The Norwegian Mother And Child Study: Environmental Specimen Collection

挪威母子队列研究(MOBA)是一项正在进行的产前队列研究。2008年完成了登记，结果在研究中有106,980例怀孕。这项研究基于父母填写的问卷，生物标本收集自母亲、父亲和孩子。这项研究的主要目的是寻找疾病的原因。NIEHS为这项研究提供了部分支持，并在2002年扩大了数据收集方案，包括从怀孕第17周的母亲那里收集更多的生物标本(额外的血清、在无微量元素容器中收集的全血样本和尿液)。这些标本将增强检查环境暴露与儿童及其母亲的各种健康后果的关系的能力。截至2009年4月30日，77,104名受试者提供了血液和尿液，这些血液和尿液是与NIEHS一起收集的。 在过去的一年里，利用MOBA数据，我们进行了一系列关于宫内暴露于烟草烟雾对健康影响的研究。发表了一份关于流产和死产的关联的报告；没有发现关联。还发表了第二份报告，即报告的宫内烟草烟雾暴露的重现性；结果表明，暴露的报告具有很高的重复性。我们现在正在检查子宫内暴露于烟草烟雾与代谢综合征组成部分的关系，并找到相关性的证据。报道这一发现的一份手稿已被修改并重新提交给一家期刊，第一份手稿被接受后，第二份手稿准备提交。 我们在MOBA方案中增加了在怀孕23周和29周时为一部分妇女收集额外的尿样。690名妇女有一套完整的三份怀孕尿液样本。我们写了一份协议来测量这些样本中有机磷农药和双酚A的代谢物水平，以确定这些水平的重复性；这些样本现在正在进行分析。这些信息将帮助我们规划未来关于与健康结果相关的研究。 我们还一直在研究全氟烷基化合物与MoBA队列中女性怀孕时间和出生体重的关系。其他人报告的与怀孕时间延长的联系也出现在MOBA数据中，但似乎是由于研究设计的人工制品；我们关于这一点的手稿已被修订并重新提交给一家期刊。一篇关于全氟化合物与出生体重之间关系的手稿也得到了一家期刊的好评，目前正在修改中。我们计划至少另外两篇基于这些数据的论文；一篇关于临床化学参数值与全氟化合物水平的关系，另一篇关于血液水平的决定因素。 由于这项研究处于相对早期的阶段，科学报告的数量仍然有限。在NIEHS，我们正在开发几项研究，这些研究将嵌套在MoBA中。目前计划进行的研究清单包括：唇腭裂的风险因素、人类基因的非孟德尔传递的搜索、母亲孕期体力活动和胎儿丢失、饮食摄入量与妊娠期糖尿病、孕期体力活动和婴儿神经发育、有机磷农药暴露与自闭症风险、以及关于全氟化合物暴露与健康的其他研究。

The Norwegian Mother and Child Cohort Study (MoBa) is an ongoing prebirth cohort study. Enrollment was completed in 2008 resulting in 106,980 pregnancies in the study. The study is based on questionnaires completed by the mother and father, and biological specimens are collected from the mother, father and child. The main purpose of the study is to find causes of diseases. NIEHS is providing partial support for the study, and in 2002 expanded the data collection protocol to include collection of more biologic specimens from the mothers during the 17th week of pregnancy (additional serum, a specimen of whole blood collected in a trace-element free container, and urine). These specimens will enhance the ability to examine the relation of environmental exposures in relation to various health outcomes in the children and their mothers. As of April 30, 2009, 77,104 subjects had provided blood and urine that was collected in conjunction with NIEHS. In the past year, using the MoBa data, we have conducted a series of studies of health effects of in utero exposure to tobacco smoke. One report, on the association with miscarriage and stillbirth was published; no association was found. A second report, on the reproducibility of reported in utero exposure to tobacco smoke, was also published; the results show the reports of exposure are highly reproducible. We are now examining in utero exposure to tobacco smoke in relation to components of the metabolic syndrome and find evidence of an association. One manuscript reporting this finding has been revised and resubmitted to a journal, and a second manusecript is ready to be submitted after the first one is accepted. We added to the MoBa protocol the collection additional urine specimens in pregnancy, at weeks 23 and 29, for a subset of women. 690 women have a complete set of three urine specimens from pregnancy. We wrote a protocol to measure the levels of metabolites of organophosphate pesticides and bisphenol A in these specimens, to determine how reproducibile the levels are; the specimens are now being analyzed. This information will help us plan future studies on associations with health outcomes. We also have been studying perfluorinated alklys in relation to time-to-pregnancy and birthweight among women in the MoBa cohort. The association with increased time-to-pregnancy reported by others was also present in the MoBa data but appears to be due to an artifact of the study design; our manuscript on this has been revised and resubmitted to a journal. A manuscript on the association of perfluorinated compounds with birthweight also received favorable reviews from a journal and is being revised. We plan at least two other papers based on these data; one on values of clincial chemistry paramters in relation to perfluorinated compound levels, and one on determinants of blood levels. Because the study is in a relatively early phase, the number of scientific reports is still limited. At NIEHS, we are developing several studies that will be nested within MoBa. A list of the studies currently planed includes: Risk Factors for Cleft Lip and Palate, A Search for the Non-mendelian Transmission of Human Genes, Mother's Physical Activity During Pregnancy and Fetal Loss, Dietary Intake and Gestational Diabetes, Physical Activity in Pregnancy and Infant Neurodevelopment, Organophosphate Pesticide Exposure and Risk of Autism, and additional studies on perfluorinated compound exposure and health.