Prenatal Exposures and Child Health Outcomes: A Statewide Study

项目摘要 来自流行病学研究的证据表明，慢性和急性应激的负面影响， 怀孕这些影响可能发生在围产期或以后的孩子的生活。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，医疗服务也发生了变化。 这些情况正在造成更高程度的痛苦，即使是对那些可能已经 以前受到保护，免受心理社会压力。对孕妇及其子女特别关切的是， 可能存在与SARS-CoV-2感染相关的直接生物学效应， 对儿童产生长期影响的关键发展时期的心理社会影响 环境儿童健康成果（ECHO）计划。这项提案涉及社会心理压力如何 可能影响围产期和神经发育结果。此外，证据 表明心理社会压力与胃肠道和阴道微生物有关。 因此，我们将确定母体微生物组或婴儿微生物组是否介导了心理社会的影响。 强调围产期和神经发育的结果。在目标1中，我们解决了母体微生物及其 在调解怀孕期间产妇心理社会压力引起的围产期结果中的作用。在目标2中，我们 重点关注母亲的心理社会压力及其对神经发育的影响， 婴儿微生物群我们将在我们正在进行的工作中审查这些目标，并将其作为 父母补助金（UG 3/UH 3 OD 023285，Paneth），我们的组织原则是， 对儿童健康风险最敏感的时期是怀孕和围产期。母 格兰特探讨了三个主要的暴露：有毒的，营养的，和炎症的分层随机抽样的国家 在怀孕头三个月招募的新生儿。在计划的1，100名新的队列二人组入组中， 根据ECHO的数据，已有700多名孕妇同意接受治疗，随访率为75%， 孩子们在婴儿期就已经被看到了。预计将有300多名妇女在该项目期间入学 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 通过两个不同但互补的ECHO范围内的项目：（1）纳入两个队列的数据 （O 'Conner & Deoni），以实现上述目标;（2）提供数据和生物标本， COVID补充（Transande），解决SARS-CoV-2血清阳性/COVID疾病以及 心理社会压力（通过问卷调查和头发中测量的皮质醇进行评估），因为它们与缩短的 妊娠和其他围产期结局。我们的努力不仅将为正在测试的特定假设提供信息， 还将为样本采集和患者互动提供“免接触”方法。本文提出的工作 补充父母补助金，解决暴露问题（母亲在怀孕期间的心理社会压力）， 大流行），不包括在父母补助金，和至少两个ECHO的成果（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).