The New England Family Study, launched in 1959 and now led by a Brown epidemiologist, spans three generations of participants and unlocks key insights for healthy aging.
PROVIDENCE, R.I. [Brown University] - It makes sense that a viral infection during a pregnancy might negatively affect the fetus - but scientists now know that some effects of an adverse event during pregnancy may not be revealed for decades. On a more empowering note, scientists have found that low stress in pregnancy, consistent parenting in a child's early years and quality preschool experiences reduce the risk of heart disease and mental illness in adulthood.
Those particular insights on how early life impacts future health, and many more, were made possible because of the New England Family Study, a one-of-a-kind research project launched in 1959 and continuing today.
"We now know that most diseases and conditions - from breast cancer to heart disease, to dementia, schizophrenia, asthma, reflux disorder - are a result of a combination of genetics and environmental factors," said Brown University epidemiologist Stephen Buka, who directs the New England Family Study. "And a lot of those environmental influences happen really early, in utero or during the first year of life, and they alter physiological development in ways that later are expressed when a person is in their 40s, 50s and 60s."
The study, which launched with the goal of understanding how conditions during pregnancy might contribute to neurodevelopmental problems in children, has followed a cohort of 17,000 pregnant women. The researchers studied the pregnant mothers as well as their children, evaluating health and development through the first seven years of life. Since then, the research team has continued to follow up with participants and has extended the study to include a third generation.
Because the study started evaluating some participants before they were born, the data offer insights into how different factors at the earliest moments of fetal development can impact a person's health over their lifetime.
"The strength of the New England Family Study lies in learning from the same families over generations, from early development through aging," said Buka, a professor of epidemiology who is the founding chair of the Department of Epidemiology at the Brown University School of Public Health. "There's nothing quite like this in the world."
Buka explains the significance in this way: Long-term studies have shown how diet, exercise and sleep are crucial for healthy aging, and how a lifetime of smoking or drinking alcohol contribute to health conditions. Yet there are people who drink and smoke and never exercise with no serious health problems, while others in excellent health develop heart disease or cancer. Part of the explanation for this disparity has to do with what happened to that healthy person even before they were born, Buka said. And if people are aware of their risks, there may be proactive actions they can take - medications or other therapeutic interventions - to reduce the severity or change the outcome.
He noted that data collected as part of the study, which has been funded by the National Institutes of Health, have allowed researchers to study a wide range of health conditions across the human lifespan and unlock key insights for healthy aging. Researchers have advanced scientific understanding of the development and treatment of cancer, heart disease, depression, schizophrenia, substance abuse and more. New England Family Study research has also identified early risks that contribute to the origins of ADHD, including lasting changes in brain structure, and those findings have contributed to establishing attention-deficit/hyperactivity disorder as a recognized medical condition.
The study has also informed interventions. For example, findings demonstrated how differences in learning styles that are apparent in the early years persist throughout adulthood, which has implications for effective provider-patient communication in asthma and diabetes management.
"Study findings have implications for public policy and how we protect and care for pregnant people and their children to prevent conditions and illnesses from developing; service implications for health care, medicine and social services; and personal implications for all of us - advice and recommendations on what we can do to remain healthy and disease-free," Buka said.
Three generations, improving the health of countless others
The New England Family Study originated from the National Collaborative Perinatal Project, which involved 12 research sites across the U.S. with the goal of understanding conditions during pregnancy that might contribute to childhood disorders such as epilepsy, cerebral palsy and blindness. Researchers were also interested in exposures that might alter the development of the fetus, such as infections, cigarette smoke and lead, as well as pregnancy complications.
The initial cohort of 17,000 pregnant participants donated blood samples, were assessed throughout prenatal care, and shared information about their health, medications and social circumstances. Researchers also collected samples from placental tissues and infant cord blood. These biological materials, which number around 800,000, remain in repositories at the National Institutes of Health.
