A South Carolina ECHO Pregnancy Cohort

南卡罗来纳州 ECHO 妊娠队列

基本信息

批准号：
10746617
负责人：
KELLY J HUNT
金额：
$ 83.32万
依托单位：
MEDICAL UNIVERSITY OF SOUTH CAROLINA
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：
2023-09-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10746617
关键词：
Adult Affect African Age Air Animals Argentina Asian Birth Black Populations Black race Characteristics Chemical Exposure Chemicals Child Child Development Childhood Conceptions Country Cuba Deep South Developing Countries Development Discipline of obstetrics Disease Disease model Disparity Egypt Enrollment Environmental Exposure Environmental Pollutants Environmental Risk Factor Ethnic Origin Exposure to Fetal Development Future Geography Goals Health Healthy People 2020 Heart Diseases Hispanic Hypertension Individual Infant Mortality Intervention Joints Latinx Lebanon Life Link Live Birth Maternal Mortality Measures Medicaid Medical Metabolic Mexico Mothers North America Not Hispanic or Latino Obesity Obstetric Delivery Occupations Outcome Pacific Islander Participant Perinatal Exposure Persons Population Population Heterogeneity Pregnancy Pregnancy Complications Pregnancy Outcome Premature Birth Protocols documentation Race Recording of previous events Recurrence Research Rest Risk Risk Factors Rural Rural Community Rural Population Site Slave Soil Source South Carolina Stress Stroke Stroke Belt Temperature United States National Institutes of Health Universities Vulnerable Populations Water Water Supply adult obesity burden of illness cardiometabolic risk cardiovascular risk factor cohort dietary early life exposure environmental chemical environmental stressor epidemiology study ethnic disparity ethnic diversity ethnic identity experience fetal geographic disparity health disparity in utero intrauterine environment meetings mortality obesity in children obesity risk obesity treatment offspring personal care products poor health outcome pregnancy disorder pregnant prenatal prenatal experience prenatal exposure prepregnancy obesity programs racial discrimination racial disparity racial diversity racial health disparity recruit research study social social vulnerability stroke incidence study population urban area

项目摘要

ABSTRACT Animal and epidemiological studies show that prenatal experiences (e.g., elevated environmental pollutants, pregnancy complications, preterm birth, stress, racial discrimination) support the ‘developmental origins of health and disease’ model in relating adverse maternal experiences to compromised fetal and child development. Hypotheses suggest that the developmental window of plasticity for obesity programming initiates in utero and extends through the first two years of life, underscoring the large impact that gestational and early life exposures and corresponding targeted interventions may have on lifetime obesity risk. Current obesity interventions may be ineffective because they target children or adults past the critical age when developmental programming occurs. Because vulnerable populations are often the most impacted by exposure to environmental stressors and poor health outcomes, it is critical that research studies include them. Therefore, the overarching objective of our proposal is to increase the diversity of the ECHO Cohort. To achieve this goal, we will recruit over 500 pregnant persons and their resulting offspring into ECHO from the Medical University of South Carolina (MUSC) and implement the ECHO-wide protocol including specialized components on Physical & Chemical exposures and child Obesity outcomes. Our proposed recruitment will include 50% Black, 30% white/other and 20% Hispanic pregnant persons with half of the pregnant persons (and their conceiving partners) also contributing to the preconception cohort. The racial and ethnic diversity of the MUSC obstetrical population (i.e., 32% Black; 53% white; 12% Hispanic; and 2% Asian/Pacific Islander), and large delivery population (i.e., over 3,000 annually) will facilitate meeting our recruitment goals. In 2022, 46% of deliveries at MUSC were covered by Medicaid and 5.5% were to Spanish speaking mothers, providing further evidence of high social vulnerability in our study population. Because previous research has often been conducted in urban areas, rural communities where many Blacks reside are often understudied. Hence, as a rural state in the Deep South with poor birth outcomes and a socially vulnerable population, South Carolina’s population is historically understudied and our contribution to ECHO will have a major impact. Our aims pertaining to ECHO-wide analyses are (1) to determine the joint impact of prenatal exposure to chemical mixtures and early gestational and life exposures (i.e., hypertensive disorders of pregnancy, preterm birth) on child obesity and metabolic health; (2) to identify racial/ethnic disparities in prenatal chemical exposures and their sources (dietary choices/opportunities, use of consumer goods and personal care products, occupation, air/water) among participants in the ECHO cohort; and (3) to determine the association of mixtures of pre- conceptual and peri-conceptual chemical exposures measured in both partners with hypertensive disorders of pregnancy, preterm birth, and child obesity.

抽象的动物和流行病学研究表明，产前经历（例如环境污染物升高、妊娠并发症、早产、压力、种族歧视）支持“发育起源” 将不良孕产妇经历与受损胎儿和儿童联系起来的健康与疾病模型假设表明肥胖编程的可塑性发育窗口。它在子宫内开始并持续到生命的头两年，强调了妊娠期的巨大影响生命早期的暴露和相应的有针对性的干预措施可能会影响终生肥胖风险。肥胖干预措施可能无效，因为它们针对的是超过临界年龄的儿童或成人因为弱势群体往往受暴露影响最大。对于环境压力因素和不良健康结果，研究将其纳入其中至关重要。因此，我们提案的首要目标是增加 ECHO 队列的多样性。为了实现这一目标，我们将从 ECHO 招募超过 500 名孕妇及其后代南卡罗来纳医科大学 (MUSC) 并实施 ECHO 范围内的协议，包括专门的我们提议的招募将涉及物理和化学暴露以及儿童肥胖结果。包括 50% 黑人、30% 白人/其他人和 20% 西班牙裔孕妇，其中一半孕妇（及其怀孕伴侣）也对孕前人群的种族和民族多样性做出了贡献。 MUSC 产科人口（即 32% 黑人；53% 白人；12% 西班牙裔；2% 亚洲/太平洋岛民），庞大的配送人数（即每年超过 3,000 人）将有助于实现我们 2022 年的招聘目标。 MUSC 46% 的分娩由医疗补助承保，其中 5.5% 的分娩对象是讲西班牙语的母亲，这提供了进一步证明我们的研究人群具有高度的社会脆弱性，因为之前的研究经常是这样的。因此，在城市地区进行的研究中，许多黑人居住的农村社区往往没有得到充分研究。南卡罗来纳州是南部腹地的农村州，出生结果不佳，人口处于社会弱势地位历史上对人口的研究不足，我们对 ECHO 的贡献将产生重大影响。与 ECHO 范围内的分析相关的内容包括 (1) 确定产前接触化学品的联合影响混合物以及妊娠早期和生活暴露（即妊娠期高血压疾病、早产）儿童肥胖和代谢健康；(2) 确定产前化学品暴露的种族/民族差异；它们的来源（饮食选择/机会、消费品和个人护理产品的使用、职业、空气/水）在ECHO队列的参与者中；（3）确定预-混合物的关联在患有高血压疾病的伴侣中测量概念性和围概念性化学暴露怀孕、早产和儿童肥胖。