The Children’s Respiratory and Environmental Workgroup (CREW) birth cohort consortium: design, methods, and study population

Abstract

Background Single birth cohort studies have been the basis for many discoveries about early life risk factors for childhood asthma but are limited in scope by sample size and characteristics of the local environment and population. The Children’s Respiratory and Environmental Workgroup (CREW) was established to integrate multiple established asthma birth cohorts and to investigate asthma phenotypes and associated causal pathways (endotypes), focusing on how they are influenced by interactions between genetics, lifestyle, and environmental exposures during the prenatal period and early childhood. Methods and results CREW is funded by the NIH Environmental influences on Child Health Outcomes (ECHO) program, and consists of 12 individual cohorts and three additional scientific centers. The CREW study population is diverse in terms of race, ethnicity, geographical distribution, and year of recruitment. We hypothesize that there are phenotypes in childhood asthma that differ based on clinical characteristics and underlying molecular mechanisms. Furthermore, we propose that asthma endotypes and their defining biomarkers can be identified based on personal and early life environmental risk factors. CREW has three phases: 1) to pool and harmonize existing data from each cohort, 2) to collect new data using standardized procedures, and 3) to enroll new families during the prenatal period to supplement and enrich extant data and enable unified systems approaches for identifying asthma phenotypes and endotypes. Conclusions The overall goal of CREW program is to develop a better understanding of how early life environmental exposures and host factors interact to promote the development of specific asthma endotypes.

Longitudinal trajectories of severe wheeze exacerbations from infancy to school age and their association with early‐life risk factors and late asthma outcomes

“…However, the proportion of subjects with early‐onset frequent exacerbations is inevitably low (even in large birth cohort studies), rendering investigations into mechanisms difficult. Pooling the data from multiple birth cohorts, such as in STELAR and CREW consortia, may facilitate such studies (eg investigating genetic predictors of different exacerbation trajectories). However, to gain insight into the mechanisms, it is likely that any findings will have to be coupled with data generated in careful studies of patients with frequent exacerbations, and in mechanistic studies in human and animal models …”

“…However, the proportion of subjects with early-onset frequent exacerbations is inevitably low (even in large birth cohort studies), rendering investigations into mechanisms difficult. Pooling the data from multiple birth cohorts, such as in STELAR 45 and CREW 46…”

A distributed geospatial approach to describe community characteristics for multisite studies

“…Our approach extends a previously developed Decentralized Geomarker Assessment for Multi-site Studies (DeGAUSS) containerization platform to perform geocoding and extraction of polygon feature geospatial data over multiple time periods and large geographic areas [5]. As an example case, we use our approach to ascertaining US census tract-level information for participants enrolled in the Children's Respiratory and Environmental Workgroup (CREW), a network of 12 birth cohorts each studying the development of allergy and asthma in childhood [6].…”

Archive for Research in Child Health (ARCH) and Baby Gut: Study Protocol for a Remote, Prospective, Longitudinal Pregnancy and Birth Cohort to Address Microbiota Development and Child Health

“…This is especially important in light of emerging evidence that the pregnancy gut microbiome is involved in fetal development and health outcomes [27]. Many cohort studies do not collect maternal fecal samples [27][28][29][30][31][32][33][34][35][36][37][38][39]. For those that do, maternal fecal samples are usually collected at birth or post-partum [40][41][42][43][44][45][46][47][48], with very few cohorts collecting fecal samples during gestation [49].…”