Project 1: Molecular Epidemiology Study of Phthalate Exposure and Preterm Birth i

项目1：邻苯二甲酸盐暴露与早产的分子流行病学研究i

• 批准号: 9249551
• 负责人: John D. Meeker
• 金额: $ 30.41万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-12 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9249551
• 关键词: Age; Area; Behavior; Behavioral; Biological; Biological Markers; Birth; Birth Rate; Chemicals; Classification; Clinical; Data; Diet; Dietary Practices; Endocrine Disruptors; Endocrine disruption; Environmental Exposure; Environmental Pollution; Environmental Risk Factor; Epidemiologic Methods; Etiology; Exposure to; Future; Genetic; Gestational Age; Hazardous Waste Sites; Health; Hormones; Individual; Infant Mortality; Inflammation; Intervention; Investigation; Island; Lead; Link; Live Birth; Measures; Mediator of activation protein; Methods; Mexico; Molecular; Molecular Epidemiology; Morbidity - disease rate; Outcome Study; Oxidative Stress; Pathway interactions; Patient Self-Report; Plasma; Play; Population; Pregnancy; Pregnant Women; Premature Birth; Prevention strategy; Prospective Studies; Prospective cohort study; Public Health; Puerto Rico; Questionnaires; Recruitment Activity; Resources; Risk; Risk Factors; Risk Reduction; Sampling; Serum; Source; Statistical Methods; Stratification; Techniques; Testing; Time; Urine; Water; Woman; Work; cohort; cost; data management; demographics; design; drinking water; environmental agent; epidemiology study; follow-up; global health; high risk population; human data; human subject; innovation; interest; modifiable risk; novel; personal care products; phthalates; pollutant; prevent; psychosocial; reproductive; residence; superfund site; urinary

PROJECT SUMMARY Preterm birth is a significant global health challenge as a leading cause of infant mortality and costly long-term morbidity. Rates of preterm birth in the U.S. have increased in recent decades for reasons that remain uncertain. The recent escalation in preterm births in Puerto Rico is especially alarming, where rates have increased from just above the U.S. average (12%) in 1997 to nearly 18% in 2009. While known risk factors for preterm birth have failed to account for this increase, there is growing evidence that environmental factors may play a key role. However, these factors remain understudied and underappreciated. The proposed project will apply state-of-the-art molecular epidemiological methods to a prospective cohort study of over 1,200 live births designed to explore environmental, clinical, demographic, behavioral and other factors that contribute to preterm birth risk in Puerto Rico. The project also aims to provide much needed information on the potential mechanistic pathways involved in preterm birth as it relates to environmental factors, and data on important predictors of phthalate exposure among pregnant women. Phthalates were chosen as the primary pollutants of interest because they are common contaminants of Superfund sites in Puerto Rico and elsewhere (several phthalates are on the ATSDR Substance Priority List), and recent studies show widespread exposure to phthalates in the U.S. population. In our preliminary work and in recent studies by others, multiple phthalates have been associated with preterm birth, reduced gestational age, and other adverse impacts potentially linked with preterm birth such as oxidative stress, inflammation, and endocrine disruption. Our preliminary data also suggests elevated exposure to certain phthalates in Puerto Rico compared to the U.S. Using data and samples generated by recruitment efforts of the Human Subjects and Sampling Core (Core C) and the Data Management integration provided by Core D, we will collect detailed questionnaire data, clinical information, and measure phthalate metabolites in urine samples collected from pregnant women at multiple time points in pregnancy. We will evaluate phthalate metabolite levels for associations with residence, water sources, water phthalate contamination, diet, activities, and product use to identify determinants of high exposure and opportunities for exposure reduction strategies. Using innovative statistical methods, we will assess the association between exposure to phthalates and risk of preterm birth, both as individual chemicals and as phthalate mixtures. We will also explore relationships between phthalate exposure and biomarkers of oxidative stress, inflammation, and endocrine disruption measured at multiple times during pregnancy to provide data on biologic pathways that may link environmental exposures with early parturition. The proposed study will provide much needed information on preterm birth risk factors in Puerto Rico and a rich resource for future investigations and follow-up. Identifying modifiable environmental risk factors for preterm birth could have huge public health impact since interventions aimed at preventing preterm birth to date remain largely ineffective.

项目摘要 早产是重大的全球健康挑战，作为婴儿死亡率和昂贵的长期原因的主要原因 发病率。由于仍然存在的原因 不确定。最近在波多黎各的早产出生的升级尤其令人震惊，费率 从1997年的美国平均水平（12％）上升到2009年的近18％。而已知的风险因素 早产未能解释这一增加，越来越多的证据表明环境因素可能 扮演关键角色。但是，这些因素仍然对其进行了研究和低估。拟议的项目将 将最先进的分子流行病学方法应用于1,200多个活产的前瞻性队列研究 旨在探索有助于的环境，临床，人口，行为和其他因素 波多黎各的早产风险。该项目还旨在提供有关潜力的急需信息 早产与环境因素有关的机械途径以及重要的数据 孕妇邻苯二甲酸盐暴露的预测因素。选择邻苯二甲酸盐作为主要污染物 兴趣是因为它们是波多黎各和其他地方的超级基金地点的常见污染物（有几个 邻苯二甲酸盐是ATSDR物质优先级），最近的研究表明， 美国人口的邻苯二甲酸盐。在我们的初步工作和其他人的最新研究中，多个邻苯二甲酸盐 与早产，妊娠年龄降低以及其他不利影响有关 以早产，例如氧化应激，炎症和内分泌破坏。我们的初步数据 建议使用数据和样品与美国相比，波多黎各与美国某些邻苯二甲酸盐的接触升高 由人类受试者和采样核心（核心C）的招聘工作以及数据产生 核心D提供的管理集成，我们将收集详细的问卷数据，临床信息， 并测量从孕妇在多个时间点收集的尿液样本中的邻苯二甲酸盐代谢物 怀孕。我们将评估邻苯二甲酸酯代谢物水平与居住，水源，水的关联 邻苯二甲酸酯污染，饮食，活动和产品用于识别高暴露的决定因素和 减少暴露策略的机会。使用创新的统计方法，我们将评估 邻苯二甲酸盐的暴露与早产风险之间的关联，无论是单个化学物质还是 邻苯二甲酸酯混合物。我们还将探索邻苯二甲酸酯暴露与氧化生物标志物之间的关系 在怀孕期间多次测量的压力，炎症和内分泌干扰，以提供有关 可能将环境暴露与早期分娩联系起来的生物学途径。拟议的研究将提供 关于波多黎各的早产危险因素的急需信息和未来的丰富资源 调查和随访。确定早产的可修改环境风险因素可能会有巨大 公共卫生影响以来，旨在防止早产迄今为止的干预措施在很大程度上仍然无效。