A South Carolina ECHO Pregnancy Cohort

摘要 动物和流行病学研究表明，产前经历(例如，环境污染物升高， 妊娠并发症、早产、压力、种族歧视)支持 将不良母体经历与受损胎儿和儿童联系起来的健康和疾病模型 发展。假说表明，肥胖计划的可塑性发育窗口 在子宫中启动并延续到生命的头两年，强调了怀孕的巨大影响 早期生活暴露和相应的针对性干预可能会对终生肥胖风险产生影响。当前 肥胖干预可能无效，因为他们针对的是超过临界年龄的儿童或成年人 发展性编程就发生了。因为易受感染的人群往往是受影响最大的 对于环境应激源和不良的健康结果，研究将它们包括在内是至关重要的。 因此，我们建议的首要目标是增加回声队列的多样性。至 为了实现这一目标，我们将招募500多名孕妇及其后代进入ECHO从 南卡罗来纳医科大学(MUSC)并实施回声范围协议，包括专门 物理和化学暴露与儿童肥胖后果的成分。我们建议的招聘将 包括50%的黑人，30%的白人/其他人和20%的西班牙裔孕妇和一半的孕妇 (和他们的受孕伴侣)也是先入为主的群体的原因之一。中国的种族和民族多样性 南加州大学产科人口(即32%的黑人；53%的白人；12%的西班牙裔；2%的亚洲/太平洋岛民)， 而庞大的送货人数(即每年超过3,000人)将有助于实现我们的招聘目标。在2022年， 在MUSC，46%的分娩由医疗补助覆盖，5.5%的分娩是给讲西班牙语的母亲，提供 进一步证明了我们研究人群中高度的社会脆弱性。因为之前的研究往往是 在城市地区进行，许多黑人居住的农村社区往往没有得到充分的研究。因此，作为一个 南卡罗来纳州位于南部腹地的农村州，出生结果不佳，社会弱势群体 历史上对人口的研究不足，我们对ECHO的贡献将产生重大影响。我们的目标 与回声范围分析有关的是：(1)确定产前接触化学物质的联合影响 混合物和早期妊娠和生活暴露(即妊娠高血压疾病、早产) 儿童肥胖与代谢健康；(2)确定产前接触化学品的种族/民族差异以及 其来源(饮食选择/机会、消费品和个人护理产品的使用、职业、 空气/水)在回声队列中的参与者之间；以及(3)确定前 高血压病双方的概念性和概念性周围化学暴露测量 怀孕、早产和儿童肥胖。

ABSTRACT Animal and epidemiological studies show that prenatal experiences (e.g., elevated environmental pollutants, pregnancy complications, preterm birth, stress, racial discrimination) support the ‘developmental origins of health and disease’ model in relating adverse maternal experiences to compromised fetal and child development. Hypotheses suggest that the developmental window of plasticity for obesity programming initiates in utero and extends through the first two years of life, underscoring the large impact that gestational and early life exposures and corresponding targeted interventions may have on lifetime obesity risk. Current obesity interventions may be ineffective because they target children or adults past the critical age when developmental programming occurs. Because vulnerable populations are often the most impacted by exposure to environmental stressors and poor health outcomes, it is critical that research studies include them. Therefore, the overarching objective of our proposal is to increase the diversity of the ECHO Cohort. To achieve this goal, we will recruit over 500 pregnant persons and their resulting offspring into ECHO from the Medical University of South Carolina (MUSC) and implement the ECHO-wide protocol including specialized components on Physical & Chemical exposures and child Obesity outcomes. Our proposed recruitment will include 50% Black, 30% white/other and 20% Hispanic pregnant persons with half of the pregnant persons (and their conceiving partners) also contributing to the preconception cohort. The racial and ethnic diversity of the MUSC obstetrical population (i.e., 32% Black; 53% white; 12% Hispanic; and 2% Asian/Pacific Islander), and large delivery population (i.e., over 3,000 annually) will facilitate meeting our recruitment goals. In 2022, 46% of deliveries at MUSC were covered by Medicaid and 5.5% were to Spanish speaking mothers, providing further evidence of high social vulnerability in our study population. Because previous research has often been conducted in urban areas, rural communities where many Blacks reside are often understudied. Hence, as a rural state in the Deep South with poor birth outcomes and a socially vulnerable population, South Carolina’s population is historically understudied and our contribution to ECHO will have a major impact. Our aims pertaining to ECHO-wide analyses are (1) to determine the joint impact of prenatal exposure to chemical mixtures and early gestational and life exposures (i.e., hypertensive disorders of pregnancy, preterm birth) on child obesity and metabolic health; (2) to identify racial/ethnic disparities in prenatal chemical exposures and their sources (dietary choices/opportunities, use of consumer goods and personal care products, occupation, air/water) among participants in the ECHO cohort; and (3) to determine the association of mixtures of pre- conceptual and peri-conceptual chemical exposures measured in both partners with hypertensive disorders of pregnancy, preterm birth, and child obesity.