Prenatal, Psychosocial and Lifestyle Factors in Mental Health Disparities among Youth

Principal Investigator: Jasmin Alves, PhD

Postdoctoral Researcher, USC Department of Internal Medicine

Offspring of mothers who had gestational diabetes mellitus (GDM) and/or obesity during pregnancy are at increased risk for mental health disorders. This risk may be greater in minority populations who are disproportionately affected by GDM and obesity during pregnancy and have higher rates of mental health disorders. Yet, evidence is lacking on whether the relationship between prenatal exposure to GDM/maternal obesity and child mental health outcomes may differ by child and mother psychosocial and lifestyle factors.

To address these gaps, the proposed project will be the first study to date to provide a comprehensive strategy to investigate modifying factors in the association between prenatal exposure to GDM/maternal obesity and child mental health. We will leverage our existing cohort of predominantly Hispanic children age 7-15 (R01DK116858) where approximately ~50% of children were exposed in utero to maternal GDM with different degrees of maternal obesity exposure at the time of pregnancy. Importantly, exposure variables were objectively recorded from Kaiser Permanente Southern California (KPSC) electronic medical records (EMR). This rich data source allows us to extract maternal pre-pregnancy weight, height and GDM screening and diagnostic laboratory glucose testing results. Additionally, the availability of sociodemographic (SES) information (including maternal education at birth, household income and race/ethnicity) allows us to minimize information bias and to examine potential moderating effects of SES on relationships between exposures to GDM and/or maternal obesity and children’s mental health outcomes. We will also collect thorough lifestyle assessments from the participants and their mothers to determine how lifestyle factors may also moderate these associations.

By identifying modifiable lifestyle factors in the mother and/or child that could ameliorate mental health in at-risk youth, targeted intervention studies can be tested as an approach to mitigate poor mental health outcomes in children exposed to GDM and/or maternal obesity.