Identifying the contributions of the gestational and caregiving environments to socioeconomic disparities in child language and cognitive development

Many correlates of poverty have been associated with poor neurodevelopmental outcomes, including psychological stress, micronutrient availability, lack of access to enriching environments, unmet basic needs, and environmental toxins. While these risk factors have been broadly studied, we have limited understanding of the biological processes by which socioeconomic disadvantage “gets under the skin” to shape development and cognitive outcomes. Theorists in the biological sciences have proposed that disadvantage gets biologically embedded during gestation, a highly sensitive period for brain development. Animal studies support this hypothesis, showing that during gestation, the exposures described above increase fetal inflammation and vascular malperfusion in the placenta. Human studies also suggest relationships between socioeconomic disadvantage - and its correlates - with adverse gestational conditions like placental inflammation and malperfusion, as well as clinical outcomes like growth restriction, premature birth, cerebral palsy and autism spectrum disorder. However, the extant human studies generally use coarse measures of placental histology that incompletely characterize the gestational environment, raising questions as to what defines an adverse environment. Additionally, studies have yet to examine whether these placental phenotypes contribute to the well-documented disparities in language and cognitive development, which have life-long learning, social, and economic implications for children and society. We seek to fill these gaps here. This proposal leverages an existing NIH-funded study of disparities in perinatal outcomes, where in-depth assessments of SES conditions and the gestational environment are being performed in 700 pregnant individuals from diverse backgrounds. Participants’ placentas are collected during delivery and undergo extensive assessment resulting in detailed characterization of histologic and molecular profiles. We will follow children born to these individuals, collecting measures of cognitive and language development during the infant-toddler period as well as preschool outcomes at age 4 years