Early Life Determinants of Child Health: A New Denver-Based Cohort

项目摘要 我们的首要目标是招募和跟踪一批新的孕妇及其伴侣， 使用ECHO队列协议进行纵向数据收集，并领导ECHO范围内的分析， 了解孕前、产前和产后/哺乳期的暴露时间和方式 影响广泛的儿童健康结果。我们将引导以解决方案为导向的科学， 通过政策、计划和实践可以预防的环境暴露，并确定 在怀孕前，产前和产后时期的积极影响，可以促进减轻 健康风险与不利的早期生活暴露有关。我们会利用当地的调查员和工作人员 专业知识，招募怀孕的人，他们的怀孕伴侣，他们的后代从一个庞大的网络， 联邦合格的卫生中心为种族，民族和社会经济多样化的人口提供服务， 丹佛，科罗拉多。在目标1中，我们建议利用ECHO队列中核心数据元素的广度 回答关于生命早期暴露与健康之间联系的以解决方案为导向的研究问题的议定书 儿童健康结果，并确定可减少风险的可改变的产前和产后因素。在 目标2，我们建议实施新的和可扩展的专门措施，以确定生物途径 将父母和家庭生活方式因素以及早期生活的物理/化学环境与儿童肥胖联系起来 和神经发育，并确定这些暴露在生命早期的易感时期。在目标3中， 描述我们的计划，招募和跟踪800多名孕妇的不同队列， 伴侣和后代，并额外招募300多名参与者，随后很有可能发生 把怀孕变成了孕前研究在目标4中，我们提出了利用数据元素的研究问题 在孕前期间收集，以确定父母的孕前暴露， 儿童健康结果，并描述可能介导这些影响的分子标志物。我们的专家团队 研究者处于有利地位，可以为ECHO专业暴露的发展做出贡献， 结果协议，并设计和实施孕前试点研究。我们经验丰富的工作人员 和MPI团队将确保成功招募和实施ECHO队列方案， 强大的样本量和高质量的数据。我们将领导ECHO范围的分析，以解决以下紧迫问题： 儿童健康和疾病的早期起源，并确定预防不良疾病的潜在目标， 环境暴露和促进生命早期的保护因素。

PROJECT SUMMARY Our overarching goal is to recruit and follow a new cohort of pregnant people and their partners, to implement longitudinal data collection using the ECHO Cohort Protocol, and to lead ECHO-wide analyses that advance understanding of when and how exposures during preconception, prenatal, and postnatal/lactational periods influence a broad range of child health outcomes. We will lead solution-oriented science to target adverse environmental exposures that may be prevented through policy, programs, and practices, and to identify positive influences in the preconception, prenatal, and postnatal periods that may be promoted to mitigate health risks associated with adverse early-life exposures. We will leverage our local investigator and staff expertise to enroll pregnant people, their conceiving partners, and their offspring from a large network of Federally Qualified Health Centers serving a racially, ethnically, and socioeconomically diverse population in Denver, Colorado. In Aim 1, we propose to utilize the breadth of Core data elements in the ECHO Cohort Protocol to answer solution-oriented research questions regarding the link between early-life exposures and childhood health outcomes, and to identify modifiable prenatal and postnatal factors that may minimize risk. In Aim 2, we propose to implement novel and scalable Specialized measures to determine biological pathways linking parent and family lifestyle factors and the physical/chemical environment of early life with child obesity and neurodevelopment, and to identify susceptible periods for these exposures in early life. In Aim 3, we describe our plans to recruit and follow a diverse cohort of over 800 pregnant people with their conceiving partner and offspring, and to additionally enroll over 300 participants with a high probability of subsequent pregnancy into a preconception study. In Aim 4, we propose research questions that utilize data elements collected during the preconception period, to identify parental preconception exposures that adversely affect child health outcomes, and to describe molecular markers that may mediate these effects. Our team of expert investigators is well-positioned to contribute to the development of the ECHO specialized exposure and outcome protocols, and to the design and implementation the preconception pilot study. Our experienced staff and MPI team will ensure successful recruitment and implementation of the ECHO Cohort Protocol to provide a robust sample size and high-quality data. We will lead ECHO-wide analyses to address pressing questions in the early-life origins of child health and disease, and to identify potential targets for prevention of adverse environmental exposures and for promotion of protective factors in early life.