Stress, Gestational Weight, & Implications for the Life Course

Obesity: What's Pregnancy Got to Do with It?

Barbara A. Laraia, PhD, MPH, RD
Assistant Professor of Medicine
University of California, San Francisco

Barbara Laraia, PhD, MPH, RD is an Assistant Professor of Medicine at UCSF and Co-Director of Research at the UCSF Center for Obesity Assessment, Study, and Treatment. Dr. Laraia is an expert in nutritional epidemiology and dietary and physical activity assessment. Dr. Laraia has focused on household food insecurity, stress and measurement of social-environmental indicators and the food environment for the past eight years. Her research has identified influences of household food insecurity on the diet, weight gain and pregnancy complications in large cohort study of pregnant women, the Pregnancy, Infection and Nutrition (PIN) study. Dr. Laraia has also focused on how the psychological stress of living in a low socioeconomic neighborhood is associated with adverse birth outcomes and decreased physical activity among pregnant women, and further more, the influence of a lack of accessibility to grocery stores has on the diet of pregnant women. Her ongoing research shows links between dysregulated eating behavior (high restraint) and food insecurity in predicting weight gain during pregnancy.

The Developmental Origins of Health and Disease: Prenatal Stress Exposure is Associated with Metabolic, Endocrine, and Immune Dysregulation in Young Adults

Pathik Wadhwa, MD, PhD
Associate Professor
School of Medicine, Departments of Psychiatry & Human Behavior, Obstetrics & Gynecology, Pediatrics, and Epidemiology
University of California, Irvine

Pathik D. Wadhwa, MD, PhD, is an Associate Professor at the University of California, Irvine, School of Medicine, with appointments in the Departments of Psychiatry & Human Behavior, Obstetrics & Gynecology, Pediatrics, and Epidemiology. Dr. Wadhwa also is Director of the UC Irvine Behavioral Perinatology/ Development, Health and Disease Research Program. Dr. Wadhwa received his medical degree from the University of Poona, India, in 1985 and his doctorate in health psychology/ behavioral medicine from the University of California, Irvine, in 1993. Dr. Wadhwa’s research and published work examines the interface between behavioral and biological processes in human pregnancy, with an emphasis on outcomes related to fetal development, birth and subsequent infant and child development and health. In particular, this work focuses on the interplay between maternal-placental-fetal neuroendocrine, immune/ inflammatory and maternal-fetal genetic processes as putative mechanisms that mediate the effects of the maternal environment (and particularly prenatal stress) on early human development. Dr. Wadhwa’s work is supported by several federal research grants from the National Institutes of Health, including a program project on gene-environment interactions in human parturition. Dr. Wadhwa also is the Co-Principal Investigator of the National Children’s Study Orange County, California (OCCA) Vanguard Center. The National Children’s Study (NCS), one of the largest, most ambitious and comprehensive projects of its kind, is a prospective cohort study of over 100,000 individuals from before conception through pregnancy, birth, infancy, childhood and adulthood till 21 years age, to examine the role of genes and environment (physical, chemical, social, biological) during development on health and subsequent disease risk. Dr. Wadhwa is the recipient of several national honors and awards, including recognition for his early career contributions from the Academy of Behavioral Medicine.

The research studies conducted by Dr. Wadhwa and his colleagues support a significant and independent role for maternal psychosocial stress during pregnancy in the etiology of prematurity-related outcomes, and suggest that these effects are mediated, in part, by the maternal-placental-fetal neuroendocrine axis, and specifically by the placental hormone corticotrophin-releasing factor. These studies also provide evidence to support the notion that the influence of maternal prenatal stress and maternal-placental hormones on the developing fetus may persist after birth, as assessed by measures of temperament and behavioral reactivity in infancy and childhood. Last, recent studies conducted by Dr. Wadhwa and colleagues suggest that exposure to high levels of prenatal stress may produce long-term alterations in key endocrine, immune and metabolic processes that persist till adult life.

Maternal Obesity and Pregnancy Complications

Janet King, PhD
Senior Scientist
Children's Hospital Oakland Research Institute
Professor Emeritus
University of California, Berkeley

Janet King, PhD is a Senior Scientist at Children’s Hospital Oakland Research Institute and a Professor Emeritus at the University of California at Berkeley and Davis. She is internationally recognized for her research in maternal nutrition. She has published over 200 papers and abstracts and trained over 60 graduate students and post-doctoral fellows. Dr. King’s research on nutrition and pregnancy is the basis for the gestation weight gain standards established by the Institute of Medicine in 1991 and the recommended dietary intakes of calcium and zinc during pregnancy. Her pioneering use of stable isotopes of zinc, calcium, and other minerals opened up a whole new approach for studying mineral requirements of pregnant and lactating women, infants, and children. Using those procedures, Dr. King has quantitated calcium, iron, and zinc needs of pregnant women living in California, Brazil, and Korea. Her techniques and kinetic models are now used worldwide. Dr. King recently extended her studies of maternal nutrition to women living in a rural area of North Vietnam.

