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Biological and Environmental Contributions to Healthy Baby Development in Diverse Population

生物和环境对不同人群婴儿健康发育的贡献

基本信息

批准号：
10018175
负责人：
PAT LEVITT
金额：
$ 28.6万
依托单位：
CHILDREN'S HOSPITAL OF LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-30 至 2021-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10018175
关键词：
Address Adverse event Age Alcohols Ambulatory Care Facilities Applications Grants Basic Science Behavioral Biological Birth Rate Blood Brain California Cannabis Child Child Development Childhood Clinic Clinical Research Cognitive Communities Complement Complex County Cultural Diversity Data Collection Data Quality Development Drops Drug Exposure Electroencephalography Emotional Ensure Environmental Risk Factor Epidemiology Equilibrium Ethics Exposure to Eye Family Fetal Alcohol Exposure Fetal Development Fetus Generations Goals Grant Hair Health Hispanics Hospitals Human Milk Income Individual Infant Inpatients Legal Life Longitudinal Studies Los Angeles Magnetic Resonance Imaging Measurement Measures Medicaid Medical Ethics Medical center Mental Health Methodology Methods Modeling Mothers Motor Activity Neonatal Abstinence Syndrome Only Child Outcome Pediatric Hospitals Pediatrics Phase Physiological Physiology Population Population Heterogeneity Poverty Pregnancy Pregnant Women Presbyterian Church Prevention program Protocols documentation Questionnaires Race Reporting Research Research Design Research Personnel Resolution Resources Risk Risk Factors Saliva Sampling Schedule Services Shapes Site Social support Spottings Stress Structure Substance of Abuse Swab Testing Time Toddler Universities Urine Visit Vulnerable Populations bilingualism cohort community clinic community partnership design developmental psychology drug of abuse early experience early life adversity early life stress ethnic diversity experience falls federal poverty level fetal fetal drug exposure fetal opioid exposure high risk high risk population interdisciplinary approach longitudinal design member metabolomics multidisciplinary multimodality neurodevelopment neuroimaging neurophysiology novel nutrition pediatric patients phase 2 designs phase 2 study physical conditioning postnatal primary caregiver psychologic psychosocial racial diversity recruit resilience safety net social study population treatment program ward wearable device

项目摘要

Children exposed during pregnancy to substances of abuse are also at high-risk for other environmental factors associated with early life stress (ELS). Basic and clinical research shows that these various exposures, individually or in combination, can disrupt early developmental trajectories of brain structure and function and enduring health risk for the child. This R34 HEAL planning grant application from Children’s Hospital Los Angeles (CHLA)/University of Southern California (USC) will be vital for consortium hypothesis generation in Phase II in order to disentangle how complex environmental factors impact brain development and function - from fetal period through the first decade - to shape cognitive, social and emotional development. The risk factors for families served by this campus of clinics, CHLA, Hollywood Presbyterian Hospital and Altamed Community Medical Center, is unparalleled in California. Of the families to be recruited, >75% are on Medicaid, more than 50% are below the federal poverty level, and there is enrichment of Hispanic/Latinx of any race. The USC-CHLA team of investigators and bilingual and multi-cultural research staff bring a depth of expertise in recruitment during pregnancy and early postnatal, as well as experimental expertise in epidemiology, neuroimaging, neurophysiology, developmental psychology and behavioral pediatrics, and biomeasures. To ensure maximum protection of a vulnerable population and effective recruitment and retention, the team includes a world- renowned expert in social/legal and medical ethics to complement our experience and community partnerships. For HEAL Phase I, two cohorts will be recruited to meet age range goals. Cohort 1 will include 40 pregnant women and their fetuses/infants to test the feasibility and utility of different study visit schedules on data quality and subject burden. Cohort 2 will include 10 mother-toddler dyads recruited from one of our two ongoing longitudinal studies investigating the impact of early life stress on development. Three specific aims will address the stated goals of the HEAL RFA: Aim 1) to develop the strategies to recruit and retain a racially- and ethnically diverse sample of pregnant women (and their fetuses), who are oversampled for adverse environmental risk factors and exposure to substances of abuse; Aim 2) to develop the strategies for managing potential legal and ethical challenges to ensure that the mother-child dyads have access to legal, social and psychological support services as needed; Aim 3) to determine the optimal study protocol for the planned, phase II study – balancing the need for high quality, longitudinal data collection with the need to minimize burden on the mother-child dyads. The multidisciplinary approaches include fetal, infant and toddler MRI, high-resolution electroencephalography and eye-tracking, promising biosamples (child buccal swab, urine and blood drops; mother breastmilk, blood and hair), and demographic, physical and mental health, social support for mother/child dyads, and behavioral- cognitive measures in children. Lessons learned from recruitment, retention and data collection will be fully shared in order to form best hypotheses and research designs for the Phase II HEAL initiative.

在怀孕期间接触滥用药物的儿童也面临其他环境因素的高风险