Council approval is hereby elicited for a Program initiative titled, “Study of Pregnancy and Neonatal Health (SPAN).”
Developmental origins of health and disease (DOHaD) research posits that early exposures can lead to biological changes from compensatory measures that affect long-term health. More recently, DOHaD and complementary genetic approaches offer opportunities to understand environmental and genetic mechanisms that underpin key pathways important for health and disease. However, critical data gaps in DOHaD remain including the father’s role, placental determinants, and timing of delivery in relation to neonatal health and development.
The goal of the initiative is to establish a pregnancy cohort (~7,800 pregnant women and 3,825 male partners) involving race/ethnic diverse populations within which these three specific aims will be explored:
- To determine whether paternal cardiovascular risk factors (e.g., BMI, HbA1c) are associated with fetal growth, neonatal anthropometry, and placental function and whether semen epigenetic differences explain associations. Although maternal factors also will be included, rarely have studies also evaluated the paternal contribution to developmental programming. Paternal health factors identified have potential for leading to a paradigm shift from focusing on women for pre-pregnancy care/advice to also including male partners.
- To conduct a genome-wide association study to identify fetal genetic loci that influence fetal growth and birth anthropometry, and to determine fetal genetic loci associated with placental age acceleration and the functional link between associated genetic loci, placental gene expression and fetal growth in African Americans. Specific genetic loci implicated in fetal growth at different windows of pregnancy have yet to be identified and genetics of birthweight in non-European ancestry populations are under-studied. Placental age acceleration has been associated with adverse pregnancy outcomes; however, no prior studies have investigated its genetic basis and mechanisms underlying the pathophysiologic links between placental age acceleration and fetal growth. Findings will provide mechanistic insight into fetal growth variation, placental aging (“epigenetic clock”) and their functional links. Replication in other ancestral populations is also planned.
- To determine the optimal time for gestational diabetes complicated deliveries between 38-39 weeks where neonatal morbidity and mortality is the lowest without increasing fetal mortality. In 2017 the American College
The proposed concept aligns with the NICHD vision areas of DOHaD and Pregnancy and Pregnancy Outcomes.
The Program initiative also aligns with the Division of Intramural Population Health Research’s (DIPHR) Epidemiology Branch mission to conduct investigator-initiated epidemiologic research on perinatal and pediatric endpoints focused on maximizing health.
Division of Intramural Population Health Research (DIPHR)
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