Developmental Impact of NICU Exposures (DINE) phase II

NICU 暴露 (DINE) 第二阶段的发育影响

• 批准号: 10745062
• 负责人: Judy Lynn Aschner
• 金额: $ 128.18万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10745062
• 关键词: Abate; Address; Adolescent; Age; Air Pollution; Area; Biological Specimen Banks; Birth; Bronchopulmonary Dysplasia; Caring; Chemical Exposure; Child; Child Development; Child Health; Child health care; Childhood Asthma; Clinical; Clinical Research; Consent; Data; Data Element; Data Set; Dedications; Dermal; Development; Endocrine Disruptors; Enrollment; Environmental Exposure; Exposure to; Face; Family; Funding; General Population; Goals; Health; Health Care Costs; High Prevalence; Hospitalization; Infant; Infrastructure; Inhalation; Intravenous; Investigation; Life; Life Cycle Stages; Link; Longterm Follow-up; Lung; Neonatal Intensive Care Units; Outcome; Participant; Pediatric cohort; Persons; Phase; Phenotype; Population; Pregnancy; Pregnant Women; Premature Birth; Premature Infant; Procedures; Protocols documentation; Research; Risk; Site; Third Pregnancy Trimester; United States; Visit; Work; adverse outcome; cohort; early childhood; early life exposure; experience; fetal; infancy; insight; interest; middle childhood; novel; participant enrollment; participant retention; pediatric health outcomes; phthalates; programs; pulmonary function; societal costs

Project Summary/Abstract The Environmental Influences on Child Health Outcomes (ECHO) program capitalizes on diverse pregnancy and pediatric cohorts to investigate the impact of a broad array of environmental influences on child health and development. Since 2016, the Developmental Impact of NICU Exposures (DINE) study has significant contribution of the to the ECHO mandate is a large, exquisitely phenotyped preterm birth cohort - a unique and sensitive population with a demonstrated large burden of adverse health outcomes. The DINE cohort readily combines rich existing clinical and research datasets and biospecimen repositories, existing infrastructure for long-term follow up and assessments of multiple ECHO exposure and outcome specialization areas, and a novel exposure and outcome profile that will continue high-yield contribution to ECHO program scientific goals. In this second phase of the ECHO program, we will continue to focus on the scientific premise that early life physical and chemical exposures, notably phthalates and air pollution, have long-lasting harmful effects on child health and development, and that these harmful effects are magnified in children born preterm. DINE contributes a unique and critically important population to ECHO in that preterm infants face significant dermal, inhalational and intravenous exposures to phthalates, ubiquitous organic endocrine disrupting chemicals, while hospitalized the neonatal intensive care unit (NICU). Premature infants experience a high prevalence of the adverse health effects that are associated with early life exposure to phthalates in term-born children, particularly abnormalities of pulmonary function. The contribution of environmental influences on adverse outcomes of preterm children is poorly understood. One additional central tenet of our work is that preterm infants can be studied to identify exposure-outcome links that may be more subtle in the general population. Large clinical studies like ECHO that enroll participants born over the entire preterm-to-term continuum allow rigorously study of this premise. Through the next phase of the ECHO program, we pursue the following Specific Aims in DINE: Aim 1. Leverage ECHO Cohort Protocol core data elements to compare exposure-outcome relationships in preterm compared to term populations. Aim 2. Leverage specialized data elements to address critical questions about the impact of early life chemical exposures on pulmonary development in a sensitive population, preterm infants. Aim 3. Implement procedures to maximize retention of existing participants with an emphasis on maintaining cohort diversity and protocol fidelity. Continued involvement of preterm infants in ECHO is critical not only to our cohort’s scientific imperatives, but also to the entire ECHO program as preterm infants constitute more than 10% of the United States population.

项目总结/摘要 环境对儿童健康结果的影响（ECHO）计划利用了不同的怀孕和 儿科队列研究广泛的环境影响对儿童健康的影响， 发展自2016年以来，NICU暴露的发育影响（DINE）研究具有重要意义。 对ECHO任务的贡献是一个大的，精致的表型早产队列-一个独特的， 敏感人群，已证明存在严重的不良健康后果负担。DINE队列很容易 结合了丰富的现有临床和研究数据集以及生物标本库， 长期随访和评估多个ECHO暴露和结果专业领域，以及一种新的 暴露和结果概况，将继续高收益的贡献，ECHO计划的科学目标。 在ECHO计划的第二阶段，我们将继续关注早期生命的科学前提， 物理和化学暴露，特别是邻苯二甲酸盐和空气污染，对儿童有长期的有害影响 这些有害影响在早产儿中更为严重。DINE贡献 对于ECHO来说，早产儿是一个独特且至关重要的人群，因为早产儿面临着严重的皮肤、吸入 以及在住院期间静脉注射邻苯二甲酸盐，这是一种普遍存在的有机内分泌干扰化学物质， 新生儿重症监护室（NICU）。早产儿经历不良健康的高患病率 与足月出生儿童早期接触邻苯二甲酸酯相关的影响，特别是异常 肺功能。环境因素对早产儿不良结局的影响是 不太了解。我们工作的另一个中心原则是，早产儿可以通过研究来识别 在一般人群中，这种联系可能更为微妙。像ECHO这样的大型临床研究， 招募出生于整个早产至足月连续体的参与者允许严格研究这一前提。 通过ECHO计划的下一阶段，我们在DINE中追求以下具体目标： 目标1.利用ECHO队列研究方案核心数据元素比较确定性结局 早产儿与足月儿的关系。 目标2.利用专门的数据元素来解决有关早期 生活化学品暴露对敏感人群早产儿肺部发育的影响。 目标3.实施程序，最大限度地留住现有参与者，重点是 保持队列多样性和方案保真度。 继续让早产儿参与超声心动图检查不仅对我们队列的科学要求至关重要， 也是整个ECHO计划的一部分，因为早产儿占美国人口的10%以上。