBP Z-scores at ages 15 (β = 0.15, 95% CI: 0.00, 0.30) and 18 (β = 0.21, 95% CI: 0.00, 0.41). Early pregnancy moderate physical work was associated with higher SBP Z-scores at age 3 (β = 0.51, 95% CI: 0.06, 0.96), but the effect did not persist in later years. Pre-pregnancy physically demanding work-related activities showed no significant associations with SBP trajectories. Maternal work hours of "1–14 hours/week" during pre-pregnancy were significantly associated with a slower rate of SBP z-score increase from mid-childhood to adolescence (β = -0.84, 95% CI: -1.58, -0.11) compared to the reference group. Similarly, work hours of "1–14 hours/week" during early and mid-pregnancy were associated with significantly lower predicted SBP z-scores at older ages, particularly at 15 and 18 years. However, no significant associations were observed for maternal work hours during the postpartum period
Conclusion: This study highlights the impact of maternal work-related factors on offspring cardiovascular health. While maternal depressive symptoms were not significantly associated with offspring SBP trajectories, moderate physical work during mid-pregnancy and prolonged standing were linked to increased SBP in adolescence. In contrast, maternal work hours of less than 15 hours/week during pre-pregnancy and early-to-mid pregnancy were associated with lower SBP. These findings underscore the importance of occupational and public health policies that consider the timing and intensity of maternal work-related exposures during pregnancy to promote long-term cardiovascular health in offspring.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
12-12-2024