The Early Tracking of Childhood Health Determinants (ETCHED) study, conducted by NIDDK's PECRB, began enrolling pregnant women (aged 18+, AI/AN or Hispanic ethnicity) in April 2022 at VHMC, Phoenix. The study aims to follow 750 mothers and their offspring for 23 years to investigate maternal risk factors' impact on offspring's birth weight, weight, and adiposity. Secondary objectives include studying maternal factors' role in child growth, neurodevelopment, and gut microbiome changes. Data collection includes demographics, medical history, and biospecimens. The study is approved by NIH IRB and involves extensive community outreach.