New York State Component A: BD-STEPS II Core

项目摘要 纽约出生缺陷研究和预防中心（NYCBDRP）提议 继续保持其进行流行病学研究以确定出生原因的良好记录 通过参与出生缺陷研究来评估妊娠缺陷II （BD-步骤II）。BD-STEPS II力求在现有努力的基础上， 早孕可能会增加怀孕的风险， 结构性出生缺陷NYCBDRP处于成功实施BD-STEPS的有利地位 二. NYCBDRP一直是疾病预防控制中心合作的国家出生缺陷的主要贡献者 预防研究（NBDPS）和出生缺陷研究，以评估妊娠结局 （BD-STEPS I）自1996年以来。NYCBDRP研究人员已经使用了NBDPS/BD-STEPS I数据 广泛研究BD-STEPS II的三个主要重点领域：急性疾病， 感染;慢性疾病，如自身免疫性疾病、高血压和哮喘;以及 药物来治疗这些疾病。NYCBDRP拥有一支经验丰富的团队， 成功地实施了拟议研究的所有方面：病例和对照确定， 临床和联系信息提取和审查、受试者招募、新生儿 血斑采集、与州传染病监测系统的联系、与 纽约州所有付款人数据库（APD）验证自我报告的药物使用情况，以及 创新的流行病学调查。NYCBDRP研究议程将重点关注 使用新的BD-STEPS问题扩展药物分析，开发分析方法， 确定罕见缺陷的风险因素和共同发生的出生缺陷模式，并探讨 慢性病和治疗对出生缺陷风险的联合影响。拟议试点 验证研究将以NYCBDRP主题专业知识为基础，重点关注 抗高血压药物使用。通过与奥尔巴尼大学的密切关系 公共卫生学院，NYCBDRP将继续吸引和指导研究生水平 学生使用NBDPS/BD-STEPS数据进行硕士和论文项目。从其 作为纽约州卫生部（NYSDOH）的一个职位，NYCBDRP将 通过捐赠员工时间，利用纽约州卫生署的大量资源， 个人病历，先天性畸形登记，传染病 监视系统和APD，以及与世界著名的沃兹沃斯中心的联系 基因研究实验室。

Project Summary The New York Center for Birth Defects Research and Prevention (NYCBDRP) proposes to continue its strong record of conducting epidemiologic research to identify the causes of birth defects through its participation in the Birth Defects Study to Evaluate Pregnancy exposureS II (BD-STEPS II). BD-STEPS II seeks to build on existing efforts to identify maternal exposures in early pregnancy that may increase the risk for having a pregnancy affected by certain major, structural birth defects. The NYCBDRP is well positioned to successfully implement BD-STEPS II. The NYCBDRP has been a major contributor to CDC's collaborative National Birth Defects Prevention Study (NBDPS) and the Birth Defects Study To Evaluate Pregnancy exposureS I (BD-STEPS I) since 1996. NYCBDRP researchers have already used NBDPS/BD-STEPS I data extensively to study the three main focus areas of BD-STEPS II: acute conditions such as infections; chronic conditions such as autoimmune disease, hypertension, and asthma; and medications to treat these conditions. The NYCBDRP has an experienced team in place to successfully implement all aspects of the proposed study: case and control ascertainment, clinical and contact information abstraction and review, subject recruitment, newborn bloodspot collection, linkages to state infectious disease surveillance systems, linkages to the New York State All Payer Database (APD) to validate self-reported medication use, and innovative epidemiologic investigations. The NYCBDRP research agenda will focus on expanding medication analyses using new BD-STEPS questions, developing analytic methods to identify risk factors for rare defects and patterns of co-occurring birth defects, and exploring the joint effects of chronic conditions and treatments on birth defect risk. The proposed pilot validation study will build on NYCBDRP subject matter expertise by focusing on antihypertensive medication use. Through a close relationship with the University at Albany School of Public Health, the NYCBDRP will continue to attract and mentor graduate-level students to conduct master's and dissertation projects using NBDPS/BD-STEPS data. From its position within the New York State Department of Health (NYSDOH), the NYCBDRP will leverage considerable NYSDOH resources through donated staff time, privileged access to individual medical records, the Congenital Malformations Registry, infectious disease surveillance systems, and the APD, and affiliation with the world-renowned Wadsworth Center laboratory for genetic studies.