Epidemiologic studies of maternal and early life metabolic risk

National Institute Of Diabetes And Digestive And Kidney Diseases

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Abstract

The ETCHED will establish a longitudinal cohort of mother/infant/child dyads among American Indian/Alaska Native (AI/AN) and Hispanic ethnic groups, to study the role of a combination of biological and environmental factors on infant/childhood obesity and cardio metabolic risk. Both Hispanic and AI/AN children have high prevalence of childhood obesity and associated metabolic risk. Prior research conducted at NIDDK, Phoenix, have shown that approximately 50% of Pima Indian children from diabetic pregnancies develop T2D by 25 years of age (Pettitt DJ, et al. NEJM, 1983). Since intrauterine exposure to diabetes leads to a higher risk of diabetes in the offspring, the risk might be greatly diminished by preventing diabetes during pregnancy or ameliorating its effects. Standard prenatal and obstetrical care has not been able to abolish this excess risk in the Pima Indians, which has remained unchanged from the 1940s to the early 1990s (Lindsay RS, et al. Diabetes 2000). The ETCHED study participants are from both Hispanic and AI/AN urban communities residing in the Phoenix Metropolitan Area in Arizona, and each community shares common cultural beliefs, norms, and experience similar environmental and health exposures, scientific observations from a longitudinal study that follows the health status of the population may be very informative for the community in framing health policy decisions. The ETCHED study, supported by the NIDDK Division of Intramural Research Program, plans to recruit approximately 150 pregnant mothers per year for 5-years (750 maternal/child dyads) and follow them through pregnancy, childbirth, and until the offspring's 18th birthday. The study is approved by the NIH IRB and registered at https://clinicaltrials.gov/ct2/show/NCT03481829. The ETCHED study began enrollment in April 2022, we have thus far screened 178 pregnant women for eligibility, we have consented 66 mothers and 34 infants for study participation. Enrollment has been slower than expected primarily due to logistical issue (staffing/space). Since this is a long term study at a new facility we expect slowly to ramp up enrollment and follow up. As of today a total of 117 maternal (prenatal/12-week postpartum and 12-month postpartum) has been completed. We have also completed 96 infant visits (12-week postnatal, 4-month, 6-month and 12-month infant visits).