PRECISE-DYAD: a prospective cohort study linking maternal and infant health trajectories in sub-Saharan Africa.

Marie-Laure Volvert, Milly Wilson, Robin Okello Owino, Hannah Blencowe, Angela Koech, Hawanatu Jah, Yahaya Idris, Onesmus Wanje, Isaac Mwaniki, Joseph Mutunga, Fatima Touray, Emily Mwadime, Anna Roca, Geoffrey Omuse, Rachel Craik, Fatoumata Kongira, Moses Mukhanya, Kalilu Bojang, Baboucar Njie, Marvin Ochieng, Umberto D'Alessandro, Grace Mwashigadi, Agnes Mutindi Mutua, Anne Rerimoi, Marleen Temmerman, Joseph Akuze, Melisa Martinez-Alvarez, Dorcas N Magai, Ben Barratt, Yorro Bah, Jing Li, Jaya Chandna, Melissa Gladstone, Amina Abubakar, Rachel M Tribe, Asma Khalil, Prestige Tatenda Makanga, Tatiana Taylor Salisbury, Hiten D Mistry, Sophie E Moore, Helen Nabwera, Veronique Filippi, Laura A Magee, Marianne Vidler, Liberty Makacha, Lucilla Poston, Esperança Sevene, Peter Von Dadelszen

Journal: BMJ open 2026;16(7):e115586

PMID: 42468953

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Abstract

PURPOSE

The PREgnancy Care Integrating Translational Science, Everywhere (PRECISE)-DYAD Study is a prospective observational cohort designed to investigate health outcomes among mother-child pairs (dyads) over the first 3 years of life in two contexts from sub-Saharan Africa. The primary objective of the study was to explore the effects of selected placenta-related complications, such as pregnancy hypertension, fetal growth restriction and preterm birth, on (1) Child health and development, and (2) Women's health and well-being, including outcomes after stillbirth.

PARTICIPANTS

The PRECISE-DYAD Study enrolled women (and their children) originally recruited into the PRECISE pregnancy cohort study in The Gambia and Kenya between July 2021 and April 2024. Participants were seen at 6 weeks to 6 months, 12 months, 24 months and 36 months postpartum. Clinical and health data, including anthropometry and diet, were collected for both mothers and children. Mother assessment included a cardiology assessment and collection of data about symptoms of COVID-19 infection. In a subset of participants, mothers were asked about their mental health, their healthcare costs during and after pregnancy, and experiences of care during labour and childbirth/delivery. Additionally, a personal environmental exposure assessment was performed for a subset of the cohort by collecting air and water quality data alongside geographical, demographic and behavioural factors. Child development was assessed using neurodevelopmental assessments, home environment evaluation and quality of life measures. Biological samples were collected from mothers and children, processed promptly and biobanked locally. Sample data were entered into an OpenSpecimen database and linked to each individual, as well as to their corresponding social determinants and clinical data.

FINDINGS TO DATE

A total of 2980 women and 2909 children completed at least one PRECISE-DYAD Study visit. The biorepository contains 108 897 biological samples from mothers and children. Baseline descriptive analysis of the cohort is reported here.

FUTURE PLANS

Analysis of data and samples will include biomarker studies, social determinants of health and epidemiological investigations. These analyses will explore how placenta-related complications and environmental exposures, such as nutrition and air quality, interact to shape maternal health, mental well-being, subsequent pregnancies and mother-child interaction, as well as child growth and neurodevelopment through early childhood. Additional work will examine the biological pathways linking these exposures to outcomes and the impacts of caring for children with moderate-to-severe disabilities on maternal well-being. Findings will be disseminated through scientific publications, conference presentations, engagement with local stakeholders and continued community outreach.

Address: Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK [email protected].; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.; Centre of Excellence in Women and Child Health, The Aga Khan University - Kenya, Nairobi, Kenya.; Centre for Maternal Reproductive Adolescent and Child Health (MARCH), London School of Hygiene and Tropical Medicine, London, England, UK.; Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Banjul, Gambia.; Amsterdam University Medical Centres, Amsterdam, Netherlands.; Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Banjul, Gambia.; ISGlobal, Barcelona, Spain.; ICREA, Barcelona, Spain.; Department of Pathology, The Aga Khan University - Kenya, Nairobi, Kenya.; Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Banjul, Gambia.; Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, England, UK.; Environmental Exposures and Public Health, Imperial College London, London, UK.; Department of Obstetrics and Gynaecology, The University of British Columbia, Vancouver, Province of British Columbia, Canada.; Institute for Human Development, The Aga Khan University - Kenya, Nairobi, Kenya.; Department of Obstetrics and Gynaecology, Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, England, UK.; Surveying and Geomatics Department, Place Alert Labs, Faculty of the Built Environment, Midlands State University, Gweru, Midlands Province, Zimbabwe.; Climate Environment and Health Department, Centre for Sexual Health and HIV/AIDS Research Zimbabwe, Harare, Harare Province, Zimbabwe.; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, England, UK.; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK.; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.; Division of Public Health and Epidemiology, College of Life Sciences, University of Leicester, Leicester, England, UK.; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.; Surveying and Geomatics Department, Place Alert Labs, Faculty of the Built Environment, Midlands State University, Gweru, Midlands Province, Zimbabwe.; Maternal Health, Centro de Investigacao em Saude de Manhica, Manhica, Maputo, Mozambique.; Physiological Science/Clinical Pharmacology, Universidade Eduardo Mondlane, Maputo, Mozambique, Mozambique.

DOI: 10.1136/bmjopen-2025-115586

MeSH Terms: Humans, Female, Prospective Studies, Pregnancy, Infant, Adult, Infant, Newborn, Infant Health, Maternal Health, Child, Preschool, Child Development, Gambia, Kenya, Pregnancy Complications