The effects of genetics, home environment, and prenatal substance use on child health and brain development are largely unknown, even though pregnancy and early childhood are incredibly important periods of growth. To address this knowledge gap, Penn State was recently awarded a five-year, $5.8 million grant and selected as part of a longitudinal NIH-funded consortium called the HEALthy Brain and Child Development (HBCD) Study.
The HBCD will establish a large cohort of 7,500 pregnant people and follow them and their children from before birth through early childhood. Findings from this cohort study will provide a template of normative neurodevelopment and help untangle the impacts of perinatal exposures to substances and childhood environments on developmental trajectories.
The first phase of the study began two years ago at several locations across the country to plan the design and approach of the study. Co-multiple principal investigator Aleksandra Zgierska, MD, professor of family and community medicine, public health sciences, and anesthesiology and perioperative medicine at Penn State College of Medicine, was awarded a Phase I HBCD grant during her previous tenure at the University of Wisconsin – Madison.
“I am a family physician who also specializes in addiction medicine. In my career, I’ve cared for and became an advocate for pregnant women with substance use disorders and their children,” said Zgierska. “These experiences led me to apply for the grant, which enabled me to collaborate with groups from across the country and plan protocols for the consortium study.”
Upon arriving at the College of Medicine in January 2020, Zgierska established new collaborations at Penn State, including with the Consortium on Substance Use and Addiction, the Clinical and Translational Science Institute, and Penn State Extension.
Working with co-multiple principal investigator Koraly Pérez-Edgar, McCourtney Professor of Child Studies and professor of psychology in the College of the Liberal Arts and associate director of the Social Science Research Institute, the team successfully competed to become a part of this important birth cohort study.
“The collaboration involving faculty at both the University Park and College of Medicine campuses of Penn State enabled this team to pull together the expertise and resources that led to this exciting opportunity to become one of 25 sites for Phase II of the HBCD Study,” said Deborah Ehrenthal, director of the Social Science Research Institute, who worked with Zgierska on the Phase I grant when they were both faculty members at University of Wisconsin - Madison.
The current award will support the collection of a large dataset across the U.S. that will enable researchers to analyze brain and cognitive development and overall health of children across a variety of regions, demographics, home environments, and maternal and family health and behaviors.
“Because the Penn State study site encompasses multiple campuses, we can recruit families from rural and semi-rural communities across a large geographic area,” said Zgierska. “Rural pregnant women, in particular, are largely understudied.”
According to Pérez-Edgar, knowledge of normal brain development and how it may be affected by exposure to opioids and other substances, stressors, trauma, and other environmental influences is critical.
“Since it is unclear how much harm may be caused by substance use alone, the project will enable researchers to disentangle substance use from other factors that can impact development and health. It will also help us predict and prevent some of the known harms of prenatal and postnatal exposure to certain drugs, including risk for future substance use, mental disorders, and other behavioral and developmental problems.”
Zgierska says the team has extensive experience to address public health threats, including addiction, pain, and mental health problems, along with experience caring for women, children, and their families, and recruiting and retaining in research studies mothers at risk of substance use and other health concerns. “We’ll be targeting the effects of substance use exposures and other factors, assembling a rich data set openly available for other research, and also providing training opportunities to students, fellows and junior faculty to support the future research pipeline.”
In addition, this research infrastructure can also be leveraged for studying urgent, emerging health threats such as the current COVID-19 pandemic and mitigate their negative effects on child development and health.
Other Penn State co-investigators on the project are Danielle Downs, professor of kinesiology and obstetrics & gynecology; Rina Eiden, professor of psychology; Jenae Neiderhiser, distinguished professor psychology and human development and family studies; Michele Diaz, professor of psychology and linguistics; Sangam Kanekar, MD, professor of diagnostic radiology, neuroradiology, and radiology; Dara Babinski, clinical psychologist and assistant professor of psychiatry; Jaimie Maines, assistant professor of obstetrics and gynecology; Tammy Corr, neonatologist and associate professor of pediatrics; and Wen-Jan Tuan, assistant professor of family and community medicine.
Additional Penn State partners include the Center for Healthy Children/Child Maltreatment Solutions Network; Social, Life, and Engineering Sciences Imaging Center; Douglas W. Pollock Center for Addiction Outreach and Research; Penn State Extension; and the Pennsylvania Office of Rural Health.
Other partners are the Appalachian Translational Research Network, Faces & Voices of Recovery, The RASE Project, Geisinger, Lehigh Valley Health Network, Mount Nittany Health, and WellSpan Health.
HBCD is funded by 10 institutes and offices at the National Institutes of Health (NIH) and through the Helping to End Addiction Long-termSM (HEAL) Initiative, and is led by the National Institute on Drug Abuse. Additional funding and support is being provided by various Penn State units.