Chemical Exposures and Infant Outcomes in the Neonatal Intensive Care Unit

新生儿重症监护病房的化学品暴露和婴儿结局

• 批准号: 8729580
• 负责人: Annemarie Stroustrup
• 金额: $ 14.58万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-03 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8729580
• 关键词: Admission activity; Affect; Area; Behavior Disorders; Biological Markers; Birth; Blood; Blood specimen; Body Size; Cadmium; Caring; Cataloging; Catalogs; Chemical Exposure; Chemicals; Child; Child health care; Childhood; Clinical; Databases; Development; Development Plans; Enrollment; Environment; Environmental Health; Evaluation; Exposure to; Fetus; Foundations; Future; Growth; Health; Healthcare; Heavy Metals; Hepatic; Hospitalization; Hospitals; Human; Human Development; Impairment; Infant; Investigation; K-Series Research Career Programs; Knowledge; Laboratory Study; Learning; Longitudinal Studies; Manganese; Measurable; Measurement; Medical; Mentorship; Metals; Methods; Neonatal; Neonatal Intensive Care Units; Neonatology; Neurologic; Neurotoxins; Newborn Infant; Outcome; Parabens; Patients; Phenols; Pilot Projects; Poison; Population; Recording of previous events; Renal clearance function; Renal function; Research; Research Personnel; Research Project Grants; Risk; Risk Factors; Running; Sampling; Source; Study Subject; Testing; Third Pregnancy Trimester; Toxic Environmental Substances; Toxic effect; Toxicology; Training; Triclosan; United States; Urine; Very Low Birth Weight Infant; Work; adverse outcome; base; biobank; career; career development; cohort; cost effective; design; experience; forging; high risk; human data; in utero; infancy; infant outcome; instrument; liver function; medical