Maternal stress and undernutrition: Interactive effects on newborn and child outcomes in Ethiopia”

孕产妇压力和营养不良：对埃塞俄比亚新生儿和儿童结局的交互影响

• 批准号: 10571122
• 负责人: Sarah Kathinka Georg Jensen
• 金额: $ 13.25万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10571122
• 关键词: Acceleration; Achievement; Adverse effects; Affect; Attention; Award; Basic Science; Biological; Biological Factors; Biological Markers; Biology; Birth; Birth Weight; Blood; Cell Aging; Cells; Child; Child Behavior Checklist; Child Development; Child Support; Childhood; Chromosomes; Clinical Nutrition; Complex; Data; Data Collection; Development; Dietary Intervention; Dryness; Electrocardiogram; Epidemiology; Ethiopia; Exposure to; Fetal Development; Fetal Growth; Folic Acid; Follow-Up Studies; Future; Genome; Goals; Infant; Infection; Inflammation; Interdisciplinary Study; Intervention; Intervention Trial; Iron; Knowledge; Knowledge acquisition; Lead; Length; Light; Link; Low Birth Weight Infant; Malnutrition; Maternal and Child Health; Mediating; Memory; Mental Health; Mothers; National Institute of Child Health and Human Development; Neurosciences; Neurosecretory Systems; Newborn Infant; Nutrient; Outcome; Oxidative Stress; Physiology; Positioning Attribute; Postpartum Period; Poverty; Pregnancy; Pregnancy Outcome; Pregnant Women; Prenatal Nutrition; Proteins; Psychological Stress; Psychopathology; Psychosocial Factor; Public Health; Randomized; Research; Resource-limited setting; Role; Rural; Schools; Shapes; Spottings; Stress; Tandem Repeat Sequences; Technical Expertise; Telomere Shortening; Time; Training; Umbilical Cord Blood; Untranslated RNA; Visual attention; Weight; Woman; Women' s Health; antenatal; antenatal care; behavior test; career; emotional functioning; energy balance; fetal; fetal programming; fetus nutrition; fortification; heart rate variability; implementation science; improved; in utero; innovation; insight; iodized salt; low income country; maternal stress; mother nutrition; nutrition; offspring; perceived stress; postnatal; prenatal; prenatal exposure; prenatal stress; primary outcome; public health relevance; research study; skills; standard care; stress reactivity; telomere; visual tracking

PROJECT SUMMARY/ABSTRACT Maternal prenatal stress and nutrition influences fetal growth and long-term child outcomes. Maternal psychological stress and undernutrition frequently co-occur and affect overlapping biological stress axes involved in fetal growth and neuroendocrine development. Still, little is known about the interactive effects of maternal prenatal stress and nutrition on fetal and long-term child outcomes. The proposed K99/R00 research will leverage data from the ongoing “Enhancing Nutrition and Antenatal Infection Treatment for Maternal and Child Health” (ENAT) trial in rural Ethiopia to examine interactive effects of maternal prenatal stress and nutrition intervention on fetal and child outcomes. ENAT randomized 2390 pregnant women to receive an “enhanced nutrition” package or “standard care” and collected data on maternal prenatal stress (Cohen's Perceived Stress Scale) throughout pregnancy. Existing ENAT data will be used to determine independent and interactive effects of maternal prenatal stress and nutrition intervention on birthweight-for-age (Aim 1, K99). During the R00 I will conduct a new follow up study with ENAT mother-child dyads at 36 months postpartum to assess children's stress-sensitive outcomes (Aim 2, R00). Specifically, the developmental follow-up study will assess child outcomes related to attention, stress reactivity, memory, and socio-emotional functioning. I will also use biospecimens from ENAT to examine whether maternal and newborn telomere lengths can serve as biomarkers of in- utero programming of BWAZ and child outcomes in relation to maternal prenatal stress and nutrition (Aim 3, R00). I hypothesize that maternal prenatal stress and nutrition intervention will have main and interactive effects on newborn and childhood outcomes. I also hypothesize that maternal and newborn telomere length will serve as biomarkers for prenatal programing effects of maternal stress and nutrition. My long-term career goal is to lead independent multi-disciplinary research delineating the complex ways in which biological and psychosocial factors influence fetal and child development in low resource environments. This award would allow me to acquire basic science knowledge of maternal-fetal nutrition and telomere biology, technical skills in advanced neurodevelopmental assessments including eye-tracking and electrocardiography, and practical skills in primary data collection and research management in a low-income country. During the R00 I will independently lead an innovative child development research study in rural Ethiopia. The proposed research aligns with NICHD's goal to improve pregnancy outcomes to maximize the lifelong health of women and children and to help all children thrive. The proposed study will generate epidemiologic and biologic evidence linking maternal prenatal nutrition and stress with newborn and childhood outcomes that are sensitive to prenatal stress and predict long-term outcomes related to school achievement and mental health. I intend to use this knowledge to guide public health decisions regarding pre- and postnatal intervention for the millions of women living in poverty both domestically and globally and to develop future intervention to support child development in low resource settings.

项目概要/摘要 母亲的产前压力和营养会影响胎儿的生长和长期的儿童结局。 营养不良经常同时发生，并影响与胎儿生长和发育相关的重叠生物应激轴。 然而，关于母亲产前压力和营养对神经内分泌发育的相互作用知之甚少。 拟议的 K99/R00 研究将利用正在进行的“增强”的数据。 埃塞俄比亚农村地区开展的“母婴健康营养和产前感染治疗”（ENAT）试验 母亲产前压力和营养干预对胎儿和儿童结局的交互影响随机 ENAT。 2390名孕妇接受“强化营养”套餐或“标准护理”并收集孕产妇数据 整个怀孕期间的产前压力（科恩感知压力量表）将用于确定。 母亲产前压力和营养干预对年龄别出生体重的独立和交互影响（目标 1， K99) 在 R00 期间，我将在产后 36 个月时对 ENAT 母子进行一项新的随访研究 评估儿童的压力敏感结果（目标 2，R00）。 具体来说，发育跟踪研究将评估。 我还将使用与注意力、压力反应性、记忆力和社会情感功能相关的儿童结果。 来自 ENAT 的生物样本来检查孕产妇和新生儿端粒长度是否可以作为体内的生物标志物 与母亲产前压力和营养相关的 BWAZ 和儿童结局的子宫规划（目标 3，R00）。 认为母亲产前应激和营养干预将对新生儿和新生儿产生主要的、交互的影响。 我还认为，母亲和新生儿的端粒长度将作为产前的生物标志物。 我的长期职业目标是领导独立的多学科。 研究描绘了生物和社会心理因素影响胎儿和儿童发育的复杂方式 在资源匮乏的环境中，这个奖项将使我获得母婴营养的基础科学知识。 和端粒生物学，高级神经发育评估的技术技能，包括眼球追踪和 心电图，以及低收入国家初级数据收集和研究管理的实用技能。 在 R00 期间，我将在埃塞俄比亚农村独立领导一项创新的儿童发展研究。 研究符合 NICHD 的目标，即改善妊娠结局，最大限度地提高妇女的终身健康和 儿童并帮助所有儿童茁壮成长拟议的研究将产生流行病学和生物学证据。 产妇产前营养和压力与对产前压力敏感的新生儿和儿童结局 预测与学校成绩和心理健康相关的长期结果我打算利用这些知识来指导。 关于对数百万生活贫困妇女进行产前和产后干预的公共卫生决定 制定未来的干预措施以支持资源匮乏环境中的儿童发展。