Environmental Contributors to Child Health Originating from the National Fetal Growth Study (ECCHO-NFGS) Animal and epidemiological studies show that many maternal prenatal experiences (e.g., poor nutrition, stress, elevated environmental pollutants) support the `fetal origins of health' model in relating adverse maternal experiences to compromised child development. The proposed study leverages the unique resources of the National Fetal Growth Study (NFGS), a cohort of 2397 racially, ethnically and geographically diverse otherwise healthy women and fetuses studied repeatedly during pregnancy. The NFGS included collection of serial ultrasound examinations; maternal anthropometry; stress, physical activity and diet questionnaires; as well as blood samples for serum lipids, cotinine, caffeine, trace elements and persistent environmental pollutants (POPs) many of which have endocrine disrupting and neurotoxic properties with the overall goal of significantly improving our understanding of the associations between maternal prenatal exposures, fetal developmental trajectories, and childhood health outcomes. In the first two years (UG3 phase), we will focus on the key outcome areas of obesity, metabolic health and neurodevelopment demonstrating our ability to re-contact, consent, collect retrospective data on growth, medical diagnoses and residential histories and begin follow-up of the NFGS children who will be ages 3-7 in 2017. We will participate in the ECHO consortium and data collection for the broader ECHO study. In the subsequent five years (UH3 phase), we will continue to follow the children to examine a range of exposures and trajectories of fetal development in relationship to childhood metabolic and endocrine health and neurobehavioral outcomes. We will use innovative statistical modeling to develop functional standards that predict risk of childhood metabolic disruption/obesity and neurobehavioral symptoms based on fetal development trajectories and in utero exposures. The ECCHO-NFGS cohort is unprecedented in its prospective detailed assessment of maternal exposures and quality controlled measures of fetal development throughout pregnancy, in the size of its cohort representing 4 races and 10 geographic locations in the United States, and in its representation of pregnant women recruited as a standard pregnant population free of any identifiable medical or obstetrical morbidities. We will evaluate detailed clinical information, continuous assessments of exposome markers of tremendous relevance during pregnancy (nutrition, stress, physical activity, medication and environmental exposures, etc.) as well as highly accurate measures of fetal growth trajectories in relationship to childhood health outcomes. It is clear that the prenatal period influences children's health; follow up of this cohort will allow for an unparalleled opportunity to discover how and why.
The proposed study (ECCHO-NFGS) provides an unprecedented opportunity to understand mechanisms of in utero exposures on risk of childhood outcomes of public health significance. The data are of the highest quality, are the most detailed serial assessments of fetal development available in any cohort. We will demonstrate our ability to engage children and standardize our research protocols to address our hypotheses (UG3) and follow this cohort prospectively for future risk assessment (UH3). The NFGS is the ideal cohort to assess the prenatal determinants of two key health outcomes ? obesity and neuroimpairment as well as be a resource for the ECHO Consortium for all four outcome focus areas.
| Paneth, Nigel; Monk, Catherine (2018) The importance of cohort research starting early in life to understanding child health. Curr Opin Pediatr 30:292-296 |
