Methods to Detect Maternal Exposures and Child Outcomes

描述（由申请人提供）：本项目的总体目标是识别与儿童发育障碍和智力迟钝（DD/MR）有关的宫内暴露关键时期的可疑有机和无机化学品。该研究将比较个体水平分析与新的时空统计方法，从对个体的聚类分析中推断出与时空暴露相关的风险。研究将分为三个阶段。在第一阶段，我们将检验在怀孕期间母亲居住的婴儿中存在DD/MR群集的假设。我们将使用医疗补助计划产前和产后医疗数据以及月地址将15.2万多对母婴联系起来，因此可以使用空间统计来识别DD/MR集群。在第二阶段，我们将测试假设，即土壤样本将显示毒性水平的变化，可用于识别可能与DD/MR相关的可疑有机和无机化学物质浓度较高的地点。这将涉及收集和分析来自群集地点和DD/MR发生率不高的比较地区的土壤样本。此外，我们将测试这样一个假设，即汞、铬、砷、多氯联苯和其他选定的化学污染物在高毒性土壤样品中的浓度将高于使用Microtox鉴定的低毒性土壤样品。我们将把高毒性和低毒性土壤的子样本送到外部分析实验室进行化学分析。在第三阶段，我们将检验一个假设，即在控制了母婴风险因素后，在胎儿发育的关键时期，母亲居住在有毒废物场所附近，与确定的化学物质接触，将与婴儿DD/MR的高风险相关。这将涉及发展结合传统和空间程序的统计方法，以分析空间关系、时间暴露（怀孕月份）和土壤样本之间的关联。这些可用于产生与DD/MR相关的特定环境暴露的假设。这项研究将是多学科和多方法的，特别强调新技术的发展，以分析环境和医疗数据的复杂关联。

DESCRIPTION (provided by applicant): The overall aim of this project is to identify suspect organic and inorganic chemicals during critical periods of intrauterine exposure that are associated with child developmental disabilities and mental retardation (DD/MR). The study will compare individual level analysis with new spatial and temporal statistical methods to infer from analysis of clusters to individuals about the risk associated with temporal and spatial exposures. The study will be divided into three phases. During Phase I we will test the hypothesis that there are clusters of DD/MR among infants identified by maternal residence during pregnancy. We will link over 152,000 maternal child pairs using Medicaid prenatal and postnatal medical data, and monthly addresses, so clusters of DD/MR can be identified using spatial statistics. During Phase II we will test the hypothesis that soil samples will show variation in toxicity levels that can be used to identify locations with potentially greater concentrations of suspect organic and inorganic chemical which may be associated with DD/MR. This will involve collecting and analyzing soil samples from cluster sites and from comparison areas where rates of DD/MR are not elevated. In addition, we will test the hypothesis that mercury, chromium, arsenic, PCBs, and other selected chemical contaminants will be measured in higher concentration in the higher toxicity soil samples compared to the lower toxicity soils, as identified using Microtox. We will send a subsample of the high and low toxicity soil for chemical analyses at an external analytical laboratory. During Phase III we will test the hypothesis that maternal residence proximal to toxic waste sites with identified chemical exposures, during critical periods of fetal development, will be associated with higher risk for DD/MR in the infant, after controlling for maternal and child risk factors. This will involve the development of statistical methods that combine traditional and spatial procedures to analyze associations between the spatial relationship, temporal exposure (month of pregnancy), and soil samples. These can be used to generate hypotheses about specific environmental exposures associated with DD/MR. This research will be both multidisciplinary and multimethod, with specific emphasis on the development of new techniques, to analyze the complex associations of environmental and medical data.