ABSTRACT
Growing evidence supports that exposures to chemical and non-chemical stressors during the prenatal and
early childhood periods adversely affect perinatal and child health, with potential lifelong health consequences
for mothers and offspring. In the United States chemical and non-chemical stressor exposures and
adverse health outcomes occur disproportionately to African American families, highlighting that
disparities begin in utero and become amplified postnatally, and underscoring the importance of
representation of this vulnerable population in environmental epidemiology cohort (EEC) research that
spans the life course. Among outcomes disproportionately experienced by African American families are
adverse perinatal health outcomes (e.g., cardiometabolic complications of pregnancy, preterm birth, small-for-
gestational age), neurodevelopmental delays, and obesity – all of which have been linked to environmental
exposures yet remain poorly understood, and poorly targeted by preventive measures, due to etiologic
complexity, the lack of biomarkers to indicate impactful exposures and/or individual susceptibility, as well as
the insufficient engagement of environmental health scientists who share cultural background with members of
affected communities in research. With NIH support, our team has established a socioeconomically diverse,
well-phenotyped African American maternal-child EEC that enrolls mothers during early pregnancy and
extends dyad follow-up through early childhood to investigate prenatal toxicant and stress exposures, along
with the microbiome, epigenome, and metabolome, on perinatal and child health outcomes. We have enrolled
700 mother-child dyads. with prenatal toxicant exposures and rates of preterm birth substantially higher than
US rates. We have employed cohort data to delineate: the role of prenatal exposures to persistent and non-
persistent chemical mixtures and chemical-psychosocial stressor mixtures in adverse birth outcomes; maternal
metabolic perturbations that associate with environmental exposures and adverse birth outcomes; the role of
maternal adversity in epigenetic age acceleration and emotional reactivity in offspring (highlighting
intergenerational impacts of exposure); and growing concern among the community about toxicant exposures
from personal care product use. To advance both environmental health science and workforce diversification,
we propose to expand: 1) enrollment and longitudinal follow-up of African American mother-child dyads, with
enrollment in a key window of susceptibility (pregnancy); 2) data collection to include measures of
environmental health equity (area-level deprivation, segregation, air pollution) and environmental injustice
(metabolic signatures of bio-transformed metabolites of personal care products used by African American
women) for inclusion in analytic models of risk for adverse perinatal health outcomes under the ‘stress-
exposure disease’ framework; and 3) engagement with early stage investigators of the Morehouse School of
Medicine NIEHS-supported Frontiers in Environmental Science and Health (FrESH) training program.