Dr. King is a member of the National Academy of Sciences, Institute of Medicine. She has been involved in implementing national and international nutrition policy by serving as Chair of the Food and Nutrition Board, Co-Vice Chair of the Committee on Scientific Evaluation of Dietary Reference Intakes for setting recommended nutrient intakes, Chair of the United Nations University, Food and Agriculture Organization, World Health Organization Joint Committee on Dietary Harmonization, currently serving as a member of the United Nations International Consultative Group on Zinc. Dr. King has received numerous awards including the Outstanding Research Scientist of the Year by the U.S. Department of Agriculture.

Excessive Weight Gain During Pregnancy: Can It Be Prevented?

Naomi Stotland, MD
Assistant Professor
Department of Obstetrics, Gynecology, and Reproductive Sciences
University of California, San Francisco

Naomi E. Stotland, MD is an Assistant Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at UCSF. She is currently a Women's Reproductive Health Research Scholar (WRHR). Dr. Stotland's research interests include weight gain, nutrition, and obesity in pregnancy. She is currently conducting qualitative research on prenatal care providers and their knowledge, attitudes and behaviors regarding weight gain counseling. She is also a co-investigator in a clinical trial of a low-glycemic diet for overweight and obese pregnant women. Dr. Stotland practices obstetrics and gynecology at San Francisco General Hospital, where she teaches UCSF residents and students. She is also the medical director of Sage Femme Midwifery, a freestanding birthing center in San Francisco.

Postpartum Weight Retention: Do We Know Enough to Intervene?

Barbara Abrams, DrPH, RD
School of Public Health
University of California, Berkeley

Barbara Abrams, DrPH, RD is Professor of Epidemiology, Maternal and Child Health, and Public Health Nutrition in the School of Public Health at the University of California, Berkeley. Her expertise includes weight and weight gain in women during pregnancy, post-partum, and menopause; maternal weight, nutrition, social factors, and perinatal health outcomes and HIV and breastfeeding. She currently serves on the Institute of Medicine's Reexamination of IOM Pregnancy Weight Guidelines committee and previously served on the IOM Committee on the Impact of Pregnancy Weight on Maternal and Child Health, the Committee on the Scientific Evaluation of W.I.C. Nutrition Risk Criteria, the Committee on Nutritional Status During Pregnancy and Lactation, and the Subcommittee on Clinical Application Guide. She was awarded the March of Dimes Agnes Higgins Award for her contributions to the field of maternal-fetal nutrition. Dr. Abrams received her B.S. in nutrition and dietetics from Simmons College in Boston. She earned her M.P.H. in nutrition, M.S. in epidemiology and Dr.P.H. in nutrition from the University of California-Berkeley. Dr. Abrams is a member of the American Dietetic Association, the American Society for Nutrition, the Society for Epidemiologic Research, the Society for Pediatric and Perinatal Epidemiologic Research, and is an affiliate member of the American College of Obstetrics and Gynecology. Prior to joining the faculty at Berkeley, she worked as a perinatal nutritionist with the Department of Obstetrics Gynecology and Reproductive Sciences at UCSF and other settings where she provided counseling and education for thousands of pregnant women and their families.

Maternal Depression and Child Obesity

Janet Wojcicki, PhD, MPH
Assistant Professor
Department of Pediatrics
University of California, San Francisco

Janet Wojcicki, PhD, MPH is Assistant Professor in the Department of Pediatrics (Division of GI, Hepatology and Nutrition) at UCSF. Her research centers on early life risk factors for obesity in Latinos, with a specific focus on psychological and sociobehavioral components. Dr. Wojcicki has a PhD in Anthropology (UCLA) and a Masters in Public Health Epidemiology (UCSF) and completed a fellowship in HIV prevention (UCSF) and in Pediatric Nutrition (UCSF).

Closing Remarks

Mary Dallman, PhD
Professor Emerita of Physiology
University of California, San Francisco

Mary Dallman, PhD, is a Professor Emerita of Physiology at UCSF and is one of the world experts on stress and metabolism, having pioneered the discoveries of how HPA axis regulation and metabolism are linked. She has deciphered the roles of stress induced glucocorticoid secretion on brain and feering behavior and the stress-damping role of pleasurable food intake on brain pituitary-adrenal responses to chronic stressors in rats. As Professor Emeritus, she remains active in mentoring and promoting training and research.