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Intergenerational Associations of Maternal Overweight or Obesity and Sleep Disorders
Intergenerational Associations of Maternal Overweight or Obesity and Sleep Disorders
Intergenerational Associations of Maternal Overweight or Obesity and Sleep Disorders

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20260202105229
ISBN  
9798291567005
DDC  
614
저자명  
Zhu, Mia Q.
서명/저자  
Intergenerational Associations of Maternal Overweight or Obesity and Sleep Disorders
발행사항  
[Sl] : University of Michigan, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
167 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-03, Section: B.
주기사항  
Advisor: Villamor, Eduardo.
학위논문주기  
Thesis (Ph.D.)--University of Michigan, 2025.
초록/해제  
요약Background: Sleep disorders are associated with increased risks of the leading causes of death worldwide including cardiovascular disease, diabetes, and cancer. While the consequences of disordered sleep are well studied, its etiology remains unclear. An emerging body of evidence suggests chronic illnesses may have an intrauterine origin. Intrauterine exposure to poor maternal nutrition has been linked to obesity, a predictor of sleep disorders, in the offspring and grandoffspring. Nevertheless, no previous studies have assessed the intergenerational associations of maternal obesity and sleep disorders.Objectives: We assessed maternal (F1 generation) early pregnancy body mass index (BMI) as a risk factor for sleep disorders, sleep apnea (aim 1) and insomnia (aim 2), in the offspring (F2 generation). To consider intergenerational effects, we evaluated grandmaternal early pregnancy (F0 generation) BMI as a risk factor for sleep apnea in the grandoffspring (aim 3).Methods: Using population-based nationwide Swedish registers, we constructed two- and three-generation cohorts consisting of, respectively, 3,281,803 and 315,461 live-born singleton births born 1983-2015. In aims 1 and 2, we utilized the two-generation cohort to compare offspring (F2) sleep apnea and insomnia risk, respectively, through early adulthood by maternal (F1) early pregnancy BMI categories using Cox proportional hazards models to estimate hazard ratios with 95% confidence intervals (CI). To control for potential confounding by shared familial factors, we conducted sibling comparisons among 1,724,473 full siblings. In aim 3, the three-generation cohort was used to compare grandoffspring (F2) childhood sleep apnea risk by grandmaternal (F0) early pregnancy BMI categories. We evaluated the extent to which this association was mediated by maternal (F1) early pregnancy BMI using causal mediation analysis. To assess whether shared familial factors explained these associations, we estimated sleep apnea risk by categories of parental full sisters' (F1) BMI, a negative control exposure.Results: Maternal (F1) overweight or obesity were associated with increased risk of sleep apnea and insomnia in the offspring (F2), in a dose-response manner. Compared with women with normal BMI, adjusted HR (95% CI) of offspring sleep apnea for maternal BMI categories overweight, obesity class I, and obesity class II or III were, respectively, 1.14 (1.09, 1.19), 1.28 (1.20, 1.36), and 1.40 (1.27, 1.54). Corresponding HR (95% CI) with insomnia as the outcome were, respectively, 1.22 (1.14, 1.30), 1.60 (1.45, 1.77), and 2.11 (1.83, 2.45). Similarly, maternal and paternal grandmaternal (F0) early pregnancy overweight or obesity were positively related with childhood sleep apnea risk in the grandoffspring (F2); Compared with maternal grandmothers with normal BMI (18.5-24.9), adjusted HR (95% CI) of grandoffspring childhood sleep apnea for grandmaternal BMI categories overweight (BMI 25.0-29.9) and obesity (BMI ≥30.0) were, respectively, 1.23 (1.02, 1.50) and 1.59 (1.15, 2.19). Maternal (F1) obesity mediated 19% of the maternal grandmaternal (F0) overweight or obesity and grandoffspring (F2) sleep apnea association. Results could not be explained by shared familial factors.Conclusions: Gestational exposure to maternal overweight or obesity may be related to sleep disorder pathogenesis in both offspring and grandoffspring. Given positive trends of obesity in recent decades, maternal overweight and obesity could be an increasingly relevant point of intervention to mitigate the adverse effects of disordered sleep in current and future generations.
일반주제명  
Public health
일반주제명  
Epidemiology
일반주제명  
Medicine
일반주제명  
Obstetrics
키워드  
Sleep apnea
키워드  
Insomnia
키워드  
Perinatal epidemiology
키워드  
Maternal obesity
키워드  
Sleep disorders
기타저자  
University of Michigan Epidemiological Science
기본자료저록  
Dissertations Abstracts International. 87-03B.
전자적 위치 및 접속  
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■0820  ▼a614
■1001  ▼aZhu,  Mia  Q.
■24510▼aIntergenerational  Associations  of  Maternal  Overweight  or  Obesity  and  Sleep  Disorders
■260    ▼a[Sl]▼bUniversity  of  Michigan▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a167  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-03,  Section:  B.
■500    ▼aAdvisor:  Villamor,  Eduardo.
■5021  ▼aThesis  (Ph.D.)--University  of  Michigan,  2025.
