Environmental Influences on Child Health Outcomes (ECHO) and Pregnancy in Ohio

项目总结/摘要 ECHO俄亥俄州队列研究中心位于全国儿童医院和俄亥俄州州立大学Wexner 医疗中心（NCH-OSUWMC）将通过收集和提供有价值的数据为ECHO队列做出贡献 对参与的怀孕个体、怀孕伴侣和 因此，我们可以通过更好地了解世界各地的孕产妇和儿童健康， 怀孕前和怀孕期间的暴露如何影响儿童的结局。俄亥俄州近1/5的儿童生活在 贫困这一比例是非西班牙裔黑人儿童的两倍多。俄亥俄州中部是多样化的， 不断增长的移民人口，包括最大的尼泊尔族和第二大索马里难民人口， 美国;六分之一的哥伦布儿童的父母是移民。我们服务的患者不仅生活在城市， 郊区和俄亥俄州中部农村，但也在俄亥俄州东南部的阿巴拉契亚部分，宾夕法尼亚州，和 西弗吉尼亚我们所服务的社区在多项孕产妇和儿童健康福利方面排名很差 指标，强调迫切需要更好地了解围产期的环境影响， 在当地和全国造成不利的儿童后果。国家卫生中心-南方妇女监测办公室卫生系统高度重视 有丰富的经验，为涉及孕妇和儿童的大型多中心NIH研究做出了贡献， 准备贡献跨学科的领导力。我们在围产期保存了大量的临床资料， 调查和丰富的生物标本数据，从怀孕的人，他们的合作伙伴，他们的孩子超过十年。 我们的研究协调员和研究人员在招募怀孕个体方面经验丰富， 儿童进行研究调查和安全和有效地处理健康数据和生物标本。的 请注意，我们在保留高风险母婴二元组的不同亚群以及怀孕方面的记录 合作伙伴，后续行动是强有力的。我们提供评估怀孕期间生活方式暴露的具体专业知识， 最突出的是孕产妇心血管健康，以及产前、产中和产后健康方面的成果专门知识 儿童神经发育。我们建议：1）评估产妇心血管健康的影响， 使用美国心脏协会生命的基本8框架对儿童社会情绪 使用现有的ECHO队列方案核心数据元素和2） 研究，使用创新的方法（连续葡萄糖监测）， 围产期母亲的精神障碍模式和儿童的社会情绪发展和行为 同时评估新生儿人体测量学作为潜在的介质。我们建议评估相互作用 通过一项关联研究， 用估算的组学数据。在一个以先入为主为中心的目标中，我们建议检查孕产妇和 父亲的先入为主的心血管健康对社会情感发展和行为的影响。我们的贡献 向ECHO队列提供多样性和专业知识，将增加知识，从而改善儿童健康。

PROJECT SUMMARY / ABSTRACT The goal of the ECHO Ohio Cohort Site at Nationwide Children’s Hospital and The Ohio State University Wexner Medical Center (NCH-OSUWMC) is to contribute to the ECHO Cohort by collecting and providing valuable data on a diverse and often underserved population of participating pregnant individuals, conceiving partners, and children who live in our region, so we can improve maternal and child health everywhere by better understanding how exposures prior to and during pregnancy impact childhood outcomes. Nearly 1/5 of Ohio’s children live in poverty. The rate is more than twice that for non-Hispanic Black children. Central Ohio is diverse with a rapidly growing immigrant population including the largest ethnic Nepali and 2nd largest Somali refugee populations in the U.S.; 1 in 6 Columbus children have an immigrant parent. The patients we serve live not only in urban, suburban, and rural central Ohio, but also within Appalachian portions of southeast Ohio, Pennsylvania, and West Virginia. The communities we serve are ranked poorly across multiple maternal and child health well-being indicators, underscoring a critical need to better understand environmental influences in the perinatal period that contribute to adverse child outcomes both locally and nationally. The NCH-OSUWMC health system is highly experienced in contributing to large multicenter NIH studies involving pregnant individuals and children and well- poised to contribute interdisciplinary leadership. We have maintained a large perinatal repository of clinical, survey, and rich biospecimen data from pregnant individuals, their partners, and their children for over a decade. Our research coordinators and investigators are highly experienced in recruiting both pregnant individuals and children for research investigations and securely and efficiently processing health data and biospecimens. Of note, our track record in retaining diverse subpopulations of high-risk maternal/child dyads, as well as conceiving partners, for follow-up is strong. We provide specific expertise in evaluating lifestyle exposures in pregnancy, most prominently in maternal cardiovascular health, and outcomes expertise in pre-, peri-, and postnatal health and childhood neurodevelopment. We propose 1) evaluating the impact of maternal cardiovascular health during pregnancy using the American Heart Association Life’s Essential 8 framework on child socioemotional development and behavior to age 21, using existing ECHO Cohort Protocol core data elements and 2) investigating, using innovative methods (continuous glucose monitoring), the association between evolving maternal dysglycemia patterns across the peripartum period and child socioemotional development and behavior while evaluating neonatal anthropometrics as potential mediators. We propose to evaluate the interaction between genes and lifestyle exposures on socioemotional development via an association study complemented with imputed -omics data. In a preconception-focused aim, we propose examining the impact of maternal and paternal preconception cardiovascular health on socioemotional development and behavior. Our contributions to the ECHO cohort, providing diversity and expertise, will enhance knowledge leading to improved child health.