Atlanta ECHO Pediatric Cohort: Examining -omics pathways from prenatal exposures to child neurodevelopment

摘要 美国黑人和其他种族和少数民族经历了更高水平的心理社会压力，并 暴露于独特的压力源，如歧视和结构性种族主义。产前心理社会应激 增加了一系列不利的孕产妇、围产期和儿童神经发育结果的风险。然而， 具有全国代表性的样本，具有孕产妇产前应激报告和预期数据 缺乏歧视和经核实的围产期和儿童健康结果，调查认为 反映面向解决方案的研究的风险和保护途径。Echo队列是前进的理想选择 关于母亲心理社会压力暴露、围产期风险途径和儿童的解决方案导向科学 作为议定书的健康结果包括产前压力的测量和受歧视的经历、社会 支持和凝聚力、产前健康行为(饮食、体力活动、睡眠、药物使用)、怀孕 并发症和分娩结局，以及社会人口统计学异质性的儿童健康结局， 全国样品。地理编码工作还使人们能够考虑结构性种族主义的地区一级措施， 允许根据NIMHD研究框架进行多层次、多领域的分析以进行调查 健康差距。我们寻求延长对我们的亚特兰大回声队列参与者在回声下的随访 并参与以解决方案为导向的团队科学。注册的儿童现在2至7岁，将 根据《回声议定书》进行年度访问，重点关注儿童神经发育 专门化成果领域。我们队列研究站点的独特贡献包括我们的跟踪能力 难以触及的种族和少数民族家庭(因为我们的队列完全由美国黑人家庭组成， 其中75%的人处于较低的社会经济地位)；我们的地理位置在世界上一个主要的大都市区 美国东南部经历了独特的区域和地区层面的压力(例如，种族隔离)；以及我们的 由心理社会、临床和经济学研究人员组成的多学科团队，具有(个性化)专业知识 暴露评估、母亲压力、围产期和分娩结果，以及儿童神经发育。鉴于我们的 团队的专业知识和初步数据，支持压力、组学途径和 关于神经发展，我们计划测试关于产前应激(包括种族压力)的新假设 歧视)导致代谢组、表观基因组和微生物组的扰动，以及它们是如何 反过来，生物学上的干扰会预测儿童的神经发育。我们还将测试种族因素的作用 Echo队列中儿童健康结果中的歧视经历以及可修改的调节因素 (产妇产前睡眠质量和产后抑郁症)和主持人(社会支持)，这将使 旨在改善儿童健康结果的潜在干预战略。

ABSTRACT Black Americans and other racial and ethnic minorities experience higher levels of psychosocial stress and are exposed to unique stressors, such as discrimination and structural racism. Prenatal psychosocial stress increases risk for a range of adverse maternal, perinatal and child neurodevelopmental outcomes. However, nationally representative samples with prospective data on maternal report of prenatal stress and discrimination and verified perinatal and child health outcomes are lacking, as are investigations that consider risk and protective pathways that reflect solution-oriented research. The ECHO Cohort is ideal for advancing solution-oriented science around maternal psychosocial stress exposures, perinatal risk pathways, and child health outcomes as the protocol includes measures of prenatal stress and experiences of discrimination, social support and cohesion, prenatal health behaviors (diet, physical activity, sleep, substance use), pregnancy complications and birth outcomes, and child health outcomes for a socio-demographically heterogenous, national sample. Geocoding efforts also enable the consideration of area level measures of structural racism, allowing for multi-level, multi-domain analyses in line with the NIMHD research framework for investigating health disparities. We seek to extend follow-up of our Atlanta ECHO Cohort participants under the ECHO Protocol and to participate in solution-oriented team science. Enrolled children are now 2 to 7 years old and will be followed with annual visits consistent with the ECHO Protocol, with a focus on child neurodevelopment as a specialized outcome area. The unique contributions of our Cohort Study site include our capacity to follow hard-to-reach racial and ethnic minority families (as our cohort is wholly composed of Black American families, 75% of whom are of lower socioeconomic status); our geographic location in a major metropolitan area in the US Southeast that experiences unique regional and area-level stressors (e.g., racialized segregation); and our multi-disciplinary team of psychosocial, clinical, and omic investigators with expertise in (personalized) exposure assessment, maternal stress, perinatal and birth outcomes, and child neurodevelopment. Given our team’s expertise, and preliminary data that supports an association between stress, omics pathways, and neurodevelopment, we plan to lead test novel hypotheses about how prenatal stress (including racial discrimination) leads to perturbations in the metabolome, epigenome and microbiome, and how these biological perturbations, in turn, predict child neurodevelopment. We will also test the role of racial discrimination experiences in children’s health outcomes in the ECHO cohort, as well as modifiable mediators (maternal prenatal sleep quality and postpartum depression) and moderators (social support) which will inform potential intervention strategies designed to improve children’s health outcomes.