Project Number: 1235-51530-008-10
Project Type: Specific Cooperative Agreement

Start Date: Apr 15, 2005
End Date: Mar 31, 2008

Objective:
The purpose of this research is to investigate the interactions over the lifecourse of growth, nutrition, and environmental factors (such as fetal environment, infancy growth patterns, and socioeconomic environment) with the development of obesity and hypertension in an historical cohort of 8,143 African Americans born in Philadelphia, PA. Subjects were recruited in the 1960¿s at Pennsylvania Hospital and followed prospectively from birth to age 7 years at the University of Pennsylvania and The Children¿s Hospital of Philadelphia (CHOP) as part of the NIH funded multicenter Collaborative Perinatal Project (CPP). Follow-up data were collected by the WM Krogman Center on a sub-sample of 650 subjects at ages 11-23 years-old as a part of the Philadelphia Blood Pressure Project (PBPP). Subsequently, the Pregnancy Across Generations (PAGE) Study was conducted by the WM Krogman Center in 1987-1991 to assess reproductive outcomes in a sub-sample of female members (n=723) of the original Philadelphia cohort. Unique data were collected at each time point, including extensive medical histories and research-quality anthropometric assessments. This dataset constitutes one of the only sources of longitudinal data starting before birth in African Americans. While some of the data from the Philadelphia branch of the CPP was transferred to the NIH and is now available from the National Archives, it is not available in a modern database format that allows convenient access for analyses. Furthermore a large amount of data from this study recently acquired from the WM Krogman Center by CHOP faculty is still available on paper forms only and may be lost to decay. We propose to preserve the critical data from the Philadelphia Branch of the CPP, PBPP, and PAGE in electronic format easily accessible to test several hypotheses related to the lifecourse model.

Approach:
The specific objectives of this proposal are: To preserve the existing data, to test various hypotheses using the lifecourse model of chronic disease development, and to make this unique dataset conveniently available to researchers from multiple disciplines, including nutrition, cardiovascular health, and neurological diseases. To preserve subjects contact information that may be used in future studies to reconstitute the cohort for additional follow-up. To determine the feasibility of a follow-up study and collect pilot data (current weight status and presence of hypertension or diabetes) by contacting a subset of the cohort. Among other, the following hypotheses will be tested: Low birth weight is associated with hypertension and central adiposity in African American adolescents and young adults. Maternal smoking during pregnancy is associated with obesity and hypertension in the offspring during childhood, adolescence, and adulthood. Early growth patterns and early nutrition are associated with hypertension in adolescence and young adulthood in African Americans, and these associations are modified by the socioeconomic environment of the mother during pregnancy. In order to accomplish these objectives, we have obtained from CHOP some internal funding to prepare the paper data for data entry, to create a database that incorporates data already entered during the original study, and to start data entry. Our CHOP internal fund are however insufficient to complete data entry, to perform data quality control, and to perform analyses. Additional USDA funding would be used to complete the tasks that are presently suspended but ready to restart immediately when additional fund is available. Furthermore, it will allow us to complete our third objective and to conduct a feasibility study of contacting this cohort and collecting pilot data. If USDA funding is obtained, the project will be completed and submitted for publications by September 2005.