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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
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The PRIMERO birth cohort: Design and baseline characteristics

Jonathan I Witonsky1, Jennifer R Elhawary2, Celeste Eng2

  • 1Department of Pediatrics, University of California, San Francisco, Calif.

The Journal of Allergy and Clinical Immunology. Global
|June 9, 2025
PubMed

Insights

Puerto Rican children in the PRIMERO study are being monitored for early-life respiratory illnesses (RIs) and asthma development. This research investigates the link between RIs and asthma in a high-risk population.

Area of Science:

  • Pediatric Respiratory Medicine
  • Environmental Epidemiology
  • Infectious Disease

Background:

  • Early-life respiratory illnesses (RIs) are associated with childhood asthma, but the causal relationship remains unclear.
  • Puerto Rican children experience a high burden of both RIs and asthma, making them a key population for this research.
  • Investigating whether RIs predispose children to asthma or if they are co-occurring conditions is crucial.

Purpose of the Study:

  • To describe the design and baseline characteristics of the Puerto Rican Infant Metagenomic and Epidemiologic Study of Respiratory Outcomes (PRIMERO) birth cohort.
  • To examine the role of respiratory viruses in the development of RIs and asthma.
  • To understand the early-life determinants and mechanisms of virus-related asthma.

Main Methods:

  • Recruitment of pregnant women at a specific hospital in Caguas, Puerto Rico.
  • Collection of clinical, social, and environmental data via questionnaires at birth and annual follow-ups.
  • Collection of various biospecimens including maternal blood, infant cord blood, infant blood at year 2, and nasal airway epithelium samples over 5 years.

Main Results:

  • 2,100 mother-child dyads enrolled between February 2020 and June 2023.
  • High participant retention (2,069 active) with robust biospecimen and visit participation.
  • Surveillance identified 6,076 RIs, with 38.4% affecting the lower respiratory tract.

Conclusions:

  • The PRIMERO birth cohort provides a unique dataset for studying virus-related asthma development.
  • Comprehensive data on viral exposures, respiratory outcomes, and airway molecular phenotypes are available.
  • The study is well-positioned to address critical questions about early-life determinants of asthma in a high-risk population.
Abstract

Keywords:
Childhood asthmaPuerto Ricobirth cohortgene–environment interactionshealth disparitiesrespiratory illnesstranscriptomicsviral pathogen detection

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