This K01 award will allow the candidate, Dr. Sarah Messiah, to gain the skills, knowledge and experience required to become an independent investigator. Using data from the Miami Prenatal Cocaine Study (MFCS, Dr. Emmalee Bandstra, Principal Investigator), Dr. Messiah will examine the relationship between in utero cocaine exposure, anthropometric growth and development of cardiometabolic disease risk factors in African American children at ages 16-18. The MPCS has collected 11 prior waves of multi-domain data on over 400 infants and their mothers/alternate caregivers through early adolescence and is now embarking on 2 additional waves of data collection at ages 16 -18 years. The proposed mentored research has three specific aims: (1) To longitudinally compare anthropometric measures (height, weight, body mass index, waist circumference, and body composition) among urban, African American children and adolescents who were or were not prenatally exposed to cocaine using a previously established and well-characterized NIDA cohort; (2) To compare cardiometabolic risk factors (fasting glucose, insulin, lipids, CRP, blood pressure) cross-sectionally among urban, African American adolescents who were or were not exposed prenatally to cocaine using a previously established and well-characterized NIDA cohort; and (3) To determine the specific effects of both prenatal and postnatal exposures of cocaine in a repeated measures multivariate analysis, controlling for effect modifiers (nicotine, alcohol and marijuana exposure, stress, anxiety and depression in children and mothers) on: (a) Overweight and obesity, (b) Underweight, and (c) > 3 cardiometabolic risk factors (often referred to as metabolic syndrome). To achieve this research and her career development goals, Dr. Messiah will follow a career development plan at the University of Miami Miller School of Medicine, designed to provide knowledge, skills, and experience in 4 core competencies (hfe course of disease, with particular emphasis on in utero cocaine exposure, longitudinal/latent growth analytical methods, embryology, and cardiometabolic disease risk factor development in childhood and subsequent risk for adult onset chronic disease). The broad, long-term goal of the proposed research is to elucidate causal and non-causal links with a specific focus upon how in utero cocaine exposure might alter the occurrence and trajectories of anthropometric grovrth, and subsequent development of cardiometabolic disease risk factors. Findings from this investigation should inform both the fields of substance use and cardiovascular research about subsequent risks of cocaine ingestion during pregnancy in offspring.