Prenatal Exposures and Child Health Outcomes: A Statewide Study

产前暴露和儿童健康结果：一项全州研究

• 批准号: 10205220
• 负责人: Charles James Barone
• 金额: $ 30.57万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10205220
• 关键词: 2019-nCoV; Address; Age; Age-Months; Archives; Biological; Birth; COVID-19; COVID-19 pandemic; Child; Child Health; Chronic stress; Clinical Research; Collaborations; Collection; Complement; Consent; Data; Development; Distress; Enrollment; Environment; Environmental Exposure; First Pregnancy Trimester; Generations; Hair; Health; Hydrocortisone; Infant; Infection; Inflammatory; Intervention; Length; Life; Link; Maternal and Child Health; Measures; Mediating; Medical; Methods; Michigan; Microbe; Mission; Neurocognitive; Nutritional; Outcome; Patients; Perinatal; Population; Pregnancy; Pregnant Women; Procedures; Psychosocial Stress; Public Health; Questionnaires; Research; Risk; Role; Sampling; Science; Security; Shotguns; Symptoms; Testing; Third Pregnancy Trimester; Time; Touch sensation; Toxicant exposure; Treatment/Psychosocial Effects; Vertical Disease Transmission; Woman; Work; acute stress; care delivery; cohort; coronavirus disease; critical period; design; epidemiology study; experience; fecal microbiome; fecal microbiota; follow-up; gut microbiome; gut microbiota; infancy; maternal microbiome; maternal stress; metagenomic sequencing; microbial; microbiome; microbiome alteration; microbiota; neurodevelopment; neurodevelopmental effect; novel; offspring; pandemic disease; parent grant; perinatal outcomes; perinatal period; preclinical study; prenatal exposure; programs; recruit; sample collection; seropositive; social; vaginal microbiome; vaginal microbiota

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).

项目概要 流行病学研究的证据表明，慢性和急性压力都会产生负面影响。 妊娠。这些影响可能会在围产期或孩子的生命后期发生。 COVID-19 全球大流行导致 社会和金融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。 这些情况甚至对部分可能患有此病的人来说也造成了更大程度的痛苦 以前受到保护，免受社会心理压力。尤其是孕妇及其孩子， 可能存在与 SARS-CoV-2 感染相关的直接生物效应以及大量间接生物效应 发展关键时期的心理社会影响，对与儿童相关的长期影响 环境儿童健康成果 (ECHO) 计划。该提案解决了心理社会压力如何 与新冠病毒大流行相关的药物可能会影响围产期和神经发育结果。此外，证据 表明社会心理压力与胃肠道和阴道微生物组有关。 因此，我们将确定母亲微生物组或婴儿微生物组是否介导社会心理的影响 对围产期和神经发育结果的压力。在目标 1 中，我们解决母体微生物及其 在调节怀孕期间母亲心理社会压力引起的围产期结局中的作用。在目标 2 中，我们 重点关注母亲的社会心理压力及其对神经发育的影响（由神经发育的变化介导） 婴儿微生物群。我们将在我们正在进行的工作的背景下审查这些目标，并将其作为 家长资助（UG3/UH3OD023285，Paneth），我们的组织原则是，对于许多环境 接触 对儿童健康风险最敏感的时期是怀孕期和围产期。家长 grant 探索了三种主要暴露：有毒、营养和炎症的分层随机样本 妊娠前三个月招募的新生儿。计划新注册 1,100 名队列二人组 ECHO 已获得 700 多名孕妇的同意，并且随访率达 75%，超过 400 儿童在婴儿期就已经出现过。该项目预计将有超过 300 名女性参与 时期。虽然这项研究将利用当地的 ECHO 队列，但该项目旨在吸引 ECHO 团队参与 通过两个不同但互补的 ECHO 范围内的项目来进行科学：（1）合并来自两个队列的数据 （O'Conner & Deoni）实现上述目标，以及 (2) 提供数据和生物样本以分离 COVID 补充剂 (Transande) 可解决 SARS-CoV-2 血清阳性/COVID 疾病以及 社会心理压力（通过问卷和头发中测量的皮质醇进行评估），因为它们与缩短有关 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“免接触”方法。本文提出的工作 通过解决暴露问题（母亲在一段时间内的社会心理压力）来补充家长补助金 大流行病），不包含在家长补助金中，以及 ECHO 的至少两项成果（PPP 和神经发育）。