■520    ▼aBackground:  Sleep  disorders  are  associated  with  increased  risks  of  the  leading  causes  of  death  worldwide  including  cardiovascular  disease,  diabetes,  and  cancer.  While  the  consequences  of  disordered  sleep  are  well  studied,  its  etiology  remains  unclear.  An  emerging  body  of  evidence  suggests  chronic  illnesses  may  have  an  intrauterine  origin.  Intrauterine  exposure  to  poor  maternal  nutrition  has  been  linked  to  obesity,  a  predictor  of  sleep  disorders,  in  the  offspring  and  grandoffspring.  Nevertheless,  no  previous  studies  have  assessed  the  intergenerational  associations  of  maternal  obesity  and  sleep  disorders.Objectives:  We  assessed  maternal  (F1  generation)  early  pregnancy  body  mass  index  (BMI)  as  a  risk  factor  for  sleep  disorders,  sleep  apnea  (aim  1)  and  insomnia  (aim  2),  in  the  offspring  (F2  generation).  To  consider  intergenerational  effects,  we  evaluated  grandmaternal  early  pregnancy  (F0  generation)  BMI  as  a  risk  factor  for  sleep  apnea  in  the  grandoffspring  (aim  3).Methods:  Using  population-based  nationwide  Swedish  registers,  we  constructed  two-  and  three-generation  cohorts  consisting  of,  respectively,  3,281,803  and  315,461  live-born  singleton  births  born  1983-2015.  In  aims  1  and  2,  we  utilized  the  two-generation  cohort  to  compare  offspring  (F2)  sleep  apnea  and  insomnia  risk,  respectively,  through  early  adulthood  by  maternal  (F1)  early  pregnancy  BMI  categories  using  Cox  proportional  hazards  models  to  estimate  hazard  ratios  with  95%  confidence  intervals  (CI).  To  control  for  potential  confounding  by  shared  familial  factors,  we  conducted  sibling  comparisons  among  1,724,473  full  siblings.  In  aim  3,  the  three-generation  cohort  was  used  to  compare  grandoffspring  (F2)  childhood  sleep  apnea  risk  by  grandmaternal  (F0)  early  pregnancy  BMI  categories.  We  evaluated  the  extent  to  which  this  association  was  mediated  by  maternal  (F1)  early  pregnancy  BMI  using  causal  mediation  analysis.  To  assess  whether  shared  familial  factors  explained  these  associations,  we  estimated  sleep  apnea  risk  by  categories  of  parental  full  sisters'  (F1)  BMI,  a  negative  control  exposure.Results:  Maternal  (F1)  overweight  or  obesity  were  associated  with  increased  risk  of  sleep  apnea  and  insomnia  in  the  offspring  (F2),  in  a  dose-response  manner.  Compared  with  women  with  normal  BMI,  adjusted  HR  (95%  CI)  of  offspring  sleep  apnea  for  maternal  BMI  categories  overweight,  obesity  class  I,  and  obesity  class  II  or  III  were,  respectively,  1.14  (1.09,  1.19),  1.28  (1.20,  1.36),  and  1.40  (1.27,  1.54).  Corresponding  HR  (95%  CI)  with  insomnia  as  the  outcome  were,  respectively,  1.22  (1.14,  1.30),  1.60  (1.45,  1.77),  and  2.11  (1.83,  2.45).  Similarly,  maternal  and  paternal  grandmaternal  (F0)  early  pregnancy  overweight  or  obesity  were  positively  related  with  childhood  sleep  apnea  risk  in  the  grandoffspring  (F2);  Compared  with  maternal  grandmothers  with  normal  BMI  (18.5-24.9),  adjusted  HR  (95%  CI)  of  grandoffspring  childhood  sleep  apnea  for  grandmaternal  BMI  categories  overweight  (BMI  25.0-29.9)  and  obesity  (BMI  ≥30.0)  were,  respectively,  1.23  (1.02,  1.50)  and  1.59  (1.15,  2.19).  Maternal  (F1)  obesity  mediated  19%  of  the  maternal  grandmaternal  (F0)  overweight  or  obesity  and  grandoffspring  (F2)  sleep  apnea  association.  Results  could  not  be  explained  by  shared  familial  factors.Conclusions:  Gestational  exposure  to  maternal  overweight  or  obesity  may  be  related  to  sleep  disorder  pathogenesis  in  both  offspring  and  grandoffspring.  Given  positive  trends  of  obesity  in  recent  decades,  maternal  overweight  and  obesity  could  be  an  increasingly  relevant  point  of  intervention  to  mitigate  the  adverse  effects  of  disordered  sleep  in  current  and  future  generations.
■590    ▼aSchool  code:  0127.
■650  4▼aPublic  health
■650  4▼aEpidemiology
■650  4▼aMedicine
■650  4▼aObstetrics
■653    ▼aSleep  apnea
■653    ▼aInsomnia
■653    ▼aPerinatal  epidemiology
■653    ▼aMaternal  obesity
■653    ▼aSleep  disorders
■690    ▼a0573
■690    ▼a0766
■690    ▼a0564
■690    ▼a0380
■71020▼aUniversity  of  Michigan▼bEpidemiological  Science.
■7730  ▼tDissertations  Abstracts  International▼g87-03B.
■790    ▼a0127
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17359875▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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