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A South Carolina ECHO Pregnancy Cohort

南卡罗来纳州 ECHO 妊娠队列

基本信息

批准号：
10746617
负责人：
KELLY J HUNT
金额：
$ 83.32万
依托单位：
MEDICAL UNIVERSITY OF SOUTH CAROLINA
依托单位国家：
美国
项目类别：
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/10746617
关键词：
Adult Affect African Age Air Animals Argentina Asian Birth Black Populations Black race Characteristics Chemical Exposure Chemicals Child Child Development Childhood Conceptions Country Cuba Deep South Developing Countries Development Discipline of obstetrics Disease Disease model Disparity Egypt Enrollment Environmental Exposure Environmental Pollutants Environmental Risk Factor Ethnic Origin Exposure to Fetal Development Future Geography Goals Health Healthy People 2020 Heart Diseases Hispanic Hypertension Individual Infant Mortality Intervention Joints Latinx Lebanon Life Link Live Birth Maternal Mortality Measures Medicaid Medical Metabolic Mexico Mothers North America Not Hispanic or Latino Obesity Obstetric Delivery Occupations Outcome Pacific Islander Participant Perinatal Exposure Persons Population Population Heterogeneity Pregnancy Pregnancy Complications Pregnancy Outcome Premature Birth Protocols documentation Race Recording of previous events Recurrence Research Rest Risk Risk Factors Rural Rural Community Rural Population Site Slave Soil Source South Carolina Stress Stroke Stroke Belt Temperature United States National Institutes of Health Universities Vulnerable Populations Water Water Supply adult obesity burden of illness cardiometabolic risk cardiovascular risk factor cohort dietary early life exposure environmental chemical environmental stressor epidemiology study ethnic disparity ethnic diversity ethnic identity experience fetal geographic disparity health disparity in utero intrauterine environment meetings mortality obesity in children obesity risk obesity treatment offspring personal care products poor health outcome pregnancy disorder pregnant prenatal prenatal experience prenatal exposure prepregnancy obesity programs racial discrimination racial disparity racial diversity racial health disparity recruit research study social social vulnerability stroke incidence study population urban area

项目摘要

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.

摘要动物和流行病学研究表明，产前经历（例如，环境污染物增加，怀孕并发症、早产、压力、种族歧视）支持“发育起源"，健康和疾病模型在不良母亲经历与胎儿和儿童受损关系中的应用发展假设表明，发育窗口的可塑性肥胖编程在子宫内开始并持续到生命的头两年，强调了妊娠的巨大影响早期生活暴露和相应的有针对性的干预措施可能对终身肥胖风险有影响。电流肥胖干预可能是无效的，因为他们针对的是儿童或成年人，发展性编程发生。因为弱势群体往往是受辐射影响最大的群体，对于环境压力因素和不良健康结果，至关重要的是，研究将其包括在内。因此，我们提案的总体目标是增加ECHO队列的多样性。到为了实现这一目标，我们将从ECHO招募500多名孕妇及其后代，南卡罗来纳州医科大学（MUSC），并实施ECHO范围内的协议，包括专门的物理和化学暴露和儿童肥胖结果的组成部分。我们的招聘计划将包括50%的黑人、30%的白色/其他和20%的西班牙裔孕妇，其中一半孕妇 (and他们的怀孕伴侣）也有助于孕前队列。种族和民族多样性 MUSC产科人口（即，32%黑人; 53%白色; 12%西班牙裔; 2%亚洲/太平洋岛民），和大的递送群体（即，每年超过3，000人）将有助于实现我们的招聘目标。2022年， MUSC的46%的分娩由医疗补助覆盖，5.5%是讲西班牙语的母亲，进一步证明了我们研究人群中的高社会脆弱性。因为以前的研究往往是在城市地区进行的研究中，许多黑人居住的农村社区往往没有得到充分的研究。因此，作为南卡罗来纳州是美国南部腹地的一个农村州，人口出生率低，社会弱势群体多，人口问题历来研究不足，我们对欧共体人道处的贡献将产生重大影响。我们的目标与ECHO范围内的分析有关的是（1）确定产前接触化学品的联合影响混合物和早期妊娠期和生命期暴露（即，妊娠期高血压疾病、早产）儿童肥胖和代谢健康;（2）确定产前化学品暴露方面的种族/民族差异，他们的来源（饮食选择/机会，消费品和个人护理产品的使用，职业，空气/水）;和（3）确定前- 在患有高血压疾病的伴侣中测量的概念和围概念化学暴露，怀孕、早产和儿童肥胖。