Prenatal Fatty Acid Supplementation and Early Childhood Asthma and Atopy in Black American Families

美国黑人家庭产前脂肪酸补充剂与儿童早期哮喘和特应性

基本信息

批准号：
10586398
负责人：
Christina Elizabeth Ciaccio
金额：
$ 59.55万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-01-01 至 2026-11-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10586398
关键词：
6 year old Affect Age Allergic Allergic Disease Animals Asthma Betula Genus Birth Black American Black race Blood Chicago Child Child Development Childhood Asthma Cities Clinical assessments Communities Control Groups Data Denmark Development Diet Dietary Fatty Acid Dietary Intervention Disease Docosahexaenoic Acids Docosahexaenoic acid supplementation Double-Blind Method Emergency Situation Emergency department visit Exposure to Family Fatty Acids Formula supplementation Goals Hospitalization Human Hydrocortisone Hypersensitivity Infant Infant formula Inflammation Inflammatory Infrastructure Laboratories Link Low income Measures Mediating Medical Records Morbidity - disease rate Mothers Neighborhoods Observational Study Omega-3 Fatty Acids Outcome Pattern Pilot Projects Pregnancy Prevalence Questionnaires Randomized, Controlled Trials Regulation Reporting Research Resource-limited setting Risk Risk Reduction Side Stress Supplementation System Testing Visit Wheezing Woman Work acceptability and feasibility atopy biobehavior black women chronic inflammatory lung disease comparison control cytokine early childhood evidence base falls fatty acid supplementation heart rate variability hospitalization rates hypothalamic-pituitary-adrenal axis immune function improved mortality neurodevelopment nutrition offspring perceived stress pregnant prenatal prenatal influence prenatal stress prenatal testing programs prospective protective effect racial disparity randomized, controlled study response stress reactivity stressor therapy design urban setting

6 year old Affect Age Allergic Allergic Disease Animals Asthma Betula Genus Birth Black American Black race Blood Chicago Child Child Development Childhood Asthma Cities Clinical assessments Communities Control Groups Data Denmark Development Diet Dietary Fatty Acid Dietary Intervention Disease Docosahexaenoic Acids Docosahexaenoic acid supplementation Double-Blind Method Emergency Situation Emergency department visit Exposure to Family Fatty Acids Formula supplementation Goals Hospitalization Human Hydrocortisone Hypersensitivity Infant Infant formula Inflammation Inflammatory Infrastructure Laboratories Link Low income Measures Mediating Medical Records Morbidity - disease rate Mothers Neighborhoods Observational Study Omega-3 Fatty Acids Outcome Pattern Pilot Projects Pregnancy Prevalence Questionnaires Randomized, Controlled Trials Regulation Reporting Research Resource-limited setting Risk Risk Reduction Side Stress Supplementation System Testing Visit Wheezing Woman Work acceptability and feasibility atopy biobehavior black women chronic inflammatory lung disease comparison control cytokine early childhood evidence base falls fatty acid supplementation heart rate variability hospitalization rates hypothalamic-pituitary-adrenal axis immune function improved mortality neurodevelopment nutrition offspring perceived stress pregnant prenatal prenatal influence prenatal stress prenatal testing programs prospective protective effect racial disparity randomized, controlled study response stress reactivity stressor therapy design urban setting

