Early Life Determinants of Child Health: A New Denver-Based Cohort

项目总结 我们的总体目标是招募和跟踪一批新的孕妇及其伴侣，以实施 使用回声队列协议进行纵向数据收集，并领导先进的回声范围分析 了解孕前、产前和产后/哺乳期暴露的时间和方式 影响广泛的儿童健康结果。我们将引领以解决方案为导向的科学来针对不利的 可通过政策、计划和实践防止的环境暴露，并确定 对怀孕前、产前和产后期的积极影响，可以促进缓解 与不良的早期生命暴露相关的健康风险。我们将利用我们当地的调查人员和工作人员 招募孕妇、他们的受孕伴侣及其后代的专业知识，来自一个庞大的 联邦合格的卫生中心，为不同种族、民族和社会经济多样性的人口提供服务 科罗拉多州丹佛市。在目标1中，我们建议利用回声队列中核心数据元素的广度 回答以解决方案为导向的研究问题的协议，这些问题涉及早期生命暴露和 评估儿童健康结果，并确定可将风险降至最低的可改变的产前和产后因素。在……里面 目标2，我们建议实施新的和可扩展的专门措施来确定生物途径 父母和家庭生活方式因素以及早年的物理/化学环境与儿童肥胖之间的关系 和神经发育，并确定早期生命中这些暴露的敏感期。在目标3中，我们 描述我们招募和跟踪800多名怀孕妇女的不同队列的计划 伙伴和后代，并额外招募300多名参与者，后续很有可能 将怀孕纳入先入为主的研究。在目标4中，我们提出了利用数据元素的研究问题 在先入为主的时期收集，以确定对父母有不利影响的先入为主的暴露 儿童健康结果，并描述可能调节这些影响的分子标记。我们的专家团队 调查人员处于有利地位，可以为ECHO专门曝光的发展做出贡献 结果方案，并对设计和实施的预想先导研究。我们经验丰富的员工 和MPI团队将确保成功招募和实施ECHO队列协议，以提供 稳健的样本量和高质量的数据。我们将领导回声范围的分析来解决紧迫的问题 儿童健康和疾病的早期起源，并确定预防不良反应的潜在目标 环境暴露和促进早期生活中的保护因素。

PROJECT SUMMARY Our overarching goal is to recruit and follow a new cohort of pregnant people and their partners, to implement longitudinal data collection using the ECHO Cohort Protocol, and to lead ECHO-wide analyses that advance understanding of when and how exposures during preconception, prenatal, and postnatal/lactational periods influence a broad range of child health outcomes. We will lead solution-oriented science to target adverse environmental exposures that may be prevented through policy, programs, and practices, and to identify positive influences in the preconception, prenatal, and postnatal periods that may be promoted to mitigate health risks associated with adverse early-life exposures. We will leverage our local investigator and staff expertise to enroll pregnant people, their conceiving partners, and their offspring from a large network of Federally Qualified Health Centers serving a racially, ethnically, and socioeconomically diverse population in Denver, Colorado. In Aim 1, we propose to utilize the breadth of Core data elements in the ECHO Cohort Protocol to answer solution-oriented research questions regarding the link between early-life exposures and childhood health outcomes, and to identify modifiable prenatal and postnatal factors that may minimize risk. In Aim 2, we propose to implement novel and scalable Specialized measures to determine biological pathways linking parent and family lifestyle factors and the physical/chemical environment of early life with child obesity and neurodevelopment, and to identify susceptible periods for these exposures in early life. In Aim 3, we describe our plans to recruit and follow a diverse cohort of over 800 pregnant people with their conceiving partner and offspring, and to additionally enroll over 300 participants with a high probability of subsequent pregnancy into a preconception study. In Aim 4, we propose research questions that utilize data elements collected during the preconception period, to identify parental preconception exposures that adversely affect child health outcomes, and to describe molecular markers that may mediate these effects. Our team of expert investigators is well-positioned to contribute to the development of the ECHO specialized exposure and outcome protocols, and to the design and implementation the preconception pilot study. Our experienced staff and MPI team will ensure successful recruitment and implementation of the ECHO Cohort Protocol to provide a robust sample size and high-quality data. We will lead ECHO-wide analyses to address pressing questions in the early-life origins of child health and disease, and to identify potential targets for prevention of adverse environmental exposures and for promotion of protective factors in early life.