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局的影响(ECHO)计划试图了解这种影响 早期环境对儿童健康和发育的影响--特别强调 和出生后健康、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第一阶段的罗切斯特-马吉奖 (UG3/UH3OD023349)是一个跟踪儿童4岁的怀孕队列。在这份提案中， 对RFA-OD-22-018有反应的第二阶段的ECHO，我们将再招募一名孕妇 队列中的375名孕妇(前5年)，并对我们现有的ECHO进行儿科随访 COART(12601)和两个罗切斯特的ECHO队列，这是第一阶段其他多站点奖的一部分 回声：道具/棱镜和潮汐-罗切斯特。在我们的儿科随访中包括这两个额外的队列- UP计划增加从第一阶段结转到第二阶段的回声队列数量 并为我们的儿科后续行动创造规模经济和效率。总的来说，我们的目标是 在罗切斯特的三个合并的ECHO队列中跟踪375名儿童。 作为对RFA的回应，我们提出了两个领域的专门成果，神经发展&上和 下呼吸道/哮喘和两个特殊暴露领域，化学暴露和产前免疫 激活/炎症，反映研究团队的专业知识和测量浓度，以及- 与妊娠和儿科队列相关的深度数据。在UG3和UH3阶段 在ECHO计划的第二阶段，我们将制定最大限度地留住现有参与者的做法， 确保招募不同的新怀孕/先孕参与者，并执行既定的回应 高保真的队列协议。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的专业知识领域进行的研究 了解孕前、围产期和出生后早期暴露如何影响儿童的健康结果。

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.