A prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort Study

项目概要/摘要。在这次更新申请中，我们将推动环境保护的成功。 对儿童健康结果的影响方案，旨在“增强几代儿童的健康， 作为妊娠和儿科队列研究中心之一。自2009年以来，新罕布什尔州出生 队列研究是一项农村前瞻性分子流行病学研究，收集了以下方面的数据和生物样本： 孕妇及其子女，目标为6 000对夫妇（包括1 005名新孕妇和2 800名 同意加入ECHO的儿童）。数据和生物样本正在被利用， 概念提案（每个提案都有一份或多份手稿），包括机会和基础设施奖， 早期职业调查人员和COVID-19补充剂，以及更多正在筹备中的产品。已经有7,440名 队列中的生物样本已被提交给由我们的达特茅斯团队领导的11个ECHO范围的实验室分析 和其他调查员。这包括ECHO全基因组关联研究，大多数参与者 正在提供DNA样本非DNA生物样本可用或正在运送至ECHO 生物储存物包括尿液、脚趾甲、毛发、血液、胎盘、胎粪、母乳、粪便和牙齿。我们带 参与ECHO项目领导、委员会和工作组，设计和共享协议，以及 制作教学视频和参与者反馈材料。我们回应了卫生公平的紧急呼吁， 促进劳动力多样性，优先处理公共卫生危机，包括对SARS的时间敏感评估- COV-2对我们最脆弱的人群。我们致力于在下一阶段加强这些努力。 我们回应了国会和机构利益相关者以及医疗保健提供者和家庭， 我计划进一步加强这种参与，以确保我们的团队具有多样化的观点和包容性， 我们工作的影响。我们会再招募1,500名孕妇，招募她们的怀孕伴侣， 如果计划另一个孩子并跟随先前累积到队列中的孩子， 在这个学习阶段诞生的。我们将坚持ECHO队列方案，依靠该计划的REDCap 中央数据库和单一IRB。我们将继续利用ECHO前所未有的数据和样本 沿着达特茅斯强大的基础设施和跨学科的 专业知识具体而言，我们将（1）通过描述农村的麻烦及其 对儿童健康结果的影响，（2）确定下呼吸道和上呼吸道疾病的早期驱动因素以及其他 结果和使用专门的暴露测量的发育中的微生物组的介导作用（例如， 膳食营养素-毒物组成）和结果（例如，呼吸道感染和疫苗反应），以及（3） 探讨孕期肥胖及妊娠伴侣因素对儿童生长发育的影响 使用的是飞行员的先入之见队列。因此，我们的研究中心填补了ECHO计划中的关键利基，并将 继续提供领导和协作，以支持其总体使命。

Project Summary/Abstract. In this renewal application, we will advance the success of the Environmental Influences on Child Health Outcomes program that seeks to “enhance the health of children for generations to come” as one of the Pregnancy and Pediatric Cohort Study Sites. Since 2009, the New Hampshire Birth Cohort Study, a rural prospective molecular epidemiology study, has accrued data and biologic samples on pregnant people and their children with a goal of 6,000 dyads (including 1,005 new pregnancies and 2,800 children consented into ECHO) by August 2023. Data and biospecimens are being leveraged for nearly 100 Concept Proposals (each with one or more manuscripts), including Opportunity and Infrastructure awards to early career investigators and COVID-19 supplements, and with more in the pipeline. Already, 7,440 of our cohort’s biospecimens have been committed to 11 ECHO-Wide laboratory analyses led by our Dartmouth team and other investigators. This includes the ECHO Genome Wide Association Study to which most participants are contributing DNA samples. Non-DNA biologic samples available or being shipped to the ECHO Biorepository include urine, toenails, hair, blood, placenta, meconium, human milk, stool, and teeth. We took part in ECHO program leadership, committees and working groups, designing and sharing protocols, and creating instructional videos and participant feedback materials. We addressed the urgent call for health equity, fostered workforce diversity, and prioritized public health crises, including time sensitive evaluation of SARS- CoV-2 on our most vulnerable populations. We are committed to strengthening these efforts in the next phase. We responded to congressional and agency stakeholders as well as health care providers and families and plan to elevate this engagement moving forward to ensure diverse perspectives and inclusion in our cohort and impact of our work. We will recruit 1,500 additional pregnant people, enlist their conceiving partner, enroll them into a preconception cohort if planning another child and follow children previously accrued into the cohort and newly born in this study phase. We will adhere to the ECHO Cohort Protocol, rely on the program’s REDCap Central database and single IRB. We will continue to capitalize on ECHO’s unprecedented data and samples from diverse populations across the USA, along with Dartmouth’s robust infrastructure and interdisciplinary expertise. Specifically, we will (1) address rural health inequities by characterizing the rural exposome and its impact on child health outcomes, (2) determine the early drivers of lower and upper airway disease and other outcomes and the mediating role of the developing microbiome using specialized measures of exposures (e.g., dietary nutrient-toxicant composition) and outcomes (e.g., respiratory infections and vaccine response), and (3) investigate the influence of inter-pregnancy adiposity and factors of the conceiving partner on child growth using the pilot preconception cohort. Thus, our study site fills a critical niche in the ECHO program and will continue to provide leadership and collaboration in support of its overall mission.