NATIONAL CHILDREN'S STUDY

国家儿童研究(NCS)是一项前瞻性的纵向队列研究，研究环境暴露和基因环境相互作用对儿童健康和发育的个体和综合影响，样本约为10万名出生在美国的儿童。这些孩子将从出生前一直被跟踪到21岁。本研究的重要性和及时性基于许多因素，包括过去证明环境暴露对儿童健康和发育产生深远影响的经验，例如孕期接触酒精和铅对儿童健康和发育产生深远影响的经验；儿童比成年人特别容易受到环境暴露的影响；已知持续的环境暴露，例如幼童普遍存在的非持久性农药水平或每天媒体暴露时间；以及有证据表明环境造成或导致自闭症、发育迟缓和发育障碍、哮喘和肥胖等高影响条件的原因。NCS的主要目的是调查环境暴露(化学、生物、物理、心理社会)以及基因-环境相互作用对妊娠结局、儿童健康和发育以及成人疾病先兆的单独和联合影响。这项研究的独特之处包括侧重于怀孕初期(以及之后)的环境暴露，以及计划暴露和结果测量的广度。NCS响应2000年《儿童健康法案》的国会授权，即NICHD和一个联邦机构联盟计划并进行一项关于环境暴露对儿童影响的纵向研究。 NCS将采用国家概率抽样方法来选择进行研究的地点和参与者。抽样设计采用多阶段聚类法。在第一阶段中，从美国所有的县中随机选择了105个地点(通常对应于单个县)。其中七个地点作为初始地点或先锋地点，参与NCS的试点阶段。由于这项研究的重点包括评估怀孕早期暴露的影响，因此孕妇及其伴侣和育龄妇女都是最初的登记目标人群。数据将以面对面接触和远程收集方法相结合的方式收集，例如电话、计算机或邮寄问卷。预期的接触频率(面对面或远程)大约是从一岁到一岁每三个月，到五岁每六个月，此后每年。对于参加研究的儿童样本，还将访问托儿所和学校环境，以收集环境样本和观察数据。预期的生物样本包括来自母亲和儿童的血液、尿液、头发和指甲剪片；来自父亲的血液、尿液和头发；脐带血、脐带和胎盘组织，以及在分娩时/前后采集的胎粪；来自母亲的阴道拭子和母乳。预期的环境样本包括空气、灰尘、土壤、食物和水。 。

The National Children's Study (NCS) is prospective longitudinal cohort study of the individual and combined effects of environmental exposures and gene environmental interactions on child health and development in a representative sample of approximately 100,000 children born in the United States. The children will be followed from before birth until age 21. The importance and timeliness of this study are based on many factors, including past experiences demonstrating profound effects of environmental exposures, such as exposures to alcohol during pregnancy and to lead in early childhood on child health and development; the special vulnerabilities of children to environmental exposures compared to adults; known ongoing exposures, such as prevalent levels of non-persistent pesticides or hours of media exposure per day in young children; and evidence for environmental contributions or causes to such high-impact conditions as autism, developmental delay and developmental disability, asthma, and obesity. The primary aim of the NCS is to investigate the separate and combined effects of environmental exposures (chemical, biological, physical, psychosocial) as well as gene-environment interactions on pregnancy outcomes, child health and development, and precursors of adult disease. Unique features of the study include its focus on environmental exposures at the earliest stages of pregnancy (as well as thereafter) and the breadth of planned exposure and outcome measurements. The NCS responds to the Congressional mandate of the Children's Health Act of 2000, that the NICHD and a consortium of federal agencies plan and conduct a longitudinal study of the impacts of environmental exposures on children. The NCS will employ a national probability sampling approach to select locations and participants for conduct of the study. The sampling design utilizes a multistage clustered approach. In the first stage, 105 locations (generally corresponding to single counties) were randomly selected from all U.S. counties. Seven of the locations serve as the initial or Vanguard Locations, participating in the pilot phase of the NCS. Because the focus of the study includes assessment of the impact of exposures that occur early in pregnancy, both pregnant women and their partners, and women of childbearing age, comprise the initial target population for enrollment. Data will be collected in combinations of face-to-face contacts and remote collection methods, e.g., telephone, computer, or mail-in questionnaires. The expected frequency of contact (face-to-face or remote) is approximately every three months through age one, every six months through age five years and annually thereafter. For a sample of children enrolled in the study, visits will also be made to child care and school settings for collection of environmental samples and observational data. Anticipated biologic specimens include blood, urine, hair, and nail clippings from mothers and children; blood, urine, and hair from fathers; cord blood, umbilical cord and placental tissues, and meconium collected at/around the time of delivery; vaginal swabs, and breast milk from mothers. Anticipated environmental samples include air, dust, soil, food, and water. .