Developmental Impact of NICU Exposures (DINE)

NICU 暴露 (DINE) 对发育的影响

• 批准号: 9355748
• 负责人: Judy Lynn Aschner
• 金额: $ 446.71万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE, INC
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9355748
• 关键词: Abate; Age; Animal Model; Behavioral; Biological Markers; Blood; Caring; Chemicals; Child; Childhood; Clinical; Cognitive; Cognitive deficits; Cohort Studies; Data; Data Set; Databases; Development; Disease; Environment; Environmental Exposure; Environmental Health; Environmental Pollution; Equipment; Equipment and Supplies; Erythropoietin; Evaluation; Exposure to; Funding Opportunities; General Population; Geography; Growth; Hair; Health; Hospital Units; Hospitals; Individual; Infant; Infant Care; Infant Health; Lead; Life; Lung; Manganese; Measurement; Measures; Medical; Metals; Methodology; Methods; Motor; Multicenter Studies; Neonatal Intensive Care Units; Neurodevelopmental Impairment; Nutritional; Obesity; Outcome; Participant; Performance; Pharmaceutical Preparations; Pharmacologic Substance; Phase; Phenotype; Plasticizers; Plastics; Population; Population Heterogeneity; Pregnancy; Premature Infant; Psychological Stress; Research; Research Infrastructure; Respiratory physiology; Risk; Route; Saliva; Savings; Severity of illness; Site; Source; Stress; Techniques; Testing; Third Pregnancy Trimester; Time; Tooth structure; Trace metal; United States; Urine; Variant; base; behavioral outcome; biobank; clinically relevant; cohort; deciduous tooth; early childhood; early life exposure; ethnic diversity; experience; fetal; flexibility; infant animal; motor deficit; neurobehavior; neurobehavioral; neurodevelopment; neuroprotection; neurotoxic; nutrition; phthalates; premature; prenatal exposure; programs; pulmonary function; reproductive; resilience; respiratory; response; surfactant; urinary

Project Summary. Each year in the United States, over 300,000 preterm infants are admitted to neonatal intensive care units (NICUs) where they are exposed to a chemical-intensive hospital environment. Many life- saving and supportive respiratory, nutritional, hematologic and pharmaceutical therapies in the NICU expose preterm infants to potentially harmful chemicals during a life stage analogous to the third trimester of gestation. Studies in term-born infants and animal models demonstrate that third trimester in utero exposure to phthalates –ubiquitous chemicals used to make plastics flexible - is associated with maladaptive neurodevelopmental, pulmonary, reproductive, and growth phenotypes. Lead (Pb) and manganese (Mn) -- an essential trace metal administered in NICU nutrition -- can be neurotoxic in excess resulting in both cognitive and motor deficits. Non-chemical exposures including psychological stress, common in the NICU environment, are also associated with abnormal neurodevelopment. Multiple environmental exposures during the sensitive developmental period when preterm infants are in the NICU may contribute to their increased risk of adverse health and behavioral outcomes later in life. Neither the individual contribution of NICU-based phthalate, Mn, Pb or stress exposure, nor the impact of concurrent and subsequent exposures on preterm infant health, risk, resilience, or disease trajectories have been explored previously. Our research capitalizes on the infrastructure, biorepositories, and extensive clinical databases of four existing preterm cohorts to explore the scientific premise that early life exposure to phthalates, metals, and stress adversely impacts neurodevelopment, lung function, growth and adiposity, and pubertal development in childhood. As part of the ECHO Pediatric Cohorts program, we will pursue the following three specific aims: Aim 1. Identify specific sources of NICU-based phthalate exposure in a large, geographically diverse population of preterm infants. Aim 1 (UG3) will use existing NICU datasets and biorepositories to determine specific routes and sources of phthalate exposure. Aim 2. Measure the impact of NICU-based phthalate exposure on multisystem health outcomes at ages 3-10. Aim 2 (UG3/UH3) examines associations among urine biomarkers of NICU phthalate exposure and childhood measures of pulmonary function, cognitive, motor, and behavioral performance, growth and pubertal development. Aim 3. Determine the impact of and interactions among early childhood phthalate, manganese, lead and stress exposures on neurodevelopmental outcomes in preterm and term children. Aim 3 (UH3) uses tooth, hair and saliva biomarkers of exposures to investigate neurobehavioral development in children born preterm and at term. Our unique cohort offers a window for direct measurement of exposures in the “third trimester” phase of rapid development in a sensitive population. This study will facilitate exposure abatement in the NICU and provide information relevant to fetal and early childhood development.

项目摘要。每年在美国，超过300,000名早产儿被接纳为新生儿 重症监护病房（NICUS）暴露于化学密集型医院环境中。许多生活 - NICU暴露于NICU中的呼吸，营养，血液学和药物疗法 在生命阶段，早产儿可能是妊娠三个月的生命阶段。 对年前出生的婴儿和动物模型的研究表明，子宫内三个月暴露于邻苯二甲酸酯 - 用于使塑料灵活的渗透化学物质与适应不良的神经发育有关， 肺，生殖和生长的表型。铅（PB）和锰（MN） - 必需的痕量金属 在NICU营养中施用 - 可以过多地神经毒性，从而导致认知和运动定义。 NICU环境中常见的非化学暴露在内，包括心理压力，也是 与异常神经发育有关。敏感的多次环境暴露 早产儿在NICU中可能有助于增加逆境风险的发展期 健康和行为成果在以后的生活中。 MN的基于NICU的邻苯二甲酸盐的个人贡献都不 PB或压力暴露，也不是并发和随后的暴露对早产儿的影响，风险，风险， 以前已经探索了韧性或疾病轨迹。 我们的研究资源是关于基础设施，生物库和四个现有的广泛临床数据库 早产同类探索科学前提，即早期寿命暴露于邻苯二甲酸盐，金属和压力 不利影响神经发育，肺功能，生长和肥胖以及青春期的发展 童年。作为回声小儿同伙计划的一部分，我们将追求以下三个具体目标： 目标1。在大型地理上确定基于NICU的邻苯二甲酸酯暴露的特定来源 早产儿的人口。 AIM 1（UG3）将使用现有的NICU数据集和生物库来确定 邻苯二甲酸盐暴露的特定路线和来源。目标2。测量基于NICU的邻苯二甲酸盐的影响 3-10岁的多系统健康结果的暴露。 AIM 2（UG3/UH3）检查 NICU邻苯二甲酸盐暴露和儿童期肺功能，认知，运动，运动的尿液生物标志物 以及行为绩效，成长和青春期发展。目标3。确定和 邻苯二甲酸盐，锰，铅和压力暴露的幼儿相互作用 早产和学期儿童的神经发育结果。 AIM 3（UH3）使用牙齿，头发和唾液 曝光的生物标志物研究出生和学期的儿童神经行为发展。 我们独特的队列提供了一个直接测量快速“三个月”阶段暴露的窗口 敏感人群的发展。这项研究将促进NICU中的曝光率消除并提供 与胎儿和幼儿发展有关的信息。