Prenatal environmental determinants of health in young adulthood: a lifecourse approach

摘要/摘要 青春期是我们应该达到健康巅峰的人生阶段。从身体上讲，年轻人将拥有 完成生长，达到最大瘦体质量，并具有最佳生育能力。很多年轻人会 已完成学业并独立生活。虽然很少有年轻人患有明显的慢性病，但许多人 已经有实质性的危险因素，如高血压、高血糖和肥胖。此外，次优的 生活方式行为，如饮食不良，睡眠不足，使用药物，以及抑郁和 焦虑阻碍了许多年轻人充分发挥他们的潜力。 现有证据表明，产前环境会影响健康和疾病风险。 生命之路。然而，大多数人类证据是基于对儿童时期的短期随访，当健康 更多的是塑料；或者根据成人队列的回顾数据，在这些队列中，暴露受到限制或受到 很大的回忆偏差和选择偏差可能是相当大的，但无法量化。 拟议的项目将利用在Project Viva Pre...中收集的丰富数据来解决这一主题 出生队列。该项目将包括已经收集的产前母亲行为(饮食、吸烟、 体力活动)和生物学(炎症、血压、血糖、体重增加、抑郁/焦虑 症状)，以及化学品的元素(接触金属、全氟辛烷磺酸、空气污染)和社会 环境(物质困难、邻里匮乏)。具体目标将集中在以下关键领域 对1000名从产前开始跟踪的年轻人的健康状况进行评估： 目标1：心脏代谢健康，基于体重、腰围、血压和生物标记物(血脂、 血糖、炎症)。 目标2：生殖健康，以激素水平、月经周期等生育指标为基础 特征(女性)和精子质量/数量(男性)。 目标3：体验式健康和幸福，基于感知的总体健康和生活质量，衡量 积极心理(如乐观)和低水平的抑郁/焦虑症状 次要目标4：健康行为，包括饮食和饮食行为、身体活动和久坐活动， 烟草和其他物质的使用，以及睡眠。 主要的假设是，更有益的产前环境将与更好的 青年时期的心脏代谢、生殖和体验性健康。Project Viva的定位是独特的 来解决这些重要的科学问题。对这一独特资源的持续支持将提供 无与伦比的机会，严格评估发育暴露对健康的影响程度 进入成年期。

Summary/Abstract Young adulthood is the life stage when we should achieve peak health. Physically, young adults will have completed their growth, reached maximal lean body mass, and have optimal fertility. Many young adults will have completed school and live independently. While few young adults have overt chronic disease, many already have substantial risk factors such as hypertension, hyperglycemia, and obesity. Moreover, suboptimal lifestyle behaviors such as poor diet, insufficient sleep, and substance use, and symptoms of depression and anxiety prevent many young adults from reaching their full potential. Existing evidence suggests that the prenatal environment influences health and disease risks across the lifecourse. However, most human evidence is based on either short-term follow-up into childhood, when health is more plastic; or on retrospective data from adult cohorts in which exposures are limited or subject to substantial recall bias, and selection bias is likely considerable yet unquantifiable. The proposed project will address this topic leveraging the rich data already collected in the Project Viva pre- birth cohort. The project will include already-collected measures of prenatal maternal behaviors (diet, smoking, physical activity) and biology (inflammation, blood pressure, glycemia, weight gain, depressive/anxiety symptoms), as well as elements of the chemical (exposures to metals, PFAS, air pollution) and social environments (material hardship, neighborhood deprivation). Specific Aims will focus on following key domains of health to be assessed in 1000 young adults followed since prenatal life: Aim 1: Cardiometabolic Health, based on weight, waist circumference, blood pressure, and biomarkers (lipids, glycemia, inflammation). Aim 2: Reproductive Health, based on fertility markers including hormone levels, menstrual cycle characteristics (for women), and sperm quality/quantity (for men). Aim 3: Experiential Health and Wellbeing, based on perceived overall health and quality of life, measures of positive psychology (e.g. optimism), and low levels of depressive/anxiety symptoms Secondary Aim 4: Health behaviors, including diet and eating behaviors, physical and sedentary activities, tobacco and other substance use, and sleep. The primary hypothesis is that a more beneficial prenatal environment will be associated with better cardiometabolic, reproductive, and experiential health in young adulthood. Project Viva is uniquely positioned to address these important scientific questions. Ongoing support of this unique resource will provide an unparalleled opportunity to rigorously evaluate the extent to which developmental exposures influence health into adulthood.