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项目摘要

Project Summary Asthma is a chronic inflammatory lung disease that currently affects an estimated 8.4% of children in the U.S., resulting in over 600,000 emergency department visits and over 75,000 hospitalizations each year (Moorman et al., 2012). For decades the burden of asthma in the U.S. has fallen disproportionately on Black children living in low- resourced communities, for whom the prevalence, morbidity and mortality rates far exceed those for White children. Black children have 2-3 times higher rates of hospitalization and emergency department visits compared with White children, and a nearly 5-fold increase in asthma-related mortality (Volerman, et al., 2019). In some neighborhoods on the South Side of Chicago the rates of asthma among young Black children are over 40% (Gupta et al., 2008). The high rate of asthma and allergy in Black children appears to be in part influenced by prenatal stress exposure. Thus, an intervention designed to improve prenatal stress regulation in Black women may also reduce the risk of asthma in their children. The Nutrition and Pregnancy Study (NAPS) (NCT02647723) is a nearly completed double-blind, randomized controlled study (RCT) of prenatal fatty acid supplementation aiming to improve birth outcomes and infant neurodevelopment via improved prenatal stress regulation. Docosahexaenoic acid (DHA), an omega-3 fatty acid, has been shown to protect against the development of asthma and atopy in controlled animal studies and in observational studies of humans. Results from two small RCTs of infant formula supplementation provide further support for the protective effects of dietary fatty acids against asthma (Birch et al., 2010; Foiles et al., 2016). The NAPS study provides an unprecedented opportunity to test the effects of prenatal DHA levels on childhood asthma and atopic disease, and to further examine how patterns of prenatal stress regulation impact that effect. We propose to conduct clinical assessments of asthma and other atopic outcomes in 130 children at 5-6 years of age whose mothers participated in the NAPS study, and to collect data from medical records and maternal report to test two aims. Aim 1: Test whether prenatal fatty acid levels are associated with asthma and atopic disease in early childhood. We hypothesize that higher prenatal blood levels of DHA will be associated with lower levels of asthma and atopy in the offspring as measured via laboratory assessments of asthma and allergic sensitization at ages 5-6 years, as well as medical record abstraction and maternal report. Aim 2: Test whether prenatal stress regulation impacts the association between prenatal fatty acid levels and asthma and atopic disease in early childhood. Our primary hypothesis is that cortisol and cytokine levels, heart rate variability, and perceived stress during pregnancy will partially mediate the association between prenatal DHA levels and childhood asthma and atopic disease. We will also test whether the association between prenatal DHA levels and early childhood asthma and atopic disease is moderated by prenatal stress regulation at baseline and by changes in stress regulation during pregnancy. To our knowledge, this will be the first test of prenatal fatty acid levels on asthma and allergy in Black children living in low-resourced environments in the U.S.

项目摘要哮喘是一种慢性炎症性肺部疾病，目前影响美国8.4％的儿童，每年导致超过600,000个急诊室就诊和75,000多个住院治疗（Moorman等， 2012）。几十年来，美国哮喘的负担一直在低位的黑人儿童中降低资源丰富的社区，其患病率，发病率和死亡率远远超过白人的社区孩子们。黑人儿童的住院率和急诊就诊的比率高2-3倍白人儿童，与哮喘相关的死亡率增加了近5倍（Volerman等，2019）。在某些人中芝加哥南侧的社区哮喘的年轻黑人儿童的哮喘发生率超过40％（Gupta ET Al。，2008）。黑人儿童的哮喘和过敏率高似乎部分受到产前压力的影响接触。因此，旨在改善黑人妇女产前压力调节的干预措施也可能会减少孩子哮喘的风险。营养和怀孕研究（NAPS）（NCT02647723）几乎完成了补充产前脂肪酸的双盲，随机对照研究（RCT）旨在改善出生结局和婴儿神经发育，通过改善产前应激调节。 Docosahexaenoic Acid（DHA），一个 omega-3脂肪酸已被证明可以预防受控动物中哮喘和特纳研究和人类观察性研究。来自两个小的婴儿配方奶粉补充剂的结果为饮食脂肪酸对哮喘的保护作用提供进一步的支持（Birch等，2010； Foiles et Al。，2016）。午睡研究为测试产前DHA水平的影响提供了前所未有的机会儿童期哮喘和特应性疾病，并进一步研究产前压力的模式如何影响影响。我们建议对130名5-6岁儿童的哮喘和其他特征性结局进行临床评估母亲参加小睡研究的年龄，并从医疗记录和产妇中收集数据报告测试两个目标。目标1：测试产前脂肪酸水平是否与哮喘和特应性疾病有关在幼儿时期。我们假设较高的DHA产前血液水平将与较低的水平有关通过实验室评估哮喘和过敏反应，在后代中的哮喘和特纳 5-6岁的年龄以及医疗记录的抽象和产妇报告。目标2：测试产前压力是否调节会影响早期产前脂肪酸水平与哮喘和特应性疾病之间的关联童年。我们的主要假设是皮质醇和细胞因子水平，心率变异性以及感知的压力怀孕期间将部分介导产前DHA水平与儿童哮喘和特应性疾病。我们还将测试产前DHA水平与幼儿哮喘之间的关联以及特应性疾病在基线时的产前应力调节和应力调节期间的变化来调节特应性疾病怀孕。据我们所知，这将是对哮喘和黑色过敏的产前脂肪酸水平的首次测试生活在美国低资源环境中的儿童