Early Determinants of Adult Health

描述(由申请人提供)：流行病学研究表明，产前可能会影响成人生活中的疾病风险，这是一个诱人的发现。出生体重受到了特别的关注；低出生体重可能会增加心血管和神经精神疾病的风险，高出生体重可能会增加乳腺癌的风险。虽然耐人寻味，但现有的关于出生体重和成人健康结果的文献没有充分讨论(1)家庭因素的潜在混杂；(2)其他胎儿生长测量的重要性；(3)潜在的生物机制；(4)母亲特征和暴露的独立影响；(5)出生后发育的贡献；以及(6)成人风险因素的潜在调节作用。 成人健康早期决定因素(Edah)计划项目将在三个研究项目中使用综合方法来调查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)项目和神经精神病学(NP)项目。我们将招募1959至1967年间在两个出生队列中登记的孕妇的后代：一个新英格兰队列(波士顿和普罗维登斯合作围产期项目地点)和一个加州队列(儿童健康和发展研究)。后代现在35-43岁--这是开始测量中间标志物并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。兄弟姐妹样本得到两个独生子女样本的补充，其中包括出生体重较高和暴露于先兆子痫的个体。合并样本总数为2538人(兄弟姐妹样本，2000人；高出生体重儿独生子女样本，350人；先兆子痫独生子女样本，178人)。暴露信息将来自前瞻性收集的关于母亲、婴儿和儿童生长的产前和产后数据，以及对存档的孕妇产前血清的血清学分析。我们将把这些出生前和出生后的数据与成人访谈和三个健康领域的临床数据结合起来。 Edah是一个跨越出生队列、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大学和哈佛大学研究团队的合作伙伴进行，加州的研究人员也将发挥主导作用。除了CVD、BC和NP项目，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)核心和血清学/激素(S/H)核心。通过汇集跨机构和科学学科的专业知识，并将两个大型出生队列结合起来实施一种新颖的设计，这项研究提供了一个无与伦比的机会来回答有关慢性病早期先兆的问题。

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.