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

摘要 NIH 环境对儿童健康结果的影响 (ECHO) 计划旨在了解其影响 早期环境对儿童健康和发展的影响——特别强调学前、围产期、 和产后健康、上呼吸道和下呼吸道、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第一期罗切斯特-马吉奖 (UG3/UH3 OD023349) 是一个跟踪儿童至 4 岁的妊娠队列。在这个提案中， 对 ECHO 第二阶段的 RFA-OD-22-018 做出反应，我们将招募额外的怀孕者 对 375 例妊娠（前 5 年）进行队列研究，并对我们现有的 ECHO 进行儿科随访 队列 (12601) 和两个位于罗切斯特的 ECHO 队列，它们是第一阶段其他多站点奖项的一部分 ECHO：PROP/PRISM 和 TIDES-Rochester。将这两个额外的队列纳入我们的儿科随访中 up 计划增加了从第一阶段结转到第二阶段的 ECHO 队列数量 ECHO 并为我们的儿科随访创造了规模经济和效率。总的来说，我们的目标是 追踪罗切斯特三个综合 ECHO 队列中的 375 名儿童。 为了回应 RFA，我们提出了两个专门成果领域：神经发育和上部和 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，反映研究团队的专业知识和测量浓度和in- 与妊娠和儿科队列相关的深度数据。整个 UG3 和 UH3 阶段 在 ECHO 计划的第二阶段，我们将采取措施最大限度地保留现有参与者， 确保招募多样化的新怀孕/孕前参与者，并实施既定的 ECHO 高保真度的队列协议。我们还将领导新颖的、以解决方案为导向的研究，利用 ECHO 平台上已有的数据和利用我们专业领域的专业知识的研究 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.