Prenatal Exposures and Child Health Outcomes: A Statewide Study

项目总结 来自流行病学研究的证据表明，慢性和急性应激在 怀孕了。这些影响可能发生在围产期或儿童生命后期。新冠肺炎全球大流行导致 社会和财政安全受到前所未有的大规模破坏，医疗保健服务也发生了变化。 这些状况造成了更高水平的痛苦，甚至对可能患有 以前受到过心理社会压力的保护。特别关注孕妇及其子女， 感染SARS-CoV-2可能有直接的生物影响，也有实质性的间接影响 发展关键时期的心理社会影响，对儿童产生长期影响 环境儿童健康结果(ECHO)计划。这项建议解决了心理社会压力如何 与COVID大流行相关的疾病可能会影响围产期和神经发育结果。此外，证据 这表明心理社会压力与胃肠道和阴道微生物群有关。 因此，我们将确定母体微生物群或婴儿微生物群是否介导了心理社会的影响。 应激对围产期和神经发育结果的影响。在目标1中，我们解决了母体微生物及其 孕期心理社会应激在调节围产儿结局中的作用在目标2中，我们 关注母体心理社会应激及其对神经发育的影响 婴儿微生物区系。我们将在我们正在进行的工作范围内审查这些目标，并将其作为 家长基金(UG3/UH3OD023285，Paneth)，其中我们的组织原则是为许多环境 暴露对儿童健康最敏感的风险时期是孕期和围产期。父辈 格兰特探索了三种主要的暴露：毒性、营养性和炎症性 在怀孕的前三个月招募的新生儿。在计划的1,100名新的队列二人组成员中 Echo，已有700多名孕妇同意，随访率为75%，400多人 儿童在婴儿期就已经被看到了。预计将有300多名妇女参加该项目 句号。虽然这项研究将利用当地的ECHO队列，但该项目旨在吸引ECHO团队 通过两个截然不同但相辅相成的全回声项目进行科学研究：(1)纳入来自两个队列的数据 (O‘Conner&Deoni)以实现上述提议的目标和(2)提供数据和生物检疫以分离 CoVID补充剂(Transande)，用于治疗SARS-CoV-2血清阳性/COVID疾病以及 心理社会压力(通过问卷和头发中的皮质醇测量来评估)，因为它们与矮小有关 妊娠和其他围产期结局。我们的努力不仅将为正在测试的具体假设提供信息，而且 还将告知样本采集和患者互动的“非接触式”方法。在此提出的工作 通过解决暴露(母亲在一段时间内的心理社会压力)来补充父母的补助 Echo的成果中至少有两项(购买力平价和神经发育)。

PROJECT SUMMARY Evidence from epidemiologic studies demonstrates the negative effects of both chronic and acute stress during gestation. These effects may occur perinatally or later in the child's life. The COVID-19 global pandemic has led to unprecedented mass disruption of social and financial security as well as changes in medical care delivery. These conditions are causing elevated levels of distress even for portions of the population that may have previously been protected from psychosocial stress. Of particular concern for pregnant women and their children, there may be direct biological effects related to infection with SARS-CoV-2 as well as substantial indirect psychosocial effects during critical periods of development with long-lasting impact on children relevant to the Environmental Child Health Outcomes (ECHO) program. This proposal addresses how psychosocial stress related to the COVID pandemic may impact perinatal and neurodevelopmental outcomes. Furthermore, evidence suggests that psychosocial stress is associated with both the gastrointestinal and vaginal microbiomes. Therefore, we will determine if maternal microbiomes or infant microbiomes mediate the impact of psychosocial stress on perinatal and neurodevelopmental outcomes. In aim 1, we address the maternal microbes and their role in mediating perinatal outcomes caused by maternal psychosocial stress during pregnancy. In aim 2, we focus on maternal psychosocial stress and its impact on neurodevelopment as mediated by the changes to the infant microbiota. We will examine these objectives in the context of our ongoing work, and as an extension of the parent grant (UG3/UH3OD023285, Paneth), where our organizing principle is that for many environmental exposures the most sensitive period of risk for child health is pregnancy and the perinatal period. The parent grant explores three primary exposures: toxic, nutritional, and inflammatory in a stratified random sample of state births recruited in the first trimester of pregnancy. Of the planned 1,100 new enrollments of cohort dyads into ECHO, more than 700 pregnant women have been consented, and, with a 75% follow up rate, more than 400 children have already been seen in infancy. Over 300 women are expected to be enrolled during the project period. While this research will leverage the local ECHO cohort, the project is designed to engage ECHO team science through two distinct but complementary ECHO-wide projects: (1) incorporation of data from two cohorts (O'Conner & Deoni) to address the aims proposed above and (2) provision of data and biospecimens to separate COVID supplement (Transande) which addresses SARS-CoV-2 seropositivity/COVID illness as well as psychosocial stress (assessed via questionnaire and cortisol measured in hair) as they relate to shortened gestation and other perinatal outcomes. Our efforts will not only inform the specific hypotheses being tested but will also inform “touch-free” methods for sample collection and patient interaction. The work proposed herein complements the parent grant by addressing an exposure (maternal psychosocial stress during a time of pandemic), not included in the parent grant, and at least two of ECHO's outcomes (PPP and neurodevelopment).