Evaluating the effect of water fluoridation on adverse birth outcomes

评估水氟化对不良分娩结局的影响

• 批准号: 10284698
• 负责人: Dana E Goin
• 金额: $ 9.96万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10284698
• 关键词: Affect; Area; Arsenic; Award; Biological Process; Birth; Birth Records; Birth Weight; California; Cardiovascular system; Characteristics; Child; Child Health; Communities; Community of Practice; Consumption; Country; Data; Data Science; Development; Education; Endocrine Disruptors; Endocrine system; Environmental Exposure; Environmental Hazards; Environmental Risk Factor; Epidemiologist; Exposure to; Fetal Growth; Fetus; Fluorides; Funding; Future; Gestational Age; Goals; Grant; Health; High Risk Woman; Hormones; Illinois; Individual; Infant; Infant Health; Knowledge; Lead; Life; Link; Low Birth Weight Infant; Machine Learning; Maternal Exposure; Maternal Health; Measures; Mentorship; Metal exposure; Mothers; National Institute of Environmental Health Sciences; Oral health; Outcome; Perinatal Epidemiology; Play; Policies; Population; Population Heterogeneity; Predisposition; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Process; Public Health; Public Health Practice; Research; Research Personnel; Research Training; Risk; Role; San Francisco; Second Pregnancy Trimester; Services; Shapes; Small for Gestational Age Infant; Socioeconomic Status; Statistical Methods; Subgroup; System; Techniques; Temperature; Thyroid Function Tests; Thyroid Hormones; Time; Toxic effect; Training; Translating; United States; United States National Institutes of Health; Universities; Urine; Variant; Vulnerable Populations; Water; Water Supply; Water fluoridation; Whole Blood; Woman; Women Status; adverse birth outcomes; adverse pregnancy outcome; clinical decision-making; cohort; drinking water; environmental chemical; fetal; health disparity; health of the mother; healthy pregnancy; improved; in utero; lead exposure; low socioeconomic status; male; neurodevelopment; novel; perinatal health; population health; prenatal exposure; pressure; programs; sex; social; social factors; systemic inflammatory response; urinary

Project Summary/Abstract The objective of this K99/R00 proposal is to estimate the effect of community water fluoridation on adverse birth outcomes in California and identify whether there are subpopulations who are especially vulnerable to fluoride exposure during pregnancy. Fluoride has been added to water supplies to promote dental health in the United States since 1945, but the impacts on pregnancy outcomes have never been assessed. It is possible that maternal and in-utero fetal exposure to fluoride increases risk of preterm birth and small-for- gestational age. A small number of studies in other countries suggest there is an increased risk of adverse birth outcomes associated with drinking water with naturally high levels of fluoride, and evidence suggests fluoride consumption can affect thyroid function and cardiovascular systems, both of which play important roles in regulating and maintaining a healthy pregnancy. Since 1995, California has required water systems with at least 10,000 service connections to fluoridate their water, but systems were only required to implement a fluoridation program once the funds were allocated. Therefore, there is a substantial amount of variability in which water systems have added fluoride over the last 25 years, and when they did so. We will leverage this variation in water fluoridation practices in California to (1) identify the effects of changes in water fluoridation on adverse birth outcomes during 2006-2017 and (2) evaluate whether there are heterogeneous exposure effects by maternal/fetal characteristics and environmental co-exposures. Furthermore, we will use the ECHO.CA.IL pregnancy cohort, which is composed of pregnant women and their children in San Francisco and Illinois, to (3a) assess whether maternal urinary fluoride during the second trimester is associated with reduced gestational age or lower birthweight-for-gestational-age-z-scores at birth and (3b) evaluate whether there are heterogeneous effects of exposure by maternal/fetal characteristics and environmental co-exposures. The research plan is bolstered by an exceptional mentorship team and training plan at the University of San Francisco, California. The proposed project builds on the applicant’s background in perinatal epidemiology and provides training in new statistical methods to identify heterogeneous exposure effects and education in the biological processes of gestation and parturition, exposure assessment of environmental chemicals, and translating scientific findings to policymakers. The combined research and training plans will enable the candidate to transition into an independent researcher of policy-relevant social and environmental factors that shape perinatal health. This research aligns with NIEHS’s strategic goals to evaluate health effects of the exposome, identify individual susceptibilities to environmental hazards, utilize data science techniques, and generate evidence that can be utilized by policymakers to improve population health.

项目总结/摘要 本K99/R 00提案的目的是评估社区水氟化对不利环境的影响。 出生结果在加州，并确定是否有亚群谁是特别容易受到 怀孕期间接触氟化物。氟化物已被添加到供水，以促进牙齿健康， 美国自1945年以来，但对妊娠结局的影响从未被评估过。 母亲和胎儿在子宫内接触氟化物可能会增加早产和小胎儿的风险。 胎龄其他国家的少数研究表明， 出生结果与饮用天然高水平氟化物的水有关，有证据表明， 氟的消耗会影响甲状腺功能和心血管系统，这两个系统都起着重要的作用 在调节和维持一个健康的怀孕。自1995年以来，加州要求供水系统 至少有10，000个服务连接来氟化他们的水，但系统只需要实施一个 一旦资金到位，就开始实施氟化项目。因此，存在大量的可变性， 过去25年来哪些供水系统添加了氟化物，以及何时添加的。 我们将利用加州水氟化实践的这种变化来（1）确定变化的影响 在2006-2017年期间，水氟化对不良出生结果的影响;（2）评估是否存在 母体/胎儿特征和环境共同暴露的异质暴露效应。 此外，我们将使用ECHO.CA.IL妊娠队列，该队列由孕妇及其 儿童在旧金山弗朗西斯科和伊利诺伊州，（3a）评估是否产妇尿氟在第二次 孕三个月与出生时胎龄减少或出生体重-胎龄-Z评分降低相关 和（3b）根据母体/胎儿特征评估是否存在暴露的异质效应， 环境共暴露。 该研究计划得到了旧金山大学卓越的导师团队和培训计划的支持 加州的弗朗西斯科。拟议的项目建立在申请人在围产期流行病学的背景， 提供新的统计方法的培训，以确定异质性暴露影响和教育， 妊娠和分娩的生物过程，环境化学品的接触评估，以及 将科学发现转化为政策制定者。合并的研究和培训计划将使 候选人过渡到政策相关的社会和环境因素， 塑造围产期健康。 这项研究符合NIEHS的战略目标，以评估健康影响的麻烦，确定个人 对环境危害的敏感性，利用数据科学技术，并生成可以 政策制定者用来改善人口健康。