Neonatal Neurobehavioral Impacts of Iodine Insufficiency and Pesticide Exposures

碘不足和农药暴露对新生儿神经行为的影响

• 批准号: 7847094
• 负责人: Susan Woskie
• 金额: $ 14.61万
• 依托单位: UNIVERSITY OF MASSACHUSETTS LOWELL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-15 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7847094
• 关键词: Address; Adverse effects; Agriculture; Applications Grants; Behavior assessment; Birth; Blood specimen; Carbamates; Categories; Child; Childhood; Cholinesterases; Collaborations; Communication; Developing Countries; Development; Dietary Iodine; Disease; Educational workshop; Electroencephalogram; Electroencephalography; Environmental Exposure; Enzymes; Epidemiologic Studies; Event-Related Potentials; Exposure to; Faculty; Fetal Development; Fetal Neurobehavioral Development; Focus Groups; Goals; Goiter; Government; Grant; Health; Hemoglobin concentration result; Hospitals; Human Development; Human Milk; Immunization; Individual; Infant; Intake; International; Interview; Iodine; Joints; Knowledge; Massachusetts; Measurement; Measures; Methods; Monitor; Mothers; Neonatal; Neurologic; Newborn Infant; Nutritional; Organophosphates; Perinatal Exposure; Pesticides; Pilot Projects; Population; Pregnant Women; Prenatal care; Prevention; Prevention program; Prospective Studies; Province; Public Health; Questionnaires; Recruitment Activity; Research; Research Personnel; Research Project Grants; Resources; Risk; Role; Sampling; Students; Surveys; Testing; Thailand; Thyroid Function Tests; Thyroid Gland; Thyroid Hormones; Thyrotropin; Umbilical Cord Blood; United States National Institutes of Health; Universities; Urine; Visit; Woman; Work; Workplace; drinking water; experience; fetal; follow-up; hazard; in utero; interest; iodine deficiency syndrome; meetings; neonate; neurobehavioral; neurobehavioral test; neurodevelopment; nutrition; pesticide exposure; pesticide poisoning; policy implication; prospective; public health relevance; response; urinary

DESCRIPTION (provided by applicant): The neonatal and childhood neurological effects of severe maternal or fetal thyroid deficiency, which may be caused by low dietary iodine, are well established. Independently, exposure to pesticides can also reduce thyroid hormone, and may exacerbate the effects of low iodine. The combination of these environmental insults may lower thyroid hormone to the extent that fetal neurobehavioral development is significantly impacted. Although Thailand has made great advances in decreasing pesticide poisoning and reducing iodine deficiency disorders (IDD), there are still many pregnant women who experience exposure to pesticides through maternal agricultural work and maternal intake of pesticide contaminated drinking water, and all of the provinces in Thailand have newborns born with iodine deficiency disorders. Considering the importance of thyroid hormones in neurobehavioral development, our main hypothesis is that pesticide exposure increases the impact of iodine insufficiency on neurodevelopment as measured in newborns by the Brazelton Newborn Behavioral Assessment Survey (BNBAS) and in 3-4 month olds by EEG/ERP (Electroencephalogram/Event Related Potential) testing. The main objectives of this planning grant are: 1) to develop and strengthen a partnership of multi-disciplinary, international researchers in Thailand and the U.S. focused on the recognition, prevention and treatment of environmental and nutritional causes of neurobehavioral deficits among Thai infants and young children; 2) to demonstrate the feasibility of conducting a prospective epidemiologic study to assess the impact of maternal/fetal sub-optimal iodine levels and pesticide exposures on thyroid hormone levels and neonatal neurobehavioral development. As part of our capacity building efforts we will establish a joint research Center for Work Environment and Nutrition in Human Development at the Mahidol Faculty of Public Health to facilitate researcher and student exchanges and collaboration. For our pilot research project, 108 pregnant women will be recruited from provincial hospitals in 3 provinces. They will be asked for information on nutrition, pesticide exposures and other potential confounders. The women will provide urine and blood samples and at birth a placental cord blood sample will be collected. Samples will be analyzed for iodine, pesticide and thyroid hormone levels. Newborns will undergo neurobehavioral testing with the BNBAS. When they return for routine 3-4 month immunizations, infants will undergo neurobehavioral testing using an EEG/ERP test battery. Breast milk will be collected from mothers for pesticide and iodine measurements. Our objective is to use this pilot study to launch a prospective study of the impact of iodine insufficiency, pesticide exposure and other potential nutritional and environmental influences, on Thai children's neurodevelopment. Additionally, a long term goal of this research is to work with the Thai Ministry of Health to develop and test prevention programs focused on prenatal care settings. PUBLIC HEALTH RELEVANCE: Not only is it of scientific interest to examine the role of environmental conditions (iodine availability and pesticide exposures) on the thyroid and subsequent fetal development, but it also may have important policy implications for public health. Developing countries have limited resources available to address a wide range of public health problems including IID and pesticide hazards. Better knowledge of the adverse effects of the interaction of pesticide exposures and iodine insufficiency will allow for more informed decisions by doctors, individuals and government public health officers and regulators.

描述（由申请方提供）：已经明确了重度母体或胎儿甲状腺缺乏对新生儿和儿童神经系统的影响，这可能是由低膳食碘引起的。独立地，暴露于农药也会降低甲状腺激素，并可能加剧低碘的影响。这些环境损伤的组合可能会降低甲状腺激素的程度，胎儿的神经行为发育受到显着影响。虽然泰国在减少农药中毒和碘缺乏病方面取得了很大进展，但仍有许多孕妇因母亲从事农业工作和母亲摄入农药污染的饮用水而接触农药，泰国所有省份都有新生儿患有碘缺乏病。 考虑到甲状腺激素在神经行为发育中的重要性，我们的主要假设是，农药暴露增加了碘缺乏对神经发育的影响，如Brazelton新生儿行为评估调查（BNBAS）和3-4个月奥尔兹的EEG/ERP（脑电图/事件相关电位）测试所测量的。该计划赠款的主要目标是：1）发展和加强泰国和美国多学科国际研究人员的伙伴关系，重点是识别、预防和治疗泰国婴幼儿神经行为缺陷的环境和营养原因; 2）证明进行前瞻性流行病学研究以评估母亲/胎儿亚适宜碘水平和农药暴露对甲状腺激素水平和新生儿神经行为发育的影响。 作为我们能力建设工作的一部分，我们将在玛希隆公共卫生学院建立一个人类发展工作环境和营养联合研究中心，以促进研究人员和学生的交流与合作。在我们的试点研究项目中，将从3个省的省级医院招募108名孕妇。他们将被要求提供有关营养、农药暴露和其他潜在混杂因素的信息。妇女将提供尿液和血液样本，并在出生时收集胎盘脐带血样本。将对样本进行碘、农药和甲状腺激素水平分析。新生儿将接受BNBAS的神经行为测试。当他们返回进行常规3-4个月的免疫接种时，婴儿将使用EEG/ERP测试电池进行神经行为测试。将从母亲那里收集母乳进行农药和碘的测量。我们的目标是利用这项试点研究，开展一项前瞻性研究，探讨碘不足、农药暴露和其他潜在的营养和环境影响对泰国儿童神经发育的影响。此外，这项研究的一个长期目标是与泰国卫生部合作，制定和测试以产前护理为重点的预防方案。 公共卫生相关性：研究环境条件（碘供应和农药暴露）对甲状腺和随后的胎儿发育的作用不仅具有科学意义，而且还可能对公共卫生产生重要的政策影响。发展中国家可用于解决一系列公共卫生问题的资源有限，包括国际传染病和农药危害。更好地了解农药接触和碘不足相互作用的不利影响，将使医生、个人和政府公共卫生官员和监管人员能够作出更明智的决定。