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: 10245293
• 负责人: Carrie Anne Karvonen-Gutierrez
• 金额: $ 39.77万
• 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/10245293
• 关键词: Aromatic Polycyclic Hydrocarbons; Biological Markers; Blood; Blood Glucose; Blood Pressure; Body Composition; Body Size; Breast Feeding; Chemicals; Child Development; Child Health; Cholesterol; Cohort Studies; Data; Data Collection; Data Set; Education; Endocrine; Endocrine disruption; 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; clinical Diagnosis; cohort; design; diabetes risk; environmental chemical; experience; exposed human population; follow up assessment; follow-up; health of the mother; health record; high risk; middle age; mullerian-inhibiting hormone; phthalates; pollutant; 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，暴露于常见的环境化学物质会破坏 内分泌和代谢功能，并对怀孕结果和儿童发育产生负面影响。研究 也证明了某些妊娠条件（例如，先兆子痫）和结果（例如，早产） 与母亲生命后期的不良健康有关。然而，缺乏对这些关系的研究 怀孕期间的暴露与母亲后来的健康之间的关系，以及怀孕结果如何影响 协会.与美国本土相比，波多黎各的许多疾病发病率都很高， 包括早产和II型糖尿病。波多黎各也有广泛污染的历史， 增加了人类对一系列污染物的接触。我们在北方海岸建立了一个海军陆战队队列 波多黎各研究怀孕期间接触一系列环境化学品的影响， 不良妊娠结局。我们已经开发了一个非常丰富的数据集，关于暴露，生物标志物， 中间效应、问卷调查和健康记录信息。CIMT也是一个参与队列 在新建立的美国范围内的ECHO研究中，根据出生于BACT的儿童的发展。 我们建议在这个庞大的数据集的基础上，继续在CIMT招募，沿着重复的 ECHO随访访视期间的受试者联系，以调查 1000名妇女怀孕后5年内的母体代谢健康和内分泌功能 在波多黎各。我们从妊娠期重复采集的尿液样本中获得了暴露生物标志物数据， 邻苯二甲酸酯代谢物、苯酚/对羟基苯甲酸酯和PAH代谢物，以及在两种尿液中测量的17种金属 还有血本研究采用新的数据和样本收集方法，分别在6个月、1年、2 我们的目标是：1）确定母亲在怀孕期间是否暴露于 与代谢健康的测量和轨迹相关联（即，身体大小，身体成分，物理 强度、临床诊断、血压和血糖、胰岛素、血脂、HbA 1c） 分娩后的随访评估; 2）调查分娩期间母亲暴露之间的关系 怀孕和内分泌功能的纵向测量（例如，雌二醇、睾酮、SHBG、FSH和 AMH）在产后随访评估中的作用; 3）探讨AMH与产后随访评估的关系 妊娠期暴露与以后妇女的健康之间的关系， （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）和其他健康的身体决定因素 (body体型、体力活动、母乳喂养、多囊卵巢综合征、月经模式等）。的 这项研究的预期成果是提供新的和急需的信息， 怀孕暴露、怀孕结果以及影响女性健康的社会因素。