# Placental DNA Methylation, Maternal Hardship and Child Neurodevelopmental Outcomes

> **NIH NIH K23** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $130,813

## Abstract

PROJECT SUMMARY/ABSTRACT
The overall goal of this application is to establish relationships among DNA methylation, maternal hardship and
neurodevelopmental impairment in extremely preterm children. The central hypothesis is that maternal hardship
clusters are associated with neurodevelopmental outcomes, especially cognitive and affective impairment, in
extremely preterm children and that this relationship is mediated by DNA methylation in the placenta. The study
will examine a diverse sample of extremely preterm children (N = 889) drawn from the Extremely Low Gestational
Age Newborns Study (ELGAN, #1UG3OD023348-01). ELGAN is a multi-center longitudinal study of the risk of
neurologic disorders in extremely preterm children. I will combine existing data on (1) prenatal maternal hardship;
(2) DNA methylation from placental specimens; and (3) neurodevelopmental impairment, specifically cognitive
and affective outcomes at ages 2 and 10. Furthermore, I will be involved in the third phase of ELGAN follow-up
to collect neurodevelopmental impairment data on participants at age 15. The Specific Aims are to (1) Establish
maternal hardship clusters using prenatal socioeconomic and stressful life events factors; (2) Identify
associations between maternal hardship clusters and child cognitive and affective outcomes at ages 2, 10 and
15 years; and (3) Determine the extent to which DNA methylation mediates the relationship between maternal
hardship and cognitive and affective outcomes. This research aligns closely with NINR’s Innovative Question
2.6 on etiological pathways to prevent chronic illnesses with known risk factors in childhood. My research
background is in nursing, with specific foci of maternal hardship, perinatal affective symptoms in minority and/or
other vulnerable mothers, and related child outcomes. My short-term career goal is to expand my research to
link maternal hardship to epigenetic mechanisms and neurodevelopmental outcomes among at-risk children.
The proposed training activities will include formal didactic, hands-on instruction and research immersion in
epigenetics, the biological bases of child neurodevelopment; experience in large interdisciplinary teams;
responsible conduct in research; and publications and attendance at conferences. I have assembled an
interdisciplinary mentoring team of internationally recognized experts. This award will move me to independence
as a researcher, support my next steps in securing funding, and help me achieve my long-term goal of becoming
a nurse leader in longitudinal research to prevent or minimize neurodevelopmental impairment related to
maternal hardship among at-risk children. My subsequent R01 will explore additional epigenetic pathways
related to hardship. I plan to use the 35 cohorts of the NIH Environment influences on Child Health Outcomes
(ECHO Program; ~ 40,000 children by 2019), which includes ELGAN, to identify modifiable factors that could be
potential targets for interventions.

## Key facts

- **NIH application ID:** 10004725
- **Project number:** 5K23NR017898-03
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Hudson Santos
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $130,813
- **Award type:** 5
- **Project period:** 2018-09-26 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10004725

## Citation

> US National Institutes of Health, RePORTER application 10004725, Placental DNA Methylation, Maternal Hardship and Child Neurodevelopmental Outcomes (5K23NR017898-03). Retrieved via AI Analytics 2026-06-14 from https://api.ai-analytics.org/grant/nih/10004725. Licensed CC0.

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