Endocrine Disruption in Pregnant Women:Thyroid Disruption and Infant Development

描述（由申请人提供）：孕妇的正常甲状腺功能对其子女的大脑发育至关重要。最近的数据表明，即使在无症状的亚临床甲状腺功能减退症的妇女，他们的后代的智力受到影响。NICHD的母胎医学单位（MFMU）网络目前正在一项多中心随机试验中前瞻性评估甲状腺激素替代治疗亚临床疾病妇女是否能改善其子女的结局。美国国家研究理事会的一个专家小组报告说，3%的发育障碍是暴露于环境暴露的直接结果，更大比例的发育障碍是由环境因素和个体遗传易感性之间的相互作用引起的。人类广泛接触工业化学品多溴二苯醚和高氯酸盐，这些内分泌干扰物已被证明会干扰动物的甲状腺功能。我们计划调查这些药物是否也会干扰孕妇的甲状腺功能，并评估对产前暴露儿童神经发育的潜在影响。我们与哥伦比亚大学的环境健康科学家合作，打算招募MFMU试验中的孕妇参加一项辅助研究，以评估多溴二苯醚和高氯酸盐的水平，并确定这些内分泌干扰物是否对母体甲状腺功能测试产生可测量的影响。这些怀孕的孩子将在一岁时进行初步评估，以评估由贝利发育商评估的结果的潜在差异。如果多溴联苯醚或高氯酸盐暴露与甲状腺功能之间的关系明显，我们将寻求额外的资金来研究五岁之前儿童发育的潜在差异。公共卫生相关性：孕妇甲状腺功能正常对胎儿大脑发育至关重要。人类广泛接触工业化学品多溴二苯醚和高氯酸盐，这些内分泌干扰物已被证明会干扰动物的甲状腺功能。我们计划调查这些药物是否会干扰孕妇的甲状腺功能，并评估它们是否对产前暴露儿童的神经发育有不良影响。

DESCRIPTION (provided by applicant): Normal thyroid function in pregnant women is essential to brain development in their children. Recent data suggests that even in asymptomatic women with subclinical hypothyroidism, intelligence of their offspring is affected. The Maternal-Fetal Medicine Units (MFMU) Network of the NICHD is currently prospectively evaluating in a multicenter randomized trial whether thyroid hormone replacement for women with subclinical disease improves outcomes for their children. An expert panel from the U.S. National Research Council reports that 3 percent of developmental disabilities are a direct result of exposure to environmental exposures, and a greater percentage arise from interactions between environmental agents and individual genetic susceptibility. There is widespread human exposure to the industrial chemicals PBDE and perchlorate, endocrine disruptors which have been shown to interfere with thyroid function in animals. We plan to investigate whether these agents also interfere with thyroid function in pregnant women and assess potential effects on neurological development of prenatally exposed children. In collaboration with the environmental health scientists at Columbia University, we intend to recruit pregnant women from the MFMU trial into an ancillary study to assess levels of PBDE and perchlorate and determine whether these endocrine disruptors have a measurable affect on maternal thyroid function tests. Children from these pregnancies would be assessed initially at one year of age to evaluate potential differences in outcomes as assessed by the Bayley's Developmental Quotient. If a relationship between PBDE or perchlorate exposure and thyroid function were evident, we would seek additional funding to study potential differences in childhood development until age five. PUBLIC HEALTH RELEVANCE: Normal thyroid function in pregnant women is essential to fetal brain development. There is widespread human exposure to the industrial chemicals PBDE and perchlorate, endocrine disruptors which have been shown to interfere with thyroid function in animals. We plan to investigate whether these agents interfere with thyroid function in pregnant women and assess whether they have adverse effects on neurodevelopment in prenatally exposed children.