The proposed study is a pilot study of a prospective cohort study that includes three generations (children, parents and grandparents) to evaluate the long-term health effects of periconceptional exposure to folic acid on women and children. It will be conducted in 4 project counties that participated in the folic acid intervention program. We propose to: 1)Explore and develop the key technical skills needed to follow-up mothers, children, fathers and grandparents in a community Intervention program to prevent neural tube defects (NTD) through the daily use of folic acid supplements during the periconceptional period, and estimate the follow-up rate;2)Build and strengthen human resource capacity in non-communicable disease research study design, human subject protection, data analysis and interpretation, and reporting in the scientific literature and to the general population;3)Evaluate these children to determine whether there are differences between children whose mothers did or did not take folic acid before and during early pregnancy with respect to growth, development, nutritional status, and cognitive ability, temperament and behavioral development;4)Evaluate the general health status of their mothers during the years following the conclusion of the initial intervention program to determine whether there are differences in general health status, and the occurrence of disease between women who did or did not take folic acid during the community folic acid intervention project;5)Obtain questionnaire information and biologic samples from members of the three generational family units to examine genetic factors and environment exposure factors in this cohort, and 6)Construct and test new hypotheses on the cause(s) and mechanism(s) of other diseases or health outcomes of interest. China CDC proposes to work jointly with scientists of US CDC closely to build and strengthen human resource capacity in chronic disease research study design, data analysis and interpretation, and reporting in scientific literature and disease control and prevention program.
