ECHO-PROTECT Cohort Study Site in Puerto Rico

项目摘要 早期环境暴露对儿童健康和发育的影响是公众关注的一个重要领域。 没有一个群体，甚至几个群体，可以单独回答-特别是当与社会 健康决定因素（SDOH）可能会影响这些暴露并改变其效果。确定该 当考虑到这些暴露影响多种相互关联的健康时， 肥胖、神经发育和生殖发育等结果。ECHO-BACT队列 波多黎各（PR）的研究中心将利用丰富和大样本的优势，重点关注这些健康结局 国家ECHO队列的规模、多样性和纵向性质以及跨 ECHO财团。ECHO-BRONT将致力于创新研究，以（目标1）研究 SDOH对妊娠期母亲饮食和肥胖、儿童早期至中期儿童饮食和肥胖的影响， 以及母婴饮食与青春期开始的关系，并（目的2）确定 在子宫内和幼儿期接触环境化学品（单独和混合）之间， 神经发育和生殖发育，跨越幼儿期、幼儿期和青春期。 最重要的是，ECHO-BACT将建立在正在进行的PR（目标3）ECHO-BACT队列的基础上， 跟踪并收集参与当前ECHO的1，100名儿童的数据和生物标本- 同时招募另外1,200名怀孕的参与者，多生1,000名孩子， 来自波多黎各的共2,100名儿童向ECHO队列提供数据和生物标本， 得不到充分服务的高危人群拟议的1,200例新怀孕将包括至少125例 从500名潜在孕前患者队列中追踪有孕前数据的已完成妊娠（目标4） 参与者和他们的怀孕伴侣（如果有的话）。 ECHO-CBT研究将为ECHO的使命做出有意义的贡献， 这将丰富联盟范围内的数据，（B）关于SDOH影响的重要创新科学， 暴露于多种化学品对多种相互关联的健康结果的影响，如肥胖，神经发育， （c）领导和参与其他新的科学方向的专门知识 涉及暴露或生物反应的生物标志物，儿童大脑或生殖发育，以及统计学 方法与ECHO联盟合作，以回答有影响力和前沿的研究问题。 我们的研究结果将为未来的临床干预，风险评估和政策制定工作提供信息， 直接关系到波多黎各和美国普通民众的服务不足。

PROJECT SUMMARY The effect of early environmental exposures on child health and development is an important area of public health that no single cohort, or even a few, can answer alone – particularly when coupled with social determinants of health (SDOH) that may influence these exposures and modify their effects. Determining this effect becomes more challenging when considering that these exposures influence multiple interrelated health outcomes such as obesity, neurodevelopment and reproductive development. The ECHO-PROTECT Cohort Site in Puerto Rico (PR) will focus on these health outcomes, taking advantage of the rich and large sample size, diversity, and longitudinal nature of the national ECHO Cohort and multi-disciplinary expertise across the ECHO consortium. ECHO-PROTECT will contribute innovative research to (Aim 1) examine the influence of SDOH on maternal diet and obesity during pregnancy, child diet and obesity during early to middle childhood, and the relationship between maternal-child diet and onset of puberty and (Aim 2) determine the relationship between in utero and early childhood exposure to environmental chemicals, individually and as mixtures, and neurodevelopment and reproductive development, across early childhood, middle childhood, and adolescence. Most importantly, ECHO-PROTECT will build upon the ongoing ECHO-PROTECT cohort in PR (Aim 3) to follow up and collect data and biospecimens from the 1,100 children that are participating in the current ECHO- PROTECT cohort, as well as recruit an additional 1,200 pregnant participants, yielding 1,000 more children, for a total of 2,100 children contributing data and biospecimens to the ECHO Cohort from Puerto Rico – an underserved, highly-exposed population. The proposed 1,200 new pregnancies will include at least 125 completed pregnancies with preconception data (Aim 4), tracked from a cohort of 500 potential preconception participants and, if available, their conceiving partner. ECHO-PROTECT research will contribute meaningfully to ECHO’s mission, offering (a) an important cohort that will enrich consortium wide data, (b) significant, innovative science on the influence of SDOH and exposure to multiple chemicals on multiple interrelated health outcomes such as obesity, neurodevelopment, and reproductive development, and (c) expertise to lead and participate in additional new scientific directions involving biomarkers of exposure or biologic response, child brain or reproductive development, and statistical methods in collaboration with the ECHO consortium, to answer impactful and cutting-edge research questions. Results from our study will inform future clinical intervention, risk assessment and policy-setting efforts, with direct relevance to both the underserved population of Puerto Rico and the U.S. general population.