# PROMISE: PReventing Obesity through healthy Maternal gestational weight gain In the Safety nEt

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2020 · $649,548

## Abstract

PROJECT SUMMARY
Women with severe obesity have high risks of adverse birth and child outcomes, including childhood obesity.
There is a profound need to reduce risks among women who enter pregnancy with severe obesity as part of
prenatal care, but there is scant evidence on appropriate Gestational Weight Gain (GWG) goals in women with
severe obesity. Moreover, severe pre-pregnancy maternal obesity, adverse birth outcomes, and child obesity
are most prevalent in low-income and racial/ethnic minority groups, who are vastly under-represented in
obstetric and pediatric obesity research.
The proposed research addresses the critical problem that GWG guidelines are likely too high for women with
severe obesity, placing children at high risk for obesity and exacerbating disparities in childhood obesity. The
overall objective of this study is to determine overall and trimester-specific GWG associated with the lowest
risk of adverse birth and longer-term outcomes in children of mothers with severe pre-pregnancy obesity. This
study leverages the ADVANCE Early Life Cohort, a unique cohort of low-income, racially and ethnically diverse
mothers and children, constructed from electronic health record (EHR) data from U.S. community health
centers. In contrast with most other EHR-based studies, this study population includes predominately publicly
insured and uninsured patients.
The proposed research will examine >37,000 mothers in ADVANCE living in 3 states (OR, CA, MA), and their
children to conduct 3 specific aims. Aim 1: Determine overall and trimester-specific GWG associated with the
lowest risk of adverse birth outcomes (small or large for gestational age, preterm birth, birth weight) in children
of mothers with severe pre-pregnancy obesity. Hypothesis: Among children of mothers with severe pre-
pregnancy obesity, birth outcomes are optimized when total and trimester-specific GWG are below current
recommendations. Aim 2: Determine overall and trimester-specific GWG associated with the lowest risk of
longer-term obesity-related outcomes (infant growth, BMI at 5 years of age) in children of mothers with severe
pre-pregnancy obesity. Hypothesis: Among children of mothers with severe pre-pregnancy obesity, early
indicators in child obesity risk are reduced with total and trimester-specific GWG below current
recommendations. Aim 3: Determine the extent to which overall and trimester-specific GWG mediate the
relationship between race/ethnicity and BMI at 5 years of age. Hypothesis: A substantial share (>10%) of
previously observed racial/ethnic disparities in childhood obesity is attributable to GWG, identifying a key point
for intervention. Study findings will inform clinical practice and GWG guidelines tailored to women with severe
pre-pregnancy obesity, both needed to reduce risk in women who enter pregnancy with severe obesity. This
study occurs in the context of a well-established collaborative research environment in the developmental
origins of disease at O...

## Key facts

- **NIH application ID:** 9887901
- **Project number:** 1R01DK118484-01A1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Janne Boone-Heinonen
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $649,548
- **Award type:** 1
- **Project period:** 2020-01-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9887901

## Citation

> US National Institutes of Health, RePORTER application 9887901, PROMISE: PReventing Obesity through healthy Maternal gestational weight gain In the Safety nEt (1R01DK118484-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9887901. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*