Exposome Contributors to Child Health Originating from National Fetal Growth Study (ECCHO-NFGS)

摘要 环境因素对儿童健康的贡献源自国家胎儿生长研究(ECCHO-NFGS) 动物和流行病学研究表明，许多产妇的产前经历(如营养不良、压力、 环境污染物升高)支持“健康的胎儿起源”模式 影响儿童发展的经验。拟议的研究充分利用了 国家胎儿生长研究(NFGS)，2397名不同种族、民族和地理差异的队列 健康的妇女和胎儿在怀孕期间反复研究。NFGS包括系列的集合 超声波检查；产妇人体测量；压力、体力活动和饮食问卷；以及 血脂、可替宁、咖啡因、微量元素和持久性环境污染物(POPs)的血液样本 其中许多具有内分泌干扰和神经毒性特性，总体目标是显著改善 我们对孕妇产前暴露、胎儿发育轨迹、 和儿童健康结果。在头两年(UG3阶段)，我们将重点关注以下关键成果领域 肥胖、新陈代谢健康和神经发育表明我们有能力重新联系、同意、收集 关于生长发育、医疗诊断和住院史的回顾数据，并开始对NFGS进行跟踪 2017年将满3-7岁的儿童。我们将参与ECHO联盟和数据收集 更广泛的回声研究。在接下来的五年(UH3阶段)，我们将继续跟随孩子们去 研究胎儿发育的一系列暴露和轨迹与儿童代谢和 内分泌健康和神经行为结果。我们将使用创新的统计建模来开发功能 预测儿童代谢紊乱/肥胖和神经行为症状风险的标准 胎儿发育轨迹和宫内暴露。Echo-NFGS的队列是前所未有的 母体暴露的前瞻性详细评估和胎儿发育的质量控制措施 在整个怀孕期间，其队列的大小代表了美国的4个种族和10个地理位置 国家，以及在其代表中被招募为标准怀孕人口的孕妇，没有任何 可识别的内科或产科疾病。我们将持续评估详细的临床信息 评估孕期极具相关性的暴露组标志物(营养、压力、身体状况 活动、药物和环境暴露等)以及高度精确的胎儿生长测量 轨迹与儿童健康结果的关系。很明显，胎儿期会影响孩子的 健康；对这一群体的后续行动将提供一个无与伦比的机会来发现如何以及为什么。

ABSTRACT Environmental Contributors to Child Health Originating from the National Fetal Growth Study (ECCHO-NFGS) Animal and epidemiological studies show that many maternal prenatal experiences (e.g., poor nutrition, stress, elevated environmental pollutants) support the `fetal origins of health' model in relating adverse maternal experiences to compromised child development. The proposed study leverages the unique resources of the National Fetal Growth Study (NFGS), a cohort of 2397 racially, ethnically and geographically diverse otherwise healthy women and fetuses studied repeatedly during pregnancy. The NFGS included collection of serial ultrasound examinations; maternal anthropometry; stress, physical activity and diet questionnaires; as well as blood samples for serum lipids, cotinine, caffeine, trace elements and persistent environmental pollutants (POPs) many of which have endocrine disrupting and neurotoxic properties with the overall goal of significantly improving our understanding of the associations between maternal prenatal exposures, fetal developmental trajectories, and childhood health outcomes. In the first two years (UG3 phase), we will focus on the key outcome areas of obesity, metabolic health and neurodevelopment demonstrating our ability to re-contact, consent, collect retrospective data on growth, medical diagnoses and residential histories and begin follow-up of the NFGS children who will be ages 3-7 in 2017. We will participate in the ECHO consortium and data collection for the broader ECHO study. In the subsequent five years (UH3 phase), we will continue to follow the children to examine a range of exposures and trajectories of fetal development in relationship to childhood metabolic and endocrine health and neurobehavioral outcomes. We will use innovative statistical modeling to develop functional standards that predict risk of childhood metabolic disruption/obesity and neurobehavioral symptoms based on fetal development trajectories and in utero exposures. The ECCHO-NFGS cohort is unprecedented in its prospective detailed assessment of maternal exposures and quality controlled measures of fetal development throughout pregnancy, in the size of its cohort representing 4 races and 10 geographic locations in the United States, and in its representation of pregnant women recruited as a standard pregnant population free of any identifiable medical or obstetrical morbidities. We will evaluate detailed clinical information, continuous assessments of exposome markers of tremendous relevance during pregnancy (nutrition, stress, physical activity, medication and environmental exposures, etc.) as well as highly accurate measures of fetal growth trajectories in relationship to childhood health outcomes. It is clear that the prenatal period influences children's health; follow up of this cohort will allow for an unparalleled opportunity to discover how and why.