The Environmental Factors in FEtal to Childhood Trajectories Cohort

项目摘要/摘要 环境对儿童健康结局的影响(ECHO)儿科队列计划于2016年启动， 汇集了30多个现有的队列，以调查广泛的早期接触在 五个关键的儿童健康结果。Echo现在正在扩大范围，包括从怀孕开始的新队列。我们 建议招募环境因素在胎儿期轨迹影响队列中参与 回声计划。影响将是2800名孕妇、他们的伴侣和他们的 在纽约州南部招募的儿童超过7年。我们这群人的科学前提是 在孩子出生前影响父母双方的健康决定因素(SDoH)在 儿童肥胖的发展。我们的具体目标是： 目的1：检验宫内化学物质和母体心理社会暴露在 怀孕相互作用，创造不同的童年成长轨迹(生长潜伏期和生长 从出生到5岁)。我们将利用在ECHO核心下收集的调查和生物标志物数据 宫内同时接触邻苯二甲酸酯和母体应激对儿童影响的模拟方案 增长轨迹。 目标2：测试早期暴露于不良社会健康决定因素(SDoH)的假设 与较高的儿童肥胖率有关，而且这种联系因种族/民族而异 背景资料。我们将利用专门的暴露数据(心理社会环境)和专门的成果 数据(肥胖)，以检验暴露在父母物质困难和心理社会脆弱性中的假设 与较高的儿童肥胖率有关，特别是对少数群体的儿童。 目标3：招募和保留2800个家庭组成的强大、多样化的队列，并实施回声方案 保真度很高。我们将与我们极其多样化的患者群体合作，并利用创新 以参与者为中心的技术支持，以及承诺的社区参与，以实现这一目标。 探索性目标4：测量先入为主的生理和心理因素的直接和交互作用 心理社会暴露对儿童体重结果的影响。我们将衡量PRE的直接和交互影响 受孕、肥胖和照料者接受社会支持对儿童肥胖风险的早期生活测量。 我们建议的队列和研究团队完全可以满足ECHO计划的当前需求： 1)解决优先解决的科学问题；2)增加登记怀孕的人数 参与者；3)促进非妊娠父母的登记；4)促进收集成见 数据；5)增加回声队列的种族、民族和社会经济多样性；6)增加 研究人员的种族、民族、职业阶段和专业背景的多样性。

PROJECT SUMMARY / ABSTRACT The Environmental influences on Child Health Outcomes (ECHO) Pediatric Cohorts program launched in 2016, bringing together more than 30 extant cohorts to investigate the roles of a broad range of early exposures on five key child health outcomes. ECHO is now expanding to include new cohorts starting in pregnancy. We propose to recruit the Environmental Factors in FEtal to Childhood Trajectories EFFECT cohort to participate in the ECHO program. EFFECT will be a prospective birth cohort of 2,800 pregnant people, their partners, and their children recruited in southern New York State over 7 years. The scientific premise of our cohort is that social determinants of health (SDoH) impacting both parents before a child’s birth play a significant role in the development of child obesity. Our Specific Aims are: Aim 1: Test the hypothesis that in-utero chemical and maternal psychosocial exposures during pregnancy interact to create differential childhood growth trajectories (growth latency and growth spurts) from birth to age 5. We will leverage survey and biomarker data collected under the ECHO core protocol to model the impact of concurrent in utero exposure to phthalates and maternal stress on childhood growth trajectories. Aim 2: Test the hypothesis that early life exposure to adverse social determinants of health (SDoH) are associated with higher rates of child obesity and that this association varies by racial/ethnic background. We will leverage specialized exposure data (psychosocial environment) and specialized outcome data (obesity) to test the hypothesis that exposure to parental material hardships and psychosocial vulnerabilities is associated with higher rates of child obesity, particularly for children from minority groups. Aim 3: Recruit and retain a robust, diverse cohort of 2,800 families and implement the ECHO protocol with high fidelity. We will partner with our extremely diverse patient population and leverage innovative participant-centric technological support as well as committed community engagement to achieve this Aim. Exploratory Aim 4: To measure the direct and interactive effects of preconception physiologic and psychosocial exposures on child weight outcomes. We will measure the direct and interactive effects of pre- conception adiposity and caregiver receipt of social support on early life measures of child obesity risk. Our proposed cohort and study team are perfectly positioned to meet the current needs of the ECHO program: 1) to address solution-oriented scientific questions of high priority; 2) to increase the number of enrolled pregnant participants; 3) to facilitate the enrollment of the non-gestational parent; 4) to facilitate collection of preconception data; 5) to increase the racial, ethnic, and socioeconomic diversity of the ECHO cohort; and 6) to increase diversity in race, ethnicity, career stage, and professional background of the research workforce.