Miami-ECHO: A Cohort of Mothers, Children and Fathers in Miami-Dade County

Variability in maternal and child health outcomes can emerge across generations, as stress experienced by mothers may influence their children’s development through both biological and psychological pathways. Without a clear understanding of the factors contributing to these outcome patterns—and without longitudinal assessment across large populations—important gaps in knowledge will remain. The Environmental influences on Child Health Outcomes (ECHO) Program seeks to advance understanding of how early life factors shape child health and development. To do this effectively, the program requires a large demographically representative cohort of children and their parents. We propose to establish the Miami-ECHO cohort site, composed of mothers, children, and fathers from Miami-Dade County (MDC), Florida. We will recruit and retain a large cohort of pregnant women (N=1,250), their offspring, and the conceiving father. In addition, we will enroll mothers who have a second pregnancy into the ECHO preconception protocol. Miami-Dade County (MDC) includes one of the largest urban population in the nation. Yet, this region is not currently represented in the ECHO Program. Our team has longstanding access to the region’s largest health care settings and has collaborated with organizations that have served families in MDC for over 40 years. To advance the goals of ECHO science, we propose to address the following aims: A) Examine social environment and placental genome influences in children’s neurodevelopment and positive health (e.g., global health) outcomes. We will determine whether the placental genome mediates the relationship between pre- and perinatal factors and children's neurodevelopment and global health during early and middle childhood; and identify the interactive (gene x epigene x environment) effects on children's neurodevelopment and global health during early and middle childhood. B) Identify factors that protect against the effects of stressors on children’s neurodevelopment and positive health (e.g., global health) outcomes. We will distinguish the effects of stressors – separately and in combination – on children's neurodevelopment and global health from early to middle childhood; and determine the degree to which the early life factors and social support mediate the effects of stress on children's neurodevelopment and global health. C) Establish the Miami ECHO cohort site of mothers, children, and fathers. And D) Identify the effects of modifiable stressors and preconception health on pregnancy morbidity and birth outcomes. These aims will contribute to better understanding child health developmental outcomes in our nation.