A South Carolina ECHO Pregnancy Cohort - Animal and epidemiological studies show that prenatal experiences (e.g., elevated environmental pollutants, pregnancy complications, preterm birth, stress) support the ‘developmental origins of health and disease’ model in relating adverse maternal experiences to compromised fetal and child development. Hypotheses suggest that the developmental window of plasticity for obesity programming initiates in utero and extends through the first two years of life, underscoring the large impact that gestational and early life exposures and corresponding targeted interventions may have on lifetime obesity risk. Current obesity interventions may be ineffective because they target children or adults past the critical age when developmental programming occurs. The ECHO pregnancy cohort has the potential to address this critical gap in knowledge. Moreover, because previous research has often been conducted in urban areas, rural communities are often understudied. Hence, as a rural state with poor birth outcomes, where few studies have been conducted, our contribution to ECHO will have a major impact. Therefore, we will recruit over 500 pregnant women and their resulting offspring into ECHO from the Medical University of South Carolina (MUSC) and implement the ECHO-wide protocol including specialized components on Physical & Chemical exposures and child Obesity outcomes. MUSC has a large obstetrical/delivery population (i.e., over 3,000 annually) that facilitates meeting our recruitment goals. Our aims pertaining to ECHO-wide analyses are (1) to determine the joint impact of prenatal exposure to chemical mixtures and early gestational and life exposures (i.e., hypertensive disorders of pregnancy, preterm birth) on child obesity and metabolic health; (2) to identify differences in prenatal chemical exposures and their sources (dietary choices/opportunities, use of consumer goods and personal care products, occupation, air/water) among ECHO cohort participants; and (3) to determine the association of mixtures of pre-conceptual and peri-conceptual chemical exposures measured in mothers and fathers with hypertensive disorders of pregnancy, preterm birth, and child obesity. In summary, our proposed aims are innovative because they address: (1) the impact of joint exposure to chemical and non-chemical stressors; (2) potential rural-urban differences in sources of chemical exposure and resulting complex chemical mixtures; and (3) determining critical windows of exposure to complex chemical mixtures.
