Pregnancy Exposures to Chemical Mixtures and Later Metabolic Health and Endocrine Function Among Women in the Puerto Rico PROTECT Cohort

波多黎各 PROTECT 队列中女性怀孕期接触化学混合物以及后期代谢健康和内分泌功能

• 批准号: 10404670
• 负责人: Carrie Anne Karvonen-Gutierrez
• 金额: $ 39.16万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-21 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10404670
• 关键词: Aromatic Polycyclic Hydrocarbons; Biological Markers; Blood; Blood Glucose; Blood Pressure; Body Composition; Body Size; Breast Feeding; Chemicals; Child Development; Child Health; Cohort Studies; Data; Data Collection; Data Set; Education; Endocrine; Endocrine disruption; Endocrinology; Environmental Exposure; Environmental Impact; Estradiol; Estrogens; Exposure to; Fetal Growth; Follicle Stimulating Hormone; Gestational Diabetes; Glucose; Glycosylated hemoglobin A; Hand Strength; Health; Health Status; Health behavior; Hormonal; Hormones; Income; Individual; Influentials; Insulin; Knowledge; LDL Cholesterol Lipoproteins; Life; Life Experience; Lipids; Longterm Follow-up; Maternal Exposure; Maternal Health; Measures; Menopause; Mental Depression; Metabolic; Metabolic Marker; Metals; Modification; Morbidity - disease rate; Mothers; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Outcome Study; Parabens; Participant; Pattern; Phenols; Physical activity; Polycystic Ovary Syndrome; Population; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Puerto Rico; Questionnaires; Recording of previous events; Research; Risk Factors; Sampling; Sex Hormone-Binding Globulin; Social support; Socioeconomic Status; Stress; Testosterone; Time; Urine; Visit; Woman; Women Status; Women' s Health; Work; adverse pregnancy outcome; blood lipid; chemical association; clinical diagnosis; cohort; design; diabetes risk; environmental chemical; experience; exposed human population; follow up assessment; follow-up; health determinants; health of the mother; health record; high risk; lipoprotein cholesterol; middle age; mullerian-inhibiting hormone; phthalates; pollutant; post pregnancy; recruit; sample collection; social determinants; social factors; sociodemographics; urinary

A rapidly growing body of research shows that exposure to common environmental chemicals can disrupt endocrine and metabolic function, and negatively impact pregnancy outcomes and child development. Studies also demonstrate that certain pregnancy conditions (e.g., preeclampsia) and outcomes (e.g., preterm birth) are associated with adverse health later in the life of the mother. However, research is lacking on the relationships between exposures in pregnancy and later health of the mother, and how pregnancy outcomes impact those associations. Puerto Rico suffers from elevated rates of numerous morbidities compared to the mainland U.S., including preterm birth and Type II diabetes. Puerto Rico also has a history of extensive contamination with increased human exposure to a range of pollutants. We established the PROTECT cohort in the northern coast of Puerto Rico to study the impacts of exposure to an array of environmental chemicals during gestation and adverse pregnancy outcomes. We have developed an incredibly rich dataset on exposures, biomarkers of intermediate effects, questionnaires, and health record information. PROTECT is also a participating cohort within the newly established US-wide ECHO study, following the development of children born into PROTECT. We propose building upon this vast dataset and continued recruitment in PROTECT, along with the repeated participant contact during the ECHO follow-up visits, to investigate status and longitudinal trajectories of maternal metabolic health and endocrine function for up to five years following pregnancy among 1000 women in Puerto Rico. We have exposure biomarker data from repeated samples collected in pregnancy on urinary phthalate metabolites, phenols/parabens, and PAH metabolites, as well as 17 metals measured in both urine and blood. In this study, with new data and sample collection on PROTECT mothers at 6 months, 1 year, 2 years, and 5 years following delivery, we aim to: 1) Determine whether maternal exposures during pregnancy are associated with measures and trajectories of metabolic health (i.e., body size, body composition, physical strength, clinical diagnoses, blood pressure, and blood glucose, insulin, lipids, HbA1c) in short- and long-term follow-up assessments after delivery; 2) Investigate the relationships between maternal exposures during pregnancy and longitudinal measures of endocrine function (e.g., estradiol, testosterone, SHBG, FSH and AMH) in the follow-up assessments after delivery; and 3) Explore effect modification of the associations between pregnancy exposures and later women’s health from the first two aims by pregnancy complications (gestational diabetes, preeclampsia, preterm birth), and/or by social determinants (socioeconomic status, social support, depression, stress, life experiences, and others) and other physical determinants of health (body size, physical activity, breast feeding, polycystic ovarian syndrome, menstrual patterns, and others). The expected outcomes of this study are to provide new and much needed information on the impacts of pregnancy exposures, pregnancy outcomes, and social factors on women’s health.

越来越多的研究表明，接触常见的环境化学物质会破坏 内分泌和代谢功能，并对妊娠结局和儿童发育产生负面影响。研究 还表明某些妊娠状况（例如先兆子痫）和结局（例如早产） 与母亲以后的健康状况不佳有关。但缺乏对其关系的研究 怀孕期间的暴露与母亲以后的健康之间的关系，以及妊娠结局如何影响这些因素 协会。与美国大陆相比，波多黎各的多种发病率较高， 包括早产和二型糖尿病。波多黎各也有广泛的污染历史 增加人类接触一系列污染物的机会。我们在北部海岸建立了 PROTECT 队列 波多黎各研究妊娠期间接触一系列环境化学物质的影响 不良妊娠结局。我们开发了一个极其丰富的关于暴露、生物标志物的数据集 中间效应、问卷和健康记录信息。 PROTECT 也是一个参与群体 在新建立的美国范围内的 ECHO 研究中，跟踪出生在 PROTECT 中的儿童的发育情况。 我们建议以这个庞大的数据集为基础，继续在 PROTECT 中招募人员，并重复进行 在 ECHO 随访期间与参与者进行联系，以调查其状态和纵向轨迹 1000 名女性怀孕后长达五年的孕产妇代谢健康和内分泌功能 在波多黎各。我们有来自怀孕期间收集的重复样本的暴露生物标志物数据 尿液中检测到的邻苯二甲酸盐代谢物、苯酚/对羟基苯甲酸酯和 PAH 代谢物以及 17 种金属 和血。在这项研究中，使用了关于 PROTECT 母亲在 6 个月、1 年、2 年时的新数据和样本收集 分娩后 5 年和 5 年，我们的目标是： 1) 确定母亲在怀孕期间是否接触过 与代谢健康的测量和轨迹相关（即身体尺寸、身体成分、身体状况） 短期和长期的体力、临床诊断、血压、血糖、胰岛素、血脂、HbA1c） 分娩后的后续评估； 2) 调查孕产妇暴露期间的关系 妊娠和内分泌功能的纵向测量（例如雌二醇、睾酮、性激素结合球蛋白（SHBG）、促卵泡激素（FSH）和 AMH）在产后的后续评估中； 3）探索协会的效果修改 妊娠并发症与前两个目标的妊娠暴露和后来妇女健康之间的关系 （妊娠糖尿病、先兆子痫、早产）和/或社会决定因素（社会经济地位、 社会支持、抑郁、压力、生活经历等）以及其他健康的身体决定因素 （体型、体力活动、母乳喂养、多囊卵巢综合征、月经模式等）。这 这项研究的预期成果是提供有关影响的新的和急需的信息 妊娠暴露、妊娠结局和社会因素对女性健康的影响。