JMIR Publications

ABSTRACT

Background Negative early-life exposures, particularly during the golden first 1000 days, may compromise organ development and cause life-long negative consequences. This paper provides a comprehensive overview of a cohort study, underpinned by an exposome and deep-phenotyping framework, aiming to identify potential consequences of exposures, including environmental pollutants during pregnancy and infancy, on child health and development. Methods The study will utilize an ongoing pregnancy cohort with 800 mother-infant pairs in Bhaktapur, Nepal. This cohort is nested within a randomized controlled trial (RCT), which investigated daily vitamin B12 supplementation commencing at ca. 15 weeks of pregnancy up to 6 months postpartum (registered with ClinicalTrials.gov, NCT03071666). The primary outcomes in the RCT were linear growth and neurodevelopment at 12 months of age. Within this project, all children will have reached school age, at which time more reliable estimates of neurodevelopmental outcomes and other health outcomes reflecting future health can be obtained. The study will include the following outcomes: neurodevelopment, vaccine response, thyroid function, growth and body composition, markers of metabolic illnesses, and lung function. Biochemical analyses will include the measurement of environmental pollutants, targeted metabolomics, vitaminomics, epigenetics, and leucocyte telomere lengths. Discussion The current study includes using a well-characterized mother-child cohort in a South Asian setting with repeated biological samples from blood, breast milk, and urine and a wide array of high-quality longitudinal data on health, growth, and neurodevelopment. Using these data, our ambition is to provide a deeper understanding of the interplay between environmental pollutants, nutrition, inflammation, and health outcomes to inform guidelines and interventions to protect vulnerable women and children in marginalized settings.