Common Mechanisms linking Pre- and Post-Natal Exposures for Child Health Outcomes

摘要 美国国立卫生研究院环境对儿童健康结果的影响（ECHO）计划旨在了解 早期环境对儿童健康和发展的影响-特别强调产前、围产期、 和产后健康，上下呼吸道，神经发育，肥胖和积极健康-以及 加强这些领域的健康和发展。ECHO第一阶段的Rochester-Magee奖 (UG3/UH3 OD 023349）是随访儿童至4岁的妊娠队列。在这一提议中， 对ECHO第二阶段的RFA-OD-22 - 018有反应，我们将招募额外的妊娠 375例妊娠队列（前5年），并对我们现有的ECHO进行儿科随访 队列（12601）和两个基于罗切斯特的ECHO队列，这两个队列是第一阶段其他多中心奖励的一部分 回声：道具/棱镜和潮汐罗切斯特。包括这两个额外的队列在我们的儿科随访- 计划增加了从第一阶段结转到第二阶段的ECHO队列数量， ECHO为我们的儿科随访创造了规模经济和效率。我们共同的目标是 在三个统一的罗切斯特ECHO队列中跟踪了375名儿童。 为了响应RFA，我们提出了两个专门成果领域：神经发育和上神经发育， 下呼吸道/哮喘，以及两个专门暴露领域，化学品暴露和产前免疫 激活/炎症，反映了研究团队的专业知识和测量浓度， 与妊娠和儿科队列相关的深度数据。在整个UG3和UH3阶段， 在ECHO计划的第二阶段，我们将制定最大限度地保留现有参与者的做法， 确保招募不同的新怀孕/孕前参与者，并实施既定的ECHO 高保真队列协议。我们还将领导新颖的和以解决方案为导向的研究， ECHO平台上已有的数据以及利用我们专业领域的研究， 了解孕前、围产期和产后早期暴露如何影响儿童健康结果。

Abstract The NIH Environmental influences on Child Health outcomes (ECHO) Program seeks to understand the impact of early environmental influences on child health and development – with a special emphasis on Pre-, Peri-, and Postnatal Health, Upper and Lower Airways, Neurodevelopment, Obesity, and Positive Health – and to enhance these areas of health and development. The Rochester-Magee award in the first phase of ECHO (UG3/UH3 OD023349) was a pregnancy cohort that followed children through age 4 years. In this proposal, which is responsive to RFA-OD-22-018 for the second phase of ECHO, we will recruit an additional pregnancy cohort of 375 pregnancies (across the first 5 years) and conduct a pediatric follow-up of our existing ECHO cohort (12601) and two Rochester-based ECHO cohorts that were part of other multi-site awards in first phase of ECHO: PROP/PRISM and TIDES-Rochester. Including these two additional cohorts in our pediatric follow- up plans increases the number of ECHO cohorts that are carried forward from the first to the second phase of ECHO and creates economies of scale and efficiencies for our pediatric follow-up. Collectively, we aim to follow 375 children across the three consolidated Rochester-based ECHO cohorts. In response to the RFA, we propose two areas of specialized outcomes, Neurodevelopment & Upper and Lower Airways/Asthma, and two areas of specialized exposures, Chemical exposure & Prenatal Immune Activation/Inflammation, that reflect expertise of the research team and measurement concentration and in- depth data related to the pregnancy and pediatric cohorts. Throughout the UG3 and UH3 phases of the second phase of the ECHO program we will institute practices to maximize retention of existing participants, ensure recruitment of diverse new pregnant/preconception participants, and implement the established ECHO Cohort Protocol with high fidelity. We will also lead novel and solution-oriented research that capitalizes on the data already on the ECHO platform and research that takes advantage of our specialized areas of expertise to understand how pre-conception, perinatal, and early postnatal exposures shape child health outcomes.