Atlanta ECHO Pediatric Cohort: Examining -omics pathways from prenatal exposures to child neurodevelopment

摘要 美国黑人和其他种族和少数民族经历更高水平的心理社会压力， 面临独特的压力源，如歧视和结构性种族主义。产前心理社会应激 增加了一系列不利的孕产妇、围产期和儿童神经发育结果的风险。然而，在这方面， 具有全国代表性的样本，关于产妇产前压力报告的前瞻性数据， 缺乏歧视和经核实的围产期和儿童健康结果， 反映以解决方案为导向的研究的风险和保护途径。ECHO队列是推进 以解决方案为导向的科学围绕孕产妇心理社会压力暴露，围产期风险途径和儿童 健康结果，因为议定书包括产前压力和歧视经历的措施， 支持和凝聚力，产前健康行为（饮食，体力活动，睡眠，物质使用），怀孕 并发症和分娩结局，以及社会人口统计学异质性的儿童健康结局， 全国抽样。地理编码工作还有助于考虑在地区一级衡量结构性种族主义， 允许根据NIMHD研究框架进行多层次、多领域分析， 健康差距。我们寻求根据ECHO延长对亚特兰大ECHO队列参与者的随访 协议和参与解决方案为导向的团队科学。入学的儿童现在是2至7岁， 遵循ECHO协议，每年进行一次访视，重点关注儿童神经发育， 专业成果领域。我们的队列研究中心的独特贡献包括我们的能力， 难以接触的种族和少数民族家庭（因为我们的队列完全由美国黑人家庭组成， 75%的人是较低的社会经济地位）;我们的地理位置在一个主要的大都市区， 美国东南部经历着独特的区域和地区层面的压力源（例如，种族隔离）;我们的 由社会心理学、临床和组学研究人员组成的多学科团队，具有（个性化） 暴露评估、母亲压力、围产期和出生结果以及儿童神经发育。鉴于我们 团队的专业知识和初步数据，支持压力，组学途径， 神经发育，我们计划领导测试关于产前压力（包括种族）如何影响神经发育的新假设。 歧视）导致代谢组，表观基因组和微生物组的扰动，以及这些扰动如何影响代谢组，表观基因组和微生物组。 生物学上的扰动反过来又能预测儿童的神经发育。我们还将测试种族的作用 ECHO队列中儿童健康结果的歧视经历，以及可改变的中介 （产妇产前睡眠质量和产后抑郁症）和主持人（社会支持），这将告知 旨在改善儿童健康结果的潜在干预战略。

ABSTRACT Black Americans and other racial and ethnic minorities experience higher levels of psychosocial stress and are exposed to unique stressors, such as discrimination and structural racism. Prenatal psychosocial stress increases risk for a range of adverse maternal, perinatal and child neurodevelopmental outcomes. However, nationally representative samples with prospective data on maternal report of prenatal stress and discrimination and verified perinatal and child health outcomes are lacking, as are investigations that consider risk and protective pathways that reflect solution-oriented research. The ECHO Cohort is ideal for advancing solution-oriented science around maternal psychosocial stress exposures, perinatal risk pathways, and child health outcomes as the protocol includes measures of prenatal stress and experiences of discrimination, social support and cohesion, prenatal health behaviors (diet, physical activity, sleep, substance use), pregnancy complications and birth outcomes, and child health outcomes for a socio-demographically heterogenous, national sample. Geocoding efforts also enable the consideration of area level measures of structural racism, allowing for multi-level, multi-domain analyses in line with the NIMHD research framework for investigating health disparities. We seek to extend follow-up of our Atlanta ECHO Cohort participants under the ECHO Protocol and to participate in solution-oriented team science. Enrolled children are now 2 to 7 years old and will be followed with annual visits consistent with the ECHO Protocol, with a focus on child neurodevelopment as a specialized outcome area. The unique contributions of our Cohort Study site include our capacity to follow hard-to-reach racial and ethnic minority families (as our cohort is wholly composed of Black American families, 75% of whom are of lower socioeconomic status); our geographic location in a major metropolitan area in the US Southeast that experiences unique regional and area-level stressors (e.g., racialized segregation); and our multi-disciplinary team of psychosocial, clinical, and omic investigators with expertise in (personalized) exposure assessment, maternal stress, perinatal and birth outcomes, and child neurodevelopment. Given our team’s expertise, and preliminary data that supports an association between stress, omics pathways, and neurodevelopment, we plan to lead test novel hypotheses about how prenatal stress (including racial discrimination) leads to perturbations in the metabolome, epigenome and microbiome, and how these biological perturbations, in turn, predict child neurodevelopment. We will also test the role of racial discrimination experiences in children’s health outcomes in the ECHO cohort, as well as modifiable mediators (maternal prenatal sleep quality and postpartum depression) and moderators (social support) which will inform potential intervention strategies designed to improve children’s health outcomes.