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Duke launches Project HOPE1000

Friday, November 9, 2018
Sallie Permar; Geeta Swamy

Project Hope1000, a new Children’s Health & Discovery Initiative (CHDI) research study led by Sallie Permar, MD, PhD, professor of pediatrics, molecular genetics and microbiology, and immunology, and associate dean of physician-scientist development for the Duke University School of Medicine, and Geeta Swamy, MD, associate professor of obstetrics and gynecology, vice dean and associate vice provost for scientific integrity for the Duke University School of Medicine, and vice chair for research and faculty development for the Department of Obstetrics and Gynecology, launches this week, coinciding with World Prematurity Day. The cohort study will be comprised of 1000 mother-infant pairs and focus on biological measures during the first 1000 days of life to understand the links between pregnancy factors and mother/infant health outcomes. New participants will be eligible to enroll in the study during the next 3 years.

“Although it is widely known that the first 1000 days of life profoundly influence lifelong health and disease, there have been few longitudinal studies that have investigated data on health, socioeconomic factors, and environmental exposures collected beginning in pregnancy through the second year of life and beyond,” said Ann Reed, MD, chair of the Department of Pediatrics and physician-in-chief of Duke Children’s. “The Project HOPE1000 study will be instrumental in furthering development of preventive strategies, diagnostics and early therapies to promote health in child and adult populations.”

While pregnancy and early life are an important developmental window that determines life-long health trajectories, pregnancy is the most significant alteration in anatomy and physiology during adulthood. Pregnancy affects nearly all major organ systems and is characterized by changes in heart function, kidney function, respiration, gut motility, and hormone secretion. Importantly, there is growing evidence that pregnancy has long-term impacts on maternal physical and mental health.

In addition, epidemiological studies have identified associations between birth weight, prematurity, maternal conditions and environmental exposures during pregnancy with later disease development. For example, low birth weight is associated with later development of cardiovascular disease, osteoporosis, type 2 diabetes, and obstructive airway disease, while various maternal factors, including diet, BMI, and gestational diabetes are correlated with cardiovascular disease, kidney disease, and metabolic syndrome.

“Reducing premature birth is a major population health goal for Duke OB-GYN and Duke Health,” noted Matthew D. Barber, MD, MHS, chair of the Department of Obstetrics and Gynecology. “While nationally preterm birth rates continue to rise, we are starting to see some progress in our local community. Notably, Duke’s Prematurity Prevention Program partnering with our Pregnancy Medical Home program are making a positive difference in our community and have been highlighted as a model to help decrease the preterm birth rate.”

Pregnant participants will enroll in Project HOPE1000 in the first or second trimester of pregnancy (up to 24 weeks of gestation) and have study visits during each trimester of pregnancy, at delivery of their baby, and at 4-6 weeks postpartum. During each of the study visits, mother and/or infant participants will provide a series of biospecimens. Additionally, each participant will wear a silicone wrist band, which will serve as a passive environmental sampler, for 5 days each trimester, and will fill out study surveys related to diet, environmental exposures, and social determinants of health. Finally, each participant will consent to long-term follow-up via their electronic health records and academic and social services data. These data will be used to identify factors that contribute to poor birth outcomes, including pre-term birth and low birth weight, maternal health outcomes, and longer-term child health and well-being outcomes, including academic achievement and growth trajectories.

The Project HOPE1000 study has been designed as a “backbone” protocol that is meant to serve the needs of multiple investigators. Research teams interested in using the data and biospecimens from the study, or who are interested in collecting additional biospecimens or data from the study participants, are encouraged to contact the study team to discuss potential future collaborations.

Primary funding for Project HOPE1000 has been provided by the Translating Duke Health Initiative.

For additional information about the research study and enrollment criteria, please email childrensdiscovery@dm.duke.edu.