The Norwegian Mother And Child Study: Environmental Specimen Collection

挪威母亲和儿童队列研究（MoBa）是一项正在进行的出生前队列研究。 入组于2008年完成，研究中有106，980例妊娠。这项研究是基于母亲和父亲完成的问卷调查，并从母亲，父亲和孩子身上收集生物标本。这项研究的主要目的是找出疾病的原因。 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，包括在怀孕第17周期间从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标本和尿液）。 这些样本将提高研究环境暴露与儿童及其母亲各种健康结果之间关系的能力。 截至2009年4月30日，77，104例受试者提供了与NIEHS联合采集的血液和尿液。 我们在MoBa方案中增加了一部分女性在妊娠第23周和第29周采集额外尿液标本的内容。 690名妇女有一套完整的三个尿液标本从怀孕。 今年，我们完成了一项研究的实验室工作，在这项研究中，我们试图测量这些标本中有机磷农药和双酚A的代谢物水平，以确定这些水平的可重复性。 我们已经了解到，在收集尿液样本时使用的防腐剂污染了游离双酚A，使样本难以分析有机磷农药代谢物。 这些信息将是非常有用的，因为我们计划未来的研究。 未来的研究寻求定量双酚A将需要测量总的和游离的BPA，以便可以估计共轭BPA。 由于标准方法不起作用，因此需要进行新的特别研究，以确定是否可以分析标本中的有机磷农药代谢物。 我们发表了一篇报告污染的论文，并确定了两个实验室，将与尿液标本，看看他们是否可以分析有机磷农药代谢物和邻苯二甲酸酯。 我们还研究了全氟烷基物质的血浆浓度与MoBa队列中女性的各种结局之间的关系。 今年，我们发表了一篇关于这些化合物血浆水平决定因素的论文。 我们正在完成一系列其他论文基于我们的数据血浆水平的化合物;一个是先兆子痫，两个是临床化学参数的值与全氟化合物水平，和一个，使用同一组妇女，是关于身体活动在怀孕和血浆水平的C-反应蛋白，炎症的标志物。 我们计划利用现有数据进行一系列新的研究，以检查a）几年内血浆水平的可靠性，B）与儿童生长有关的暴露，以及c）与儿童感染有关的暴露。 由于我们对全氟烷基物质的兴趣，我们还一直在合作研究这些化合物的药代动力学，从而深入了解流行病学研究结果。 在过去的一年里，我们发表了一篇关于这些化合物的药代动力学的论文。 NIEHS的科学家们正在开发几项将嵌套在MoBa中的研究。 目前计划开展的研究包括：脑瘫的风险因素、人类基因的非孟德尔传播研究、饮食摄入与妊娠糖尿病、妊娠期体力活动与婴儿神经发育、有机磷农药接触与自闭症风险，以及关于全氟化合物接触与健康的其他研究。

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. 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 published one paper reporting the contamination, and have identified two laboratories that will work with the urine specimens to see if they can analyze them for organophosphate pesticide metabolites and phthalates. We also have studied the plasma concentration of perfluoralkyl substances in relation to various outcomes among women in the MoBa cohort. This year we published one paper on the determinants of plasma levels of these compounds. We are completing a series of other papers based on our data on plasma levels of the compounds; one is on preeclampsia, two are on values of clinical chemistry parameters in relation to perfluorinated compound levels, 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. We are planning a series of new studies, using the data in hand, to examine a) the reliability of the plasma levels over a period of several years, b) exposure in relation to child growth, and c) exposure in relation to infections in childhood. Because of our interest in perfluoroalkyl substances, we have also been collaborating on studies of the pharmacokinetics of these compounds, which provide insight into epidemiologic findings. We published one paper on the pharmacokinetics of these compounds in the past year. Scientists at NIEHS 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, 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.