Preconception and Prenatal Health Impacting Factors and Child Health

孕前和产前健康影响因素和儿童健康

• 批准号: 10746579
• 负责人: Lyndsay Ammon Avalos
• 金额: $ 202.38万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10746579
• 关键词: Address; Adverse effects; Affect; Anxiety; Birth; Blood; Body mass index; California; Cannabis; Censuses; Characteristics; Child; Child Health; Clinic Visits; Clinical Research; Conceptions; Data; Devices; Diet; Dietary Practices; Electronic cigarette; Ensure; Exposure to; Fetal Development; Functional disorder; Growth; Health; Hour; Human Milk; Individual; Infant; Intervention; Joints; Learning; Life; Life Style; Link; Low income; Measures; Mediating; Medical center; Mental Depression; Metabolic; Movement; Neighborhoods; Neurodevelopmental Disorder; Neurodevelopmental Impairment; Obesity; Opioid; Outcome; Pathway interactions; Personal Satisfaction; Phase; Physical activity; Pilot Projects; Policies; Population Heterogeneity; Pregnancy; Prevention; Prevention strategy; Problem behavior; Program Development; Protocols documentation; Quality Control; Race; Research; Risk Factors; Role; Sampling; Science; Sleep; Social Problems; Stress; Time; Umbilical Cord Blood; Visit; cohort; ethnic minority population; evidence base; experience; good diet; healthy weight; improved; indexing; lifestyle factors; member; metabolomics; mother nutrition; neurodevelopment; novel; obesity in children; offspring; participant retention; postnatal; pregnant; prenatal; prenatal exposure; prenatal health; prevent; programs; psychological distress; racial minority population; recruit; residential segregation; sex assigned at birth; social vulnerability; substance use

Abstract Childhood obesity and neurodevelopmental impairments have increased in recent decades and are the most prevalent conditions threatening child’s health and well-being. The consequences of these conditions signify the need to identify modifiable factors to target for upstream prevention. Emerging evidence suggests that prenatal exposures to psychological distress, substance use, and lifestyle factors during critical windows of fetal development may operate to developmentally program childhood obesity and neurodevelopment (ND). However, few studies have taken a multiple exposure approach to understand the individual and joint effects of these exposures. In Aim 1 we will examine the role of in utero exposure to psychological distress and substance use on child growth, adiposity, obesity, and ND and the extent to which prenatal lifestyle factors and neighborhood factors may mitigate these associations. Further, while maternal diet and physical activity impact infant growth and adiposity, few studies in diverse populations have assessed mechanistic pathways and little is known about their impact on ND. We propose the 24-hour movement profile and metabolomics as our specialized measures of lifestyle, and obesity and ND as our specialized outcomes. The 24-hour movement profile incorporates the interdependent relationships between device-based measures of physical activity and sleep during pregnancy to better inform interventions. Metabolomics can elucidate mechanistic pathways and will be measured repeatedly on the samples collected according to the ECHO protocol (prenatal blood, cord blood, postnatal child’s blood, and breastmilk). In Aim 2 we will clarify the joint effects of maternal prenatal dietary patterns and the 24-hour movement and child growth, obesity, and ND and whether metabolomic signatures prenatally, at birth, and postnatally mediate these associations. For Aims 1 and 2 we will also examine how associations vary by neighborhood characteristics and infant sex assigned at birth. In Aim 3 we will maximize recruitment and retention by implementing evidence-based strategies focused on engaging diverse groups in clinical research and implementing the ECHO Cohort Protocol applying systematic quality control approaches and best practices. We propose to contribute to the ECHO Program by recruiting a diverse cohort of 1,800 pregnant individuals from two medical centers at Kaiser Permanente Northern California serving a diverse population (~70% racial/ethnic minority groups with 50% having a low income), the conceiving partner, their resulting child, and to follow all of them at multiple visits after the child is born. In Aim 4 we will explore the role of preconception maternal and paternal lifestyle factors on infant birth size to identify critical time periods to intervene on to prevent upstream risk factors for childhood obesity and ND. All members of our diverse research team will have equal opportunity to contribute to all aspects of our project and to be involved in the new ECHO phase. Findings from this study will have important implications for informing interventions, prevention strategies and policies to ensure optimal health and well-being for all children.

抽象的 近几十年来，儿童肥胖和神经发育障碍有所增加，是最大的 普遍的条件威胁着孩子的健康和福祉。这些条件的后果表示 需要确定可修改因素以靶向上游预防。新兴证据表明 在关键窗口中，产前暴露于心理困扰，药物使用和生活方式因素 胎儿发育可能会开发开发儿童肥胖和神经发育（ND）。 但是，很少有研究采用多种暴露方法来了解个人和关节 这些暴露的影响。在AIM 1中，我们将研究子宫中的角色 以及对儿童成长，肥胖，肥胖和ND的使用以及产前生活方式因素的程度 邻里因素可能会减轻这些关联。此外，何时饮食和体育锻炼 影响婴儿的生长和肥胖，很少有研究的研究评估了机械途径 关于它们对ND的影响知之甚少。我们提出24小时运动概况和代谢组学作为 我们的专业生活方式措施，肥胖和ND作为我们的专业成果。 24小时 运动曲线结合了基于设备的物理测量之间的相互依存关系 怀孕期间的活动和睡眠，以更好地告知干预措施。代谢组学可以阐明机械 途径将根据回声协议（产前）的样品重复测量 血液，脐带血，产后孩子的血和母乳）。在AIM 2中，我们将澄清产妇的联合影响 产前饮食模式以及24小时运动和儿童成长，肥胖和ND以及是否是否 出生时，出生时和产后介导这些关联的代谢组学特征。对于目标1和2我们 还将研究社会在出生时分配的邻里人物和婴儿性别的变化。 目标3我们将通过实施专注于证据的策略来最大化招聘和保留 吸引各个小组参与临床研究和实施Echo队列协议，应用系统 质量控制方法和最佳实践。我们建议通过招募一个 来自Kaiser Permanente Northern的两个医疗中心的1,800名孕妇的各种队列 加利福尼亚州为潜水员人口服务（〜70％的种族/少数民族群体，有50％的收入低收入）， 构思伴侣，他们由此导致的孩子，并在孩子出生后多次拜访所有人。目标 4我们将探讨先男性材料和父亲生活方式因素对婴儿出生规模的作用 干预以防止儿童肥胖和ND的上游风险因素的关键时间段。所有成员 我们的潜水员研究团队将有平等的机会为我们的项目的各个方面做出贡献，并成为 参与新的回声阶段。这项研究的发现将对告知 干预，预防策略和政策，以确保所有儿童的最佳健康和福祉。