PROJECT SUMMARY / ABSTRACT
The goal of the ECHO Ohio Cohort Site at Nationwide Children’s Hospital and The Ohio State University Wexner
Medical Center (NCH-OSUWMC) is to contribute to the ECHO Cohort by collecting and providing valuable data
on a diverse and often underserved population of participating pregnant individuals, conceiving partners, and
children who live in our region, so we can improve maternal and child health everywhere by better understanding
how exposures prior to and during pregnancy impact childhood outcomes. Nearly 1/5 of Ohio’s children live in
poverty. The rate is more than twice that for non-Hispanic Black children. Central Ohio is diverse with a rapidly
growing immigrant population including the largest ethnic Nepali and 2nd largest Somali refugee populations in
the U.S.; 1 in 6 Columbus children have an immigrant parent. The patients we serve live not only in urban,
suburban, and rural central Ohio, but also within Appalachian portions of southeast Ohio, Pennsylvania, and
West Virginia. The communities we serve are ranked poorly across multiple maternal and child health well-being
indicators, underscoring a critical need to better understand environmental influences in the perinatal period that
contribute to adverse child outcomes both locally and nationally. The NCH-OSUWMC health system is highly
experienced in contributing to large multicenter NIH studies involving pregnant individuals and children and well-
poised to contribute interdisciplinary leadership. We have maintained a large perinatal repository of clinical,
survey, and rich biospecimen data from pregnant individuals, their partners, and their children for over a decade.
Our research coordinators and investigators are highly experienced in recruiting both pregnant individuals and
children for research investigations and securely and efficiently processing health data and biospecimens. Of
note, our track record in retaining diverse subpopulations of high-risk maternal/child dyads, as well as conceiving
partners, for follow-up is strong. We provide specific expertise in evaluating lifestyle exposures in pregnancy,
most prominently in maternal cardiovascular health, and outcomes expertise in pre-, peri-, and postnatal health
and childhood neurodevelopment. We propose 1) evaluating the impact of maternal cardiovascular health during
pregnancy using the American Heart Association Life’s Essential 8 framework on child socioemotional
development and behavior to age 21, using existing ECHO Cohort Protocol core data elements and 2)
investigating, using innovative methods (continuous glucose monitoring), the association between evolving
maternal dysglycemia patterns across the peripartum period and child socioemotional development and behavior
while evaluating neonatal anthropometrics as potential mediators. We propose to evaluate the interaction
between genes and lifestyle exposures on socioemotional development via an association study complemented
with imputed -omics data. In a preconception-focused aim, we propose examining the impact of maternal and
paternal preconception cardiovascular health on socioemotional development and behavior. Our contributions
to the ECHO cohort, providing diversity and expertise, will enhance knowledge leading to improved child health.