Developmental Pathways to Health and Disease: Metabolic, Neurodevelopmental and Related Outcomes. (GUSTO)
This study aims to test the following two hypotheses in women recruited in early pregnancy and whose children will be followed up till at least 9 years of age.
- Epigenetic changes in conceptual tissues obtained at birth reflect the environment that the fetus was exposed to during development.
- The pattern of epigenetic marks in gene promoters obtained from DNA in birth tissues, together with genotype, phenotype, and environmental exposures, can be utilized to assess how the perinatal environment affects subsequent metabolic, neurodevelopmental and other phenotypes.
Neurological and Mental Health Conditions
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Growing Up in Singapore Towards Healthy Outcomes|
- Pattern of epigenetic marks in birth tissues [ Time Frame: Perinatal ] [ Designated as safety issue: No ]To examine how epigenetic change at birth both reflects past developmental influences and, in association with other factors, influences future trajectories of development and its relationship to NCDs.
- Influence of prenatal and early postnatal factors [ Time Frame: During pregnancy and infancy period ] [ Designated as safety issue: No ]Maternal nutrition, lifestyle, and emotional health and/or nutrition and other signals in infancy can influence the development of phenotypes in childhood that confer risk for later metabolic and mental disorders.
Biospecimen Retention: Samples With DNA
During pregnancy; Mother: blood, buccal and hair samples. At delivery; cord, cord blood and placenta. During infancy; Stool, nasal, buccal samples from the children breast milk from breastfeeding mothers
|Study Start Date:||June 2009|
|Estimated Study Completion Date:||June 2020|
|Estimated Primary Completion Date:||June 2020 (Final data collection date for primary outcome measure)|
Pregnant mothers, neonates, infants and children
Women in their early pregnancy who are attending the first trimester antenatal ultrasound scan at the public maternity units at KK Women's and Children's Hospital (KKH) and National University Hospital (NUH). Only women age 18 years and above who are Singapore Citizens or Singapore Permanent Residents. Participants have to intend to eventually deliver in NUH or KKH and to reside in Singapore for the next 5 years. Willingness to donate cord, cord blood and placenta. The fetus should be racially homogenous with both sets of grandparents of the same ethnicity. Babies born from these mothers will be followed up until the child is at least 9 years of age.
The dramatic emergence of non-communicable diseases (NCDs) in Asia has coincided with the rapid socioeconomic and nutritional transition taking place in the region, with the prevalence of diabetes rising five-fold in Singapore in less than four decades. One unique aspect of the epidemic has been the significant ethnic differences in predisposition among Asians and in the ethnic variation between BMI and the risk of developing insulin resistance. Apart from genetic factors, the differences in diet, lifestyle, cultural and religious practices might have altered the developmental programming through effects on the mechanisms of developmental plasticity. A center piece of this study is to examine how epigenetic change at birth both reflects past developmental influences and, in association with other factors, influences future trajectories of development and its relationship to NCDs. The longitudinal GUSTO birth cohort study allow us to examine associations between genomic variation and developmental-environmental interactions in the three distinct ethnic groups, Chinese, Malays and Indians, present in the Singaporean population.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01174875
|National University Hospital|
|Principal Investigator:||Yap-Seng Chong||National University Health System|