The Illinois Kids Development Study ECHO Pregnancy and Pediatric Cohort

项目摘要 这是一个有竞争力的续约申请（1），以继续跟踪伊利诺伊州儿童发展研究的儿童 （2）继续招募新的孕妇加入IKIDS- ECHO队列。我们持续招聘的一个关键目标是增加种族/民族和收入的多样性 通过与社区机构的新招聘合作伙伴关系-香槟-厄巴纳公共 健康区（CUPHD）和承诺医疗保健（我们当地的联邦合格的健康中心）-提供服务， 主要是低收入、种族和族裔多样化的孕妇群体。具体而言，我们建议 通过我们的合作伙伴关系，招募660名额外的孕妇（及其怀孕伴侣，如果有的话）， 在下一阶段的ECHO中，这两个实体。我们将在很大程度上依赖社区参与， 建立社区咨询委员会，以及焦点小组的反馈意见，以制定招聘和保留计划 有效保留我们现有的2级参与者和招募，注册， 保留新的怀孕参与者。这些参与者中的一个子集报告了中度到高度的可能性， 再次怀孕将被纳入计划的孕前试点研究。我们的科学目标是 在一系列ECHO概念文件中得到了解决，并将建立在我们以前调查 母亲产前压力或化学品暴露对出生结果和神经发育的影响。利用来自 多个ECHO队列将使我们能够应用最先进的混合方法来调查以下因素的影响： 多种化学和非化学应激源对出生结局（出生时胎龄;出生体重;肛门生殖器 距离）和儿童认知发展（来自NIH工具箱认知成套测验的特定领域;测量 语言发展）。我们还将使用新的方法来评估健康的母亲饮食的能力 以减轻这些风险对我们感兴趣的结果的负面影响。我们的假设是 产前应激源和/或化学品暴露共同影响儿童神经发育和出生 结果，这些影响可以通过健康的饮食来减轻。我们将使用多种产前检查方法 核心ECHO方案（目标1）、多种研究和新型邻苯二甲酸酯/替代品导致的心理社会压力 ECHO-WC-HHEAR新化学品分析（目标2）中的酚类或化学品和应激物 我们的混合模型。为了评估饮食的影响，我们将使用一种新的方法，其中我们将包括多个 使用既定的饮食质量指数计算的饮食成分，以及母亲的多种措施， 心理社会压力或多种化学物质，以了解饮食/压力或饮食/化学物质的累积效应 混合物，并评估健康饮食的特定成分是否可以减轻或消除 母亲压力或化学品暴露与儿童认知或出生结果。最后，一个探索性的目标将 评估母亲孕前压力源与（1）出生结局和（2）神经发育的关系 在婴儿时期。

PROJECT SUMMARY This is a competitive renewal application (1) to continue to follow children in the Illinois Kids Development Study (IKIDS) who are Level 2 participants in ECHO, and (2) to continue recruiting new pregnant women into the IKIDS- ECHO cohort. A key goal of our continued recruiting effort is to increase the racial/ethnic and income diversity of our cohort through new recruiting partnerships with community agencies – the Champaign-Urbana Public Health District (CUPHD) and Promise Health Care (our local federally qualified health center) – that serve a primarily low-income, racially and ethnically diverse population of pregnant women. Specifically, we propose to enroll 660 additional pregnant women (and their conceiving partners, if available) through our partnerships with these two entities during the next phase of ECHO. We will rely heavily on community engagement, input from an established Community Advisory Board, and feedback from focus groups to develop recruitment and retention strategies that are effective for both retaining our current Level 2 participants and recruiting, enrolling, and retaining new pregnant participants. A subset of these participants who report a moderate to high likelihood of becoming pregnant again will be enrolled in the planned preconception pilot study. Our scientific aims will be addressed in a series of ECHO Concept Papers and will build on our previous work investigating the impacts of maternal prenatal stress or chemical exposures on birth outcomes and neurodevelopment. Leveraging data from multiple ECHO cohorts will allow us to apply state-of-the-art mixtures methods to investigate the impact of multiple chemical and non-chemical stressors on birth outcomes (gestational age at birth; birth weight; anogenital distance) and child cognitive development (specific domains from the NIH toolbox cognitive battery; measures of language development). We will also use novel approaches to evaluate the ability of a healthy maternal diet to mitigate the negative impact of these exposures on our outcomes of interest. Our hypothesis is that multiple prenatal stressors and/or chemical exposures jointly impact child neurodevelopment and birth outcomes, and these impacts can be mitigated by a healthy diet. We will use multiple measures of prenatal psychosocial stress from the core ECHO protocol (Aim 1), multiple studied and novel phthalates/replacements and phenols from the ECHO-WC-HHEAR novel chemicals analysis (Aim 2) or both chemicals and stressors in our mixtures models. To assess the impact of diet, we will use a novel approach in which we will include multiple dietary components calculated using established diet quality indices, together with multiple measures of maternal psychosocial stress or multiple chemicals, to understand the cumulative effects of the diet/stress or diet/chemical mixture and to evaluate if particular components of healthier diets can lessen or negate adverse associations of maternal stress or chemical exposures with child cognition or birth outcomes. Lastly, an exploratory aim will evaluate associations of maternal preconception stressors with (1) birth outcomes and (2) neurodevelopment during infancy.