Comp A: CALIFORNIA CENTER OF BD-STEPS III FINDING CAUSES AND PREVENTIVES OF BIRTH DEFECTS

摘要 出生缺陷是美国婴儿死亡的主要原因。出生缺陷也有 巨大的相关情感和经济代价。加州中心的研究工作， 独立或与其他出生缺陷研究和研究中心合作 预防对国家出生缺陷预防研究(NBDPS)和出生的贡献 评估妊娠暴露(BD-STEPS)的缺陷研究一直处于 公共卫生出生缺陷研究。有了这个新的融资机会，这里指的是“BD- 步骤III“以区别于2013年启动的早期BD-STEPS方案(BD-STEPS I)和 2018年(BD-Steps II)，我们中心将进一步提高对潜力的科学认识 特定出生缺陷的原因，这无疑将对风险产生重要影响 评估和预防常见、昂贵和致命的出生缺陷。在此应用程序中，我们 提出以下目标： 目标1：加强生育中心的流行病学公共卫生研究能力 在一个地区积极参与BD-STEP III的缺陷和研究与预防 美国的种族/民族、社会经济特征和 暴露在环境中。 目标2：利用BD-步骤I-III中的数据，以及较早的NBDPS(以及可能的其他数据 加州独有的资源)，进行严格的合作和当地研究，以确定 选定出生缺陷的潜在可修改风险因素(并酌情结合使用 遗传易感性)，以减少美国出生缺陷的公共卫生负担。 加州中心装备精良，可以为BD-STEPS III做出贡献-它是 出生缺陷流行病学和丰富的发展经验，数据收集和 传播以人口为基础的出生缺陷研究的信息，例如 在疾控中心出生缺陷研究中心内的出色表现及其高度 创新的研究组合。该应用程序描述了加州中心将如何 完成目标1和目标2，从而将进一步加深关于原因和 预防人类出生缺陷。加州中心拥有丰富的指挥经验 与发展战略--步骤三重点领域有关的研究，其中包括产妇慢性病 以及他们的治疗，怀孕期间的传染病，以及药物。我们已经提议 几个分析查询，并使用额外的创新数据集和 分析方法，这将使我们能够协作地继续阐明贡献 这些因素和其他可改变的出生缺陷风险因素。

ABSTRACT Birth defects are the leading cause of infant mortality in the US. Birth defects also have enormous associated emotional and economic costs. The California Center's research efforts, both independently and in collaboration with other Centers for Birth Defects Research and Prevention contributing to the National Birth Defects Prevention Study (NBDPS) and the Birth Defects Study to Evaluate Pregnancy Exposures (BD-STEPS), have been at the forefront of public health birth defects research. With this new funding opportunity, referred to here as “BD- STEPS III” to distinguish from earlier BD-STEPS programs initiated in 2013 (BD-STEPS I) and 2018 (BD-STEPS II), our Center will further enhance scientific understanding of the potential causes of specific birth defects, which will undoubtedly have important implications for risk assessment and prevention of common, costly, and deadly birth defects. In this application we propose the following aims: Aim 1: Enhance the epidemiologic public health research capacity of the Centers for Birth Defects and Research and Prevention by actively participating in BD-STEPS III in a region of the US that is highly diverse in its race/ethnicity, socioeconomic characteristics, and environmental exposures. Aim 2: Utilize data from BD-STEPS I-III, as well as the earlier NBDPS (and likely other data sources unique to California), to conduct rigorous collaborative and local studies that will identify potential modifiable risk factors for selected birth defects (and where appropriate, in combination with genetic susceptibility) to reduce the public health burden of birth defects in the US. The California Center is well-equipped to contribute to BD-STEPS III – it is a world leader in birth defects epidemiology and highly experienced in the development, data collection and dissemination of information from population-based studies of birth defects, exemplified by its outstanding performance within the CDC Centers for Birth Defects Research and its highly innovative research portfolio. The application describes how the California Center will accomplish Aims 1 and 2 and will thereby further the knowledge base about causes and prevention for human birth defects. The California Center has extensive experience conducting research related to the BD-STEPS III areas of focus, which include maternal chronic diseases and their treatment, infectious disease in pregnancy, and medications. We have proposed several analytic inquiries, complemented by the use of additional innovative datasets and analytic approaches, which will enable us to collaboratively continue elucidating the contribution of these and other modifiable risk factors to birth defects.