Preconception and Prenatal Health Impacting Factors and Child Health

孕前和产前健康影响因素和儿童健康

• 批准号: 10746579
• 负责人: Lyndsay Ammon Avalos
• 金额: $ 202.38万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10746579
• 关键词: Address; Adverse effects; Affect; Anxiety; Birth; Blood; Body mass index; California; Cannabis; Censuses; Characteristics; Child; Child Health; Clinic Visits; Clinical Research; Conceptions; Data; Devices; Diet; Dietary Practices; Electronic cigarette; Ensure; Exposure to; Fetal Development; Functional disorder; Growth; Health; Hour; Human Milk; Individual; Infant; Intervention; Joints; Learning; Life; Life Style; Link; Low income; Measures; Mediating; Medical center; Mental Depression; Metabolic; Movement; Neighborhoods; Neurodevelopmental Disorder; Neurodevelopmental Impairment; Obesity; Opioid; Outcome; Pathway interactions; Personal Satisfaction; Phase; Physical activity; Pilot Projects; Policies; Population Heterogeneity; Pregnancy; Prevention; Prevention strategy; Problem behavior; Program Development; Protocols documentation; Quality Control; Race; Research; Risk Factors; Role; Sampling; Science; Sleep; Social Problems; Stress; Time; Umbilical Cord Blood; Visit; cohort; ethnic minority population; evidence base; experience; good diet; healthy weight; improved; indexing; lifestyle factors; member; metabolomics; mother nutrition; neurodevelopment; novel; obesity in children; offspring; participant retention; postnatal; pregnant; prenatal; prenatal exposure; prenatal health; prevent; programs; psychological distress; racial minority population; recruit; residential segregation; sex assigned at birth; social vulnerability; substance use

Abstract Childhood obesity and neurodevelopmental impairments have increased in recent decades and are the most prevalent conditions threatening child’s health and well-being. The consequences of these conditions signify the need to identify modifiable factors to target for upstream prevention. Emerging evidence suggests that prenatal exposures to psychological distress, substance use, and lifestyle factors during critical windows of fetal development may operate to developmentally program childhood obesity and neurodevelopment (ND). However, few studies have taken a multiple exposure approach to understand the individual and joint effects of these exposures. In Aim 1 we will examine the role of in utero exposure to psychological distress and substance use on child growth, adiposity, obesity, and ND and the extent to which prenatal lifestyle factors and neighborhood factors may mitigate these associations. Further, while maternal diet and physical activity impact infant growth and adiposity, few studies in diverse populations have assessed mechanistic pathways and little is known about their impact on ND. We propose the 24-hour movement profile and metabolomics as our specialized measures of lifestyle, and obesity and ND as our specialized outcomes. The 24-hour movement profile incorporates the interdependent relationships between device-based measures of physical activity and sleep during pregnancy to better inform interventions. Metabolomics can elucidate mechanistic pathways and will be measured repeatedly on the samples collected according to the ECHO protocol (prenatal blood, cord blood, postnatal child’s blood, and breastmilk). In Aim 2 we will clarify the joint effects of maternal prenatal dietary patterns and the 24-hour movement and child growth, obesity, and ND and whether metabolomic signatures prenatally, at birth, and postnatally mediate these associations. For Aims 1 and 2 we will also examine how associations vary by neighborhood characteristics and infant sex assigned at birth. In Aim 3 we will maximize recruitment and retention by implementing evidence-based strategies focused on engaging diverse groups in clinical research and implementing the ECHO Cohort Protocol applying systematic quality control approaches and best practices. We propose to contribute to the ECHO Program by recruiting a diverse cohort of 1,800 pregnant individuals from two medical centers at Kaiser Permanente Northern California serving a diverse population (~70% racial/ethnic minority groups with 50% having a low income), the conceiving partner, their resulting child, and to follow all of them at multiple visits after the child is born. In Aim 4 we will explore the role of preconception maternal and paternal lifestyle factors on infant birth size to identify critical time periods to intervene on to prevent upstream risk factors for childhood obesity and ND. All members of our diverse research team will have equal opportunity to contribute to all aspects of our project and to be involved in the new ECHO phase. Findings from this study will have important implications for informing interventions, prevention strategies and policies to ensure optimal health and well-being for all children.

摘要 近几十年来，儿童肥胖和神经发育障碍有所增加， 威胁儿童健康和福祉的普遍情况。这些条件的后果意味着 有必要确定可改变的因素，以针对上游预防。新出现的证据表明 产前暴露于心理困扰，物质使用和生活方式因素，在关键窗口期， 胎儿发育可在发育上规划儿童肥胖和神经发育（ND）。 然而，很少有研究采取多重暴露的方法来了解个体和关节 这些曝光的影响。在目标1中，我们将研究子宫内暴露于心理痛苦的作用 和物质使用对儿童生长、肥胖、肥胖和ND的影响，以及产前生活方式因素 并且邻近因素可以减轻这些关联。此外，虽然母亲的饮食和体力活动 影响婴儿生长和肥胖，很少有研究在不同人群中评估机制途径 但对它们对ND的影响知之甚少。我们提出了24小时运动曲线和代谢组学， 我们的生活方式的专门措施，肥胖和ND作为我们的专门结果。24小时 运动轮廓结合了基于设备的物理测量之间的相互依赖关系， 怀孕期间的活动和睡眠，以更好地为干预措施提供信息。代谢组学可以阐明 并将根据ECHO方案（产前）对收集的样本进行重复测量 血液、脐带血、产后儿童血液和母乳）。在目标2中，我们将阐明孕产妇的联合作用。 产前饮食模式和24小时运动与儿童生长、肥胖和ND以及是否 产前、出生时和出生后的代谢组学特征介导这些关联。对于目标1和2，我们 还将研究如何协会不同的邻里特点和婴儿出生时分配的性别。在 目标3我们将通过实施以证据为基础的战略， 让不同的群体参与临床研究，并实施ECHO队列方案， 质量控制方法和最佳做法。我们建议通过招募一名 来自Kaiser Permanente北方两个医疗中心的1,800名孕妇的不同队列 加州服务于多样化的人口（约70%的种族/少数民族群体，50%的人收入较低）， 怀孕的伴侣，他们产生的孩子，并在孩子出生后多次访问他们所有人。在Aim中 我们将探讨孕前母亲和父亲的生活方式因素对婴儿出生大小的作用， 关键时间段进行干预，以预防儿童肥胖和ND的上游风险因素。所有成员 我们多元化的研究团队将有平等的机会为我们项目的各个方面做出贡献， 参与新的ECHO阶段。这项研究的结果将对告知 这些措施、预防战略和政策旨在确保所有儿童的最佳健康和福祉。