0859 Impact of Social Determinants of Health and Sleep on Cardiometabolic Health in Pregnant African American Women

Abstract Introduction Cardiometabolic Disease disproportionately impacts African American (AA) women with higher gestational diabetes risk compared to their White counterparts, often progressing to post-partum type 2 diabetes across the United States. Thus, pregnancy is a critical period to assess cardiometabolic health (CMH) in this population. This study aimed to explore the impact of Social Determinants of Health (SDoH) and sleep-related outcomes on insulin resistance. Methods Data from 70 AA pregnant women enrolled in the BETTER lifestyle counseling study (NCT05234125) who completed surveys and provided blood samples were analyzed. SDoH factors encompassed stress level (Perceived Stress Scale), social support perceptions (Multidimensional Scale of Perceived Social Support), and demographic indicators such as income and education. Sleep assessments included evaluations of sleep quality (Pittsburgh Sleep Quality Index), sleep apnea risk measuring the apnea-hypopnea index (Watch-PAT One), insomnia symptoms (Insomnia Severity Index), and sleep hygiene (Sleep Hygiene Index). Insulin resistance was quantified using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) as the outcome variable. Multiple regression analyses including demographic variables with a p 0.2 in bivariate analyses were performed to determine the predictive capacity of SDoH and sleep variables on HOMA-IR. Results The mean age was 30.4 (SD 5.72; range:18.5-42 years); mean gestational weeks (GWs) was 18.03 (SD 3.021; range:10.6-23.1); and mean body mass index (BMI) was 33.09 kg/m2 (SD 5.63; range:16.2-47.1). After controlling for covariates (age, GWs, BMI, income, and education), higher stress (β=.251, p.05), poor sleep quality (β=.279, p.05), and higher insomnia symptoms (β=.248, p.05) were significantly associated with higher insulin resistance. These results contribute important insights into the impact of both SDoH and sleep-related outcomes on insulin resistance among AA women during pregnancy. Conclusion SDoH and sleep, particularly stress and sleep disturbances, are linked to CMH, highlighting the importance of comprehensive assessment to address cardiometabolic disease risks for AA women during their pregnancy. Further research is needed to understand the causal aspects of these associations and develop targeted interventions to optimize the CMH, and enhance maternal and child health outcomes in this population. Support (if any) The National Center on Minority Health and Health Disparities at The National Institute of Health of the United States, R01MD015724.