Pre-conceptual and early pregnancy influences on maternal and offspring health.
Incepted in 2007 as a collaborative effort with the two major public maternity hospitals in Singapore, National University Health System (NUHS) and the KK Women’s & Children’s Hospital (KKH), GUSTO is the region’s leading longitudinal birth cohort study that combines multi-ethnic Asian participants with detailed records of ante and post-natal data and biological specimens from both mother and child. These data include rare insights into newborn body composition and correlated future obesity via infant MRIs in the 1st week of birth, molecular analysis of birth tissues (placenta, umbilical cord, cord blood) and ongoing breast milk, stool, nasal and buccal swab specimens post-natal up to 2 years of age for the over 1500 mother-child pairs recruited. [Clinical/experimental] assessments include nutritional, biochemical, imaging, molecular and cognitive studies of the mothers and infants, with extensive implications for understanding future metabolic compromise, allergic and respiratory illnesses, cognitive spectrum childhood disorders and more. Additional information on the GUSTO study is available online at http://gusto.sg.
The preconceptual period is now recognized as a time when the mothers’ condition can profoundly affect subsequent development of her child through the induction of relevant epigenetic signals occurring both before and soon after conception. We plan to set up a cohort study of women recruited before pregnancy, GUSTO-Mum, to investigate this potentially important clinical window. This additional cohort also permits a critically important opportunity to replicate and extend our findings from GUSTO, including associations between specific epigenetic ‘marks’ and developmental outcomes in the offspring. We will recruit 900 women aged between 18 and 40 years who are actively seeking pregnancy over an 18-month window of which we estimate at least 400 will get pregnant during the recruitment window. Detailed pre-pregnancy, pregnancy & early childhood phenotyping will be conducted.
This approach is critical for the establishment of effective prevention studies since the influences of maternal health on offspring phenotype can occur very early in development prior to any contact with obstetric health services. Our overall aim is to translate DOHaD science into advances in prevention and intervention strategies targeting healthy childhood development, and reducing the risk of metabolic and mental diseases.