Maintenance and Enhancement of the Atlanta African American Maternal-Child Cohort

Emory University, Atlanta GA

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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. In the United States, African American mothers and children disproportionately experience adverse outcomes – including cardiometabolic complications of pregnancy, preterm birth, small-for-gestational age, neurodevelopmental delays and obesity. While these outcomes are most prevalent among African Americans, they occur across the US population at rates exceeding Healthy People targets. Notably, all of these conditions have been linked to environmental exposures yet remain poorly understood and inadequately addressed by preventive strategies. Progress in mitigating these adverse maternal-child health conditions in the United States has been hindered by the etiologic complexity of these perinatal and child health outcomes, the lack of biomarkers to indicate impactful exposures and individual susceptibility, and the insufficient pipeline of environmental health scientists trained in both exposure science and social epidemiology. With NIH support, our team has established a socioeconomically diverse, deeply phenotyped African American maternal-child environmental epidemiology cohort (EEC) that enrolls mothers during early pregnancy and follows dyads through early childhood to investigate prenatal toxicant and stress exposures, along with the microbiome, epigenome, and metabolome, on perinatal and child health. To date, we have enrolled >700 mother-child dyads, with documented rates of prenatal toxicant exposures, preterm birth, and obesity substantially exceeding national rates, underscoring the cohort’s unique value in advancing understanding of maternal-child health and informing solutions applicable to broader US populations. We have leveraged this cohort to characterize the impact of prenatal exposures to persistent and non-persistent chemical-psychosocial stressor mixtures on adverse birth outcomes; identify maternal metabolic perturbations associated with environmental exposures and adverse birth outcomes; and examine the relationship between maternal stress and offspring epigenetic age acceleration and emotional reactivity (highlighting intergenerational impacts of exposure); and investigate toxicant exposures associated with personal care product use. To further advance environmental health science and the environmental health workforce, we propose to: 1) Expand cohort enrollment and longitudinal follow-up, focusing on critical windows of susceptibility (pregnancy); 2) Enhance data collection to include area-level environmental measures (traffic-related air pollution, residence in a food desert) and metabolic signatures of bio-transformed metabolites of personal care products for inclusion in analytic models of risk for adverse perinatal health outcomes; and 3) Engage in data sharing and collaborative mentoring with early-stage investigators in environmental health training programs at Emory University, University of Georgia, and Morehouse School of Medicine.