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. 2021 Apr 1;11(4):e044798.
doi: 10.1136/bmjopen-2020-044798.

Cohort profile: Understanding Pregnancy Signals and Infant Development (UPSIDE): a pregnancy cohort study on prenatal exposure mechanisms for child health

Thomas O'Connor  1   2   3   4   5 , Meghan Best  2 , Jessica Brunner  1   2   6 , Allison Avrich Ciesla  1 , Allison Cunning  2 , Ntemena Kapula  2   6 , Amber Kautz  7 , Leena Khoury  1   2 , Allison Macomber  2 , Ying Meng  6 , Richard K Miller  2 , Hannah Murphy  2 , Carolyn M Salafia  8   9 , Ana Vallejo Sefair  5 , Jishyra Serrano  2 , Emily Barrett  10   11   12 ; UPSIDE study
Collaborators, Affiliations

Cohort profile: Understanding Pregnancy Signals and Infant Development (UPSIDE): a pregnancy cohort study on prenatal exposure mechanisms for child health

Thomas O'Connor et al. BMJ Open. .

Abstract

Purpose: Extensive research suggests that maternal prenatal distress is reliably related to perinatal and child health outcomes-which may persist into adulthood. However, basic questions remain regarding mechanisms involved. To better understand these mechanisms, we developed the Understanding Pregnancy Signals and Infant Development (UPSIDE) cohort study, which has several distinguishing features, including repeated assessments across trimesters, analysis of multiple biological pathways of interest, and incorporation of placental structure and function as mediators of child health outcomes.

Participants: Women with normal risk pregnancies were recruited at <14 weeks gestation. Study visits occurred in each trimester and included extensive psychological, sociodemographic, health behaviour and biospecimen collection. Placenta and cord blood were collected at birth. Child visits (ongoing) occur at birth and 1, 6, 12, 24, 36 and 48 months of age and use standard anthropometric, clinical, behavioural, biological and neuroimaging methods to assess child physical and neurodevelopment.

Findings to date: We recruited 326 pregnancies; 294 (90%) were retained through birth. Success rates for prenatal biospecimen collection were high across all trimesters (96%-99% for blood, 94%-97% for urine, 96%-99% for saliva, 96% of placentas, 88% for cord blood and 93% for buccal swab). Ninety-four per cent of eligible babies (n=277) participated in a birth examination; postnatal visits are ongoing.

Future plans: The current phase of the study follows children through age 4 to examine child neurodevelopment and physical development. In addition, the cohort participates in the National Institutes of Health's Environmental influences on Child Health Outcomes programme, a national study of 50 000 families examining early environmental influences on perinatal outcomes, neurodevelopment, obesity and airway disease. Future research will leverage the rich repository of biological samples and clinical data to expand research on the mechanisms of child health outcomes in relation to environmental chemical exposures, genetics and the microbiome.

Keywords: epidemiology; obstetrics; paediatrics; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Consort figure on recruitment and retention in the upside study (n=326).
Figure 2
Figure 2
Timing of placental delivery in relation to standard work hours (spontaneous births only).
See this image and copyright information in PMC

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