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。 利用MOBA数据，我们对宫内暴露于烟草烟雾对健康的影响进行了一系列研究。2012年，我们发表了其中的两篇文章。首先，我们检查了宫内暴露于烟草烟雾与代谢综合征和妊娠期糖尿病的关系，并发现了相关性的证据。在第二篇相关手稿中，我们报告了宫内吸烟与成年后血浆甘油三酯升高的关系。 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。今年，我们完成了一项研究的实验室工作，在这项研究中，我们试图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。我们了解到，收集尿样时使用的防腐剂污染了游离双酚A，使标本难以分析有机磷农药代谢物。这些信息在我们计划未来的研究时将非常有用。未来寻求双酚A定量的研究将需要测量总的和游离的双酚A，以便可以估计结合的双酚A。需要进行专门的新研究，以确定是否可以分析样本中的有机磷农药代谢物，因为标准方法不起作用。 我们还研究了全氟代烷基化合物与MoBA队列中女性出生体重的关系。我们关于这一点的手稿于2012年发表。我们正在完成至少另外四篇基于这些数据的论文；两篇是关于与全氟化合物水平相关的临床化学参数值的，一篇是关于这些化合物血液水平的决定因素的，还有一篇是关于怀孕期间的体力活动和血浆C反应蛋白水平的，C反应蛋白是炎症的标志。在过去的一年里，我们开展了一项关于全氟化合物和先兆子痫的新研究，实验室工作正在进行中。 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包括：脑瘫的风险因素、人类基因的非孟德尔传递途径、母亲孕期体力活动与胎儿丢失、饮食摄入量与妊娠期糖尿病、孕期体力活动与婴儿神经发育、有机磷农药暴露与自闭症风险、以及全氟化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. Using the MoBa data, we have conducted a series of studies of health effects of in utero exposure to tobacco smoke. In 2012 we published two of these. First, we examined in utero exposure to tobacco smoke in relation to components of the metabolic syndrome and gestational diabetes mellitus and found evidence of an association. In the second, related manuscript, we reported the association of in utero exposure to tobacco smoking with elevated plasma triglycerides in adulthood. 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. This year the laboratory work was completed for a study in which we attempted to measure the levels of metabolites of organophosphate pesticides and bisphenol A in these specimens, to determine how reproducibile the levels were. We have learned that the preservative used in the collection of the urine specimens contaminated them with free bisphenol A, and makes the specimens difficult to analyze for organophosphate pesticide metabolites. This information will be of great use as we plan future studies. Future studies seeking to quantitate bisphenol A will need to measure total and free BPA, so that conjuated BPA can be estimated. Special new studies will be needed to see if the specimens can be analyzed for organophosphate pesticide metabolites, because the standard approach will not work. We also have studied perfluorinated alkyls in relation to birthweight among women in the MoBa cohort. Our manuscript on this was published in 2012. We are completing at least four other papers based on these data; two are on values of clinical chemistry parameters in relation to perfluorinated compound levels, one is on determinants of blood levels of these compounds, and one, using the same group of women, is about physical activity in pregnancy and plasma levels of C-reactive protein, a marker of inflammation. In the past year we developed a new study on perfluorinated compounds and preeclampsia, and the laboratory work for this is underway. 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 planned includes: Risk factors for cerebral palsy, 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.