(1201) The Invisible Weight: Trauma Exposure and Early Gestational Weight Gain

Increased early gestational weight gain (eGWG), weight gained in the 1^st & 2^nd trimesters, is associated with adverse pregnancy outcomes (APOs), including hypertensive disorders of pregnancy (HDP). Prior research has established links between trauma exposure & weight dysregulation outside of pregnancy. However, the impact of trauma on eGWG remains poorly understood. Given the known risks of increased eGWG, we evaluated the association between trauma exposures & eGWG.

Study Design:

We performed a secondary analysis of a prospective longitudinal cohort study investigating associations between trauma exposures & APOs at an urban safety net hospital. Childhood trauma (CT), Post-Traumatic Stress (PTSD), Lifetime Stress (LS) and Adult Trauma (AT) were captured using validated trauma exposure questionnaires (Table 1). Weight, systolic & diastolic blood pressure (BP) were recorded in each trimester. eGWG was calculated as (final 2^nd trimester weight-initial 1^st trimester weight). BP nadirs, calculated as (final 2^nd trimester BP-initial 1^st trimester BP), were used as markers for hypertensive risk. Linear regression models were conducted to investigate associations between trauma exposure scores & eGWG, adjusting for confounders.

Results:

Consistent with prior studies, eGWG in our cohort (N=328) was associated with a blunted systolic BP nadir, independent of age, body mass index (BMI), & chronic HTN (b=0.24, 95% CI 0.03-0.44, p=0.026), increasing the risk for HDP. CT (b=0.17, 95% CI 0.05-0.29, p=0.006), PTSD (b=0.18, 95% CI 0.02-0.33, p=0.026) & LS (b=0.95, 95% CI 0.10-1.81, p=0.03) scores were associated with eGWG when controlling for BMI. There was no association between AT scores & eGWG (b=1.17, 95% CI -0.40-2.74, p=0.14) or between any trauma scores & 3^rd trimester weight gain (p >0.05).

Conclusion:

Our data demonstrate that CT, PTSD & LS are associated with increased eGWG, suggesting that pre-pregnancy trauma exposure influences gestational metabolic regulation. Further studies need to explore underlying mechanisms & test trauma-informed interventions to optimize eGWG & improve maternal health outcomes.