Prenatal Environment And Child Health (PEACH) in ECHO

ECHO 中的产前环境和儿童健康 (PEACH)

• 批准号: 10746727
• 负责人: Rebecca Jean Schmidt
• 金额: $ 127.36万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 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/10746727
• 关键词: Address; Affect; Age; Assessment tool; Attention deficit hyperactivity disorder; Attenuated; Behavior; Behavioral; Biological; Blood; California; Chemicals; Child; Child Behavior Checklist; Child Health; Clinical; Clinical assessments; Communities; Community Outreach; Conceptions; Data; Development; Developmental Delay Disorders; Disparity; Dose; Educational Activities; Ensure; Environment; Environmental Epidemiology; Environmental Exposure; Environmental Pollutants; Epigenetic Process; Ethnic Origin; Exposure to; Family; First Pregnancy Trimester; Folic Acid; Food; Genetic; Grain; Guidelines; Health; Health Policy; Heavy Metals; Hispanic Populations; Intake; Intervention; Link; Measures; Mediating; Neural Tube Defects; Neurodevelopmental Disorder; Nutritional; Outcome; Participant; Pathway interactions; Persons; Placenta; Plasticizers; Policies; Population Heterogeneity; Prevalence; Preventive measure; Problem behavior; Protocols documentation; Psychosocial Stress; Public Health; Quality of life; Race; Recommendation; Research; Resources; Risk; Shapes; Site; Social Functioning; Subgroup; Translations; Underrepresented Populations; United States National Institutes of Health; Visit; Work; autism spectrum disorder; autistic; behavioral outcome; cohort; community engagement; executive function; experience; flexibility; folic acid supplementation; fortification; high risk; improved; in utero; innovation; language outcome; novel; nutritional epidemiology; people of color; perceived discrimination; personal care products; pregnant; prenatal; prenatal exposure; programs; racial diversity; randomized trial; recruit; reproductive epidemiology; social; socioeconomics; success; trait

Prenatal Environment And Child Health (PEACH) in ECHO Abstract Few modifiable factors have been identified that improve neurodevelopmental (ND) outcomes. One such factor, supplemental folic acid (SFA), taken before and during the first weeks post-conception, reduced risk for neural tube defects (NTDs) by up to 70% in randomized trials, initiating mandatory food grain fortification and guidelines for SFA intake for people who could or had become pregnant, with subsequent increases in blood folate concentrations and reduced NTD prevalence. While generally regarded as a public health success, the impacts have not been evenly distributed across sub-populations within the US, with Hispanic populations at higher risk for NTDs, more likely to have suboptimal folate status, and less likely to take SFA. Further, the biologic mechanisms behind this protection remain unclear. Prenatal SFA and adequate folate status has since been associated with improved behavioral and language outcomes, higher executive functioning, and reduced risk for attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and associated traits. High folate/SFA has also been shown to attenuate increased risks associated with several contaminant exposures that are more prevalent in groups that are under-represented in research and/or more likely to have sub-optimal folate status and less likely to meet SFA intake recommendations. One example includes plasticizers in personal care products that are more prevalent in Hispanic populations and are linked to increased ND risk which is attenuated with prenatal SFA. Many gaps in understanding and implementation of SFA measures need to be addressed to increase the public health impact of SFA interventions to their fullest potential: 1) How does the timing of SFA initiation and its association with blood folate differ across subpopulations? 2) What other child health outcomes are associated with prenatal SFA and blood folate? 3) How do these associations differ by the timing and dose of SFA intake? 4) How do doses and timing of SFA and folate concentrations linked with improved child outcomes differ across people with different genetic, environmental, and nutritional backgrounds? 5) Does periconceptional SFA/folate status modify associations between environmental contaminants, including novel chemicals, and ND outcomes including behavioral problems and high autistic traits? 6) What biologic pathways are modified in utero by periconceptional SFA and suboptimal folate status? 7) How do those biologic pathways relate to known ND pathways? 8) How does the conceiving partner's preconception folate status relate to placenta epigenetics and the child's outcomes? Our strong team with relevant expertise in reproductive, environmental and nutritional epidemiology, interactions, epigenetics and ND assessment, plus ample experience engaging community partners, will recruit 740 expecting families in Northern California representing diverse racial, ethnic, socioeconomic, genetic and environmental backgrounds to enrich the ECHO cohort with participants traditionally underrepresented in research to address these gaps and produce findings that will substantially inform public health policies for more effective improvement of child developmental outcomes.

ECHO 中的产前环境和儿童健康 (PEACH) 抽象的 几乎没有发现可以改善神经发育（ND）结果的可改变因素。其中一个因素， 补充叶酸（SFA），在受孕前和受孕后第一周内服用，可降低神经系统疾病的风险 随机试验中管缺陷 (NTD) 高达 70%，启动强制性食品谷物强化和指南 对于可能或已经怀孕的人来说，摄入 SFA 会导致血液叶酸含量增加 浓度并降低 NTD 患病率。虽然通常被认为是公共卫生方面的成功，但其影响 美国境内各亚人群的分布并不均匀，西班牙裔人群的风险更高 对于 NTD，更有可能叶酸状态欠佳，并且不太可能服用 SFA。此外，生物 这种保护背后的机制仍不清楚。此后，产前 SFA 和充足的叶酸状态已被 与改善行为和语言结果、提高执行功能以及降低风险相关 注意力缺陷/多动障碍 (ADHD)、自闭症谱系障碍 (ASD) 和相关特征。高的 叶酸/SFA 还被证明可以减轻与多种污染物暴露相关的风险增加 在研究中代表性不足和/或更有可能处于次优状态的群体中更为普遍 叶酸状况，不太可能达到 SFA 摄入量建议。一个例子包括个人用品中的增塑剂 护理产品在西班牙裔人群中更为普遍，并且与 ND 风险增加有关， 产前 SFA 减弱。对 SFA 措施的理解和实施方面存在许多差距，需要予以纠正 旨在最大限度地发挥 SFA 干预措施对公共卫生的影响：1) SFA 开始的时间及其与血液叶酸的关系在不同亚群中是否有所不同？ 2）还有什么孩子 健康结果与产前 SFA 和血液叶酸有关吗？ 3) 这些协会有何不同 摄入SFA的时间和剂量？ 4) SFA 的剂量和时间以及叶酸浓度如何与 对于具有不同遗传、环境和营养背景的人来说，改善的儿童结局会有所不同吗？ 5) 围孕期 SFA/叶酸状态是否会改变环境污染物之间的关联，包括 新型化学物质和 ND 结果（包括行为问题和高度自闭症特征）？ 6）什么生物制剂 围孕期 SFA 和次优叶酸状态是否会在子宫内改变途径？ 7）那些生物制剂如何 途径与已知的 ND 途径相关吗？ 8) 受孕伴侣的孕前叶酸状况有何关系 胎盘表观遗传学和孩子的结局？我们强大的团队在生殖、 环境和营养流行病学、相互作用、表观遗传学和 ND 评估，以及充足的 经验丰富的社区合作伙伴，将招募 740 名北加州的待产家庭代表 不同的种族、民族、社会经济、遗传和环境背景，以丰富 ECHO 群体 传统上参与者在研究中的代表性不足，以解决这些差距并产生将有助于 为公共卫生政策提供实质性信息，以更有效地改善儿童发展成果。