Early Determinants of Adult Health

描述（由申请人提供）：流行病学研究中出现了令人鼓舞的发现，表明产前阶段可能影响成年后的疾病风险。出生体重过轻受到特别关注;出生体重过轻可能会增加心血管和神经精神疾病的风险，出生体重过高可能会增加乳腺癌的风险。虽然令人感兴趣，但现有的关于出生体重和成人健康结局的文献尚未充分说明（1）家庭因素的潜在混淆;（2）其他胎儿生长指标的重要性;（3）潜在的生物学机制;（4）母体特征和暴露的独立影响;（5）出生后生长的贡献;（6）成人风险因素的潜在介导。 成人健康的早期决定因素（EDAH）计划项目将解决这些问题，采用综合方法调查三个研究项目中的成人健康的早期决定因素：心血管风险（CVD）项目，乳腺癌风险（BC）项目和神经精神（NP）项目。 我们将招募1959年至1967年期间入组两个出生队列的孕妇的后代：新英格兰队列（围产期合作项目的波士顿和普罗维登斯地点）和加州队列（儿童健康和发育研究）。这些后代现在35-43岁，这是开始测量中间标记物和跟踪成人疾病的理想年龄。这项研究的核心是兄弟姐妹样本，这将使我们能够控制家庭因素，如社会经济地位。兄弟姐妹样本由两个独生子女样本补充，其中包括高出生体重和暴露于先兆子痫的个体。总组合样本为2538个个体（同胞样本，2000个个体;高出生体重独生子女样本，350个个体;先兆子痫独生子女样本，178个个体）。 暴露信息将来源于前瞻性收集的母亲、婴儿和儿童生长的产前和产后数据，以及存档的母亲产前血清的血清学分析。我们将联合收割机将这些产前和产后数据与成人访谈和三个健康领域的临床数据相结合。 EDAH是一个跨出生队列，学术机构和科学领域的合作研究计划。因此，该计划项目将作为哥伦比亚和哈佛大学研究团队的合作伙伴进行，加州的研究人员也发挥了主导作用。除了CVD，BC和NP项目外，它还包括四个核心：行政和科学领导（ASL）核心，位置和评估（LA）核心，生物统计和数据管理（BDM）核心以及血清学/激素（S/H）核心。通过汇集各机构和科学学科的专业知识，并结合两个大型出生队列来实施一种新颖的设计，该研究提供了一个无与伦比的机会来回答有关慢性病早期前因的问题。

DESCRIPTION (provided by applicant): Tantalizing findings have emerged from epidemiologic studies to suggest that the prenatal period may influence disease risk in adult life. Birthweight has received particular attention; low birthweight may increase the risk of cardiovascular and neuropsychiatric diseases, high birthweight may increase risk of breast cancer. While intriguing, the existing literature on birthweight and adult health outcomes has not adequately addressed (1) potential confounding by family factors; (2) the importance of other measures of fetal growth; (3) potential biologic mechanisms; (4) the independent effect of maternal characteristics and exposures; (5) the contribution of postnatal growth; and (6) potential mediation by adult risk factors. The Early Determinants of Adult Health (EDAH) Program Project will address these issues using an integrative approach to investigate early determinants of adult health in three research projects: a cardiovascular risk (CVD) Project, a breast cancer risk (BC) Project, and a neuropsychiatric (NP) Project. We will recruit offspring of pregnant women who were enrolled during 1959 to 1967 in two birth cohorts: a New England cohort (Boston and Providence sites of the Collaborative Perinatal Project) and a California cohort (Child Health and Development Study). The offspring are now 35-43 years old--an ideal age to start measuring intermediate markers and following for adult diseases. The centerpiece of the study is a Sibling sample, which will enable us to control for family factors such as socioeconomic status. The Sibling sample is complemented by two Single Child samples which comprise individuals with high birthweight and with exposure to preeclampsia. The total combined sample is 2538 individuals (Sibling sample, 2000 individuals; high birthweight Single Child sample, 350 individuals; and Preeclampsia Single Child sample, 178 individuals). Exposure information will be derived from prospectively collected pre and postnatal data on mothers, infants, and childhood growth, as well as from serologic analysis of archived maternal prenatal sera. We will combine these pre and postnatal data with the adult interview and clinical data in the three health domains. The EDAH is a collaborative research program which cuts across birth cohorts, academic institutions, and scientific domains. Thus, the Program Project will be conducted as partnership of research teams at Columbia and Harvard Universities, with California investigators also playing a leading role. In addition to the CVD, BC, and NP Projects, it includes four Cores: the Administrative and Scientific Leadership (ASL) Core, the Location and Assessment (LA) Core, the Biostatistics and Data Management (BDM) Core, and the Serology/Hormone (S/H) Core. By bringing together expertise across institutions and scientific disciplines, and combining two large birth cohorts to implement a novel design, the study provides an unparalleled opportunity to answer questions about early antecedents of chronic disease.