Prenatal Exposures and Child Health Outcomes 2: Increasing ECHO Urban and Rural Diversity

项目摘要 这份申请来自密歇根州的一个机构联盟，该联盟参与了 回声计划。ARCH队列的参与者是在第一次产前访问时登记的，主要是在密歇根州的兰辛， 2008-2016年间，其中532家成功同意参与ECHO，其中85% 每年的后续访问都是最新的。2016年，我们将招聘范围扩大到另外20个诊所。 我们在第一次产前访问时再次招募，并创建了3月份的队列，这是一个分层的随机样本 出生在密西西比州的下半岛。我们的目标是在全州范围内对1000名新生儿进行抽样，然后选择登记 密歇根州弗林特的另外100名新生儿和我们目前3月份的总研究人群同意ECHO(Level 2名参与者)包括1,084名孕妇和955名新生儿。我们预计将招收1100名孕妇 到2022年底，到2023年8月31日出生1100人。我们的随访率为一年(86%)、两年 (75%)和三年(76%)超过了婴儿/早期儿童随访研究中常见的情况。我们会 通过与其他ECHO队列合作完成以下目标，进一步为ECHO科学做出贡献： 目的1.使用在ECHO核心方案中收集的数据，我们将调查a)微量营养素水平的影响 孕期；b)婴儿早期喂养模式和肠道微生物群；c)早期生活中的逆境 母亲、家庭和邻里压力的交叉水平，所有这些都与我们的专业结果有关， 神经发育。目标2.使用通过专门方案收集的数据，我们将研究混合物的影响 孕期全氟和多氟烷基物质、邻苯二甲酸盐和重金属对儿童体重的影响 指数、代谢功能和神经发育。在这个目标中，我们将把肠道微生物群作为一种 潜在影响调节剂/修改剂。目标3。我们将跟踪1600多名来自我们的 目前的队列，并招募另外540名孕妇生产450名活产同意回声。我们还瞄准了 为预计450名活产婴儿中的大约225名母亲登记，以便从 我们预计他将招募67名后续儿童，以产生约2200名密歇根州的总研究样本 母子配对。新招募的孕妇将全部来自以非裔美国人为主的城市 (底特律和弗林特)或密歇根州北部服务不足的农村社区，以促进规模和多样性 在整个回声队列中。目标4.我们将检查男性受孕前暴露于加速精子的情况 表观遗传老化对后代神经发育和肥胖的影响，并检验我们 可以识别前循环血浆中细胞外预条件分泌组的特征 与反复早产风险增加相关的受孕妇女。当我们有了 完成了我们对孕妇及其子女的招募和详细评估，并 在可行的情况下，我们将能够为联合国系统的总体目标作出重大贡献 ECHO计划，包括扩大ECHO队列的多样性，并为全ECHO科学做出贡献。

Project Summary This application is from a coalition of Michigan institutions that participated in the first UG3 and UH3 phases of the ECHO program. Participants in the ARCH cohort were enrolled at first prenatal visit, largely in Lansing, MI, between 2008 – 2016, 532 of whom were successfully consented for participation in ECHO, and 85% of whom are up to date on their annual follow-up visits. In 2016, we expanded recruitment to 20 additional clinics sites. We again recruited at first prenatal visit and created the MARCH cohort, which is a stratified random sample of births in the lower peninsula of MI. We aimed for a statewide sample of 1,000 births and then chose to enroll an additional 100 births in Flint, MI, and our current total MARCH study population consented to ECHO (Level 2 participants) consists of 1,084 pregnancies and 955 births. We anticipate having enrolled 1,100 pregnancies by the end of 2022, and 1,100 births by August 31, 2023. Our follow-up rates at one year (86%), two years (75%) and three years (76%) exceed what is commonly found in infant/early child follow up studies. We will further contribute to ECHO science by completing the following aims in collaboration with other ECHO cohorts: Aim 1. Using data collected in the ECHO core protocol, we will investigate the effects of a) micronutrient levels in pregnancy; b) early infancy feeding patterns and the gut microbiome; and c) early life adversity at multiple intersecting levels of maternal, family, and neighborhood stressors, all in relation to our specialized outcome, neurodevelopment. Aim 2. Using data collected in a specialized protocol, we will study the effects of mixtures of per- and polyfluoroalkyl substances (PFAS), phthalates and heavy metals in pregnancy on child body mass index, metabolic function, and neurodevelopment. In this aim as well, we will examine the gut microbiome as a potential effect mediator/modifier. Aim 3. We will follow the more than 1,600 ECHO participants from our current cohorts and recruit another 540 pregnancies to yield 450 live births consented to ECHO. We also aim to enroll approximately 225 mothers of the anticipated 450 live births for pre-conceptional data collection from whom we anticipate enrolling 67 subsequent children to produce a total study sample of some 2,200 Michigan mother/child pairs. Newly recruited pregnancies will all be from either dominantly African American cities (Detroit and Flint) or underserved rural communities in northern Michigan to contribute to the size and diversity of the overall ECHO cohort. Aim 4. We will examine preconception exposures in men that accelerate sperm epigenetic aging for their effects on offspring neurodevelopment and obesity and test the hypothesis that we can identify a signature of the extracellular preconditioned secretome in the circulating plasma of pre- conceptional women that is associated with an increased risk of recurrent preterm birth. When we have completed our recruitment and detailed assessments of pregnant women, their children, and conceiving partners where feasible, we will be able to make a very substantial contribution to the overall goals of the ECHO program, including enlarging the diversity of the ECHO Cohort and contributing to ECHO-wide science.