Prenatal Environment And Child Health (PEACH) in ECHO

ECHO 中的产前环境和儿童健康 (PEACH)

• 批准号: 10746727
• 负责人: Rebecca Jean Schmidt
• 金额: $ 127.36万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 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/10746727
• 关键词: Address; Affect; Age; Assessment tool; Attention deficit hyperactivity disorder; Attenuated; Behavior; Behavioral; Biological; Blood; California; Chemicals; Child; Child Behavior Checklist; Child Health; Clinical; Clinical assessments; Communities; Community Outreach; Conceptions; Data; Development; Developmental Delay Disorders; Disparity; Dose; Educational Activities; Ensure; Environment; Environmental Epidemiology; Environmental Exposure; Environmental Pollutants; Epigenetic Process; Ethnic Origin; Exposure to; Family; First Pregnancy Trimester; Folic Acid; Food; Genetic; Grain; Guidelines; Health; Health Policy; Heavy Metals; Hispanic Populations; Intake; Intervention; Link; Measures; Mediating; Neural Tube Defects; Neurodevelopmental Disorder; Nutritional; Outcome; Participant; Pathway interactions; Persons; Placenta; Plasticizers; Policies; Population Heterogeneity; Prevalence; Preventive measure; Problem behavior; Protocols documentation; Psychosocial Stress; Public Health; Quality of life; Race; Recommendation; Research; Resources; Risk; Shapes; Site; Social Functioning; Subgroup; Translations; Underrepresented Populations; United States National Institutes of Health; Visit; Work; autism spectrum disorder; autistic; behavioral outcome; cohort; community engagement; executive function; experience; flexibility; folic acid supplementation; fortification; high risk; improved; in utero; innovation; language outcome; novel; nutritional epidemiology; people of color; perceived discrimination; personal care products; pregnant; prenatal; prenatal exposure; programs; racial diversity; randomized trial; recruit; reproductive epidemiology; social; socioeconomics; success; trait; Address; Affect; Age; Assessment tool; Attention deficit hyperactivity disorder; Attenuated; Behavior; Behavioral; Biological; Blood; California; Chemicals; Child; Child Behavior Checklist; Child Health; Clinical; Clinical assessments; Communities; Community Outreach; Conceptions; Data; Development; Developmental Delay Disorders; Disparity; Dose; Educational Activities; Ensure; Environment; Environmental Epidemiology; Environmental Exposure; Environmental Pollutants; Epigenetic Process; Ethnic Origin; Exposure to; Family; First Pregnancy Trimester; Folic Acid; Food; Genetic; Grain; Guidelines; Health; Health Policy; Heavy Metals; Hispanic Populations; Intake; Intervention; Link; Measures; Mediating; Neural Tube Defects; Neurodevelopmental Disorder; Nutritional; Outcome; Participant; Pathway interactions; Persons; Placenta; Plasticizers; Policies; Population Heterogeneity; Prevalence; Preventive measure; Problem behavior; Protocols documentation; Psychosocial Stress; Public Health; Quality of life; Race; Recommendation; Research; Resources; Risk; Shapes; Site; Social Functioning; Subgroup; Translations; Underrepresented Populations; United States National Institutes of Health; Visit; Work; autism spectrum disorder; autistic; behavioral outcome; cohort; community engagement; executive function; experience; flexibility; folic acid supplementation; fortification; high risk; improved; in utero; innovation; language outcome; novel; nutritional epidemiology; people of color; perceived discrimination; personal care products; pregnant; prenatal; prenatal exposure; programs; racial diversity; randomized trial; recruit; reproductive epidemiology; social; socioeconomics; success; trait

Prenatal Environment And Child Health (PEACH) in ECHO Abstract Few modifiable factors have been identified that improve neurodevelopmental (ND) outcomes. One such factor, supplemental folic acid (SFA), taken before and during the first weeks post-conception, reduced risk for neural tube defects (NTDs) by up to 70% in randomized trials, initiating mandatory food grain fortification and guidelines for SFA intake for people who could or had become pregnant, with subsequent increases in blood folate concentrations and reduced NTD prevalence. While generally regarded as a public health success, the impacts have not been evenly distributed across sub-populations within the US, with Hispanic populations at higher risk for NTDs, more likely to have suboptimal folate status, and less likely to take SFA. Further, the biologic mechanisms behind this protection remain unclear. Prenatal SFA and adequate folate status has since been associated with improved behavioral and language outcomes, higher executive functioning, and reduced risk for attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and associated traits. High folate/SFA has also been shown to attenuate increased risks associated with several contaminant exposures that are more prevalent in groups that are under-represented in research and/or more likely to have sub-optimal folate status and less likely to meet SFA intake recommendations. One example includes plasticizers in personal care products that are more prevalent in Hispanic populations and are linked to increased ND risk which is attenuated with prenatal SFA. Many gaps in understanding and implementation of SFA measures need to be addressed to increase the public health impact of SFA interventions to their fullest potential: 1) How does the timing of SFA initiation and its association with blood folate differ across subpopulations? 2) What other child health outcomes are associated with prenatal SFA and blood folate? 3) How do these associations differ by the timing and dose of SFA intake? 4) How do doses and timing of SFA and folate concentrations linked with improved child outcomes differ across people with different genetic, environmental, and nutritional backgrounds? 5) Does periconceptional SFA/folate status modify associations between environmental contaminants, including novel chemicals, and ND outcomes including behavioral problems and high autistic traits? 6) What biologic pathways are modified in utero by periconceptional SFA and suboptimal folate status? 7) How do those biologic pathways relate to known ND pathways? 8) How does the conceiving partner's preconception folate status relate to placenta epigenetics and the child's outcomes? Our strong team with relevant expertise in reproductive, environmental and nutritional epidemiology, interactions, epigenetics and ND assessment, plus ample experience engaging community partners, will recruit 740 expecting families in Northern California representing diverse racial, ethnic, socioeconomic, genetic and environmental backgrounds to enrich the ECHO cohort with participants traditionally underrepresented in research to address these gaps and produce findings that will substantially inform public health policies for more effective improvement of child developmental outcomes.

Echo中的产前环境与儿童健康（桃） 抽象的 几乎没有发现改善神经发育（ND）结果的可修改因素。一个这样的因素， 概念前和概念前几周服用的补充叶酸（SFA）降低​​了神经的风险 在随机试验中，高达70％的管缺陷（NTD）启动强制性粮食防御工事和指南 对于可能或已怀孕的人的SFA摄入量，随后增加了血叶 浓度和NTD患病率降低。虽然通常被认为是公共卫生的成功，但影响 没有在美国境内的子人群中均匀分布，西班牙裔人口较高 对于NTD，更有可能具有次优的叶酸状态，而服用SFA的可能性较小。此外，生物学 这种保护背后的机制尚不清楚。此后，产前SFA和足够的叶酸状况 与改善行为和语言成果相关，更高的执行功能以及降低的风险 注意缺陷/多动症（ADHD），自闭症谱系障碍（ASD）和相关特征。高的 叶酸/SFA也已被证明可减弱与几种污染物暴露有关的增加风险 在研究中代表不足和/或更有可能具有优化的组中，这更为普遍 叶酸状态，不太可能满足SFA摄入建议。一个示例包括个人的增塑剂 在西班牙裔人群中更普遍的护理产品，并且与增加的风险增加有关 与产前SFA衰减。理解和实施SFA措施的许多差距必须是 解决的目的是提高SFA干预措施对其最大潜力的公共卫生影响：1） SFA启动的时机及其与血叶酸的关联在亚种群中有所不同吗？ 2）其他孩子 健康结果与产前SFA和血叶酸有关吗？ 3）这些关联如何因 SFA摄入的时间和剂量？ 4）SFA和叶酸浓度的剂量和时间如何 在具有不同遗传，环境和营养背景不同的人群中，儿童结局的改善不同吗？ 5）受感受性的SFA/叶酸状态会修改环境污染物之间的关联，包括 新颖的化学物质以及包括行为问题和高自闭症特征的结果？ 6）什么生物学 途径受感受的SFA和次优叶酸状态在子宫内修改了途径？ 7）这些生物学如何 途径与已知的ND途径有关？ 8）构想伴侣的先入叶酸状况如何关系 胎盘表观遗传学和孩子的结果？我们的强大团队具有相关的生殖专业知识， 环境和营养流行病学，相互作用，表观遗传学和ND评估，以及充足的 经验参与社区合作伙伴的经验，将招募740个期望在北加州代表的家庭 多种种族，种族，社会经济，遗传和环境背景，以丰富回声队列 传统上，参与者在研究中的人数不足，无法解决这些差距，并产生的发现将 实质上为公共卫生政策提供了更有效改善儿童发育成果的信息。