Project 1 addresses one of the most pressing health issues in the United States: the preventable loss of life and long-term morbidity associated with maternal health complications. Unlike many clinical trials or biobank studies that begin data collection during or after pregnancy, Project 1 uniquely centers the preconception period as a biologically sensitive window for intervention. Recent insights on the cumulative biological toll of chronic stress exposure on women, from exposures ranging from interpersonal trauma to neighborhood deprivation can result in persistent activation of the HPA axis, elevated inflammatory markers, and disruptions in epigenetic regulation of immune pathways. Project 1 operationalizes these insights through quantitative assessments of life course stress trauma alongside comprehensive multi-omics profiling, allowing for the identification of mechanistic pathways linking stress to maternal health outcomes. Our team is one of the first in the nation to integrate tissue-based digital spatial profiling with maternal immune analysis in longitudinally followed women. This work not only improves scientific understanding but lays the foundation for a new generation of early-warning biomarkers that could predict risk for preterm birth, gestational diabetes, or hypertensive disorders before pregnancy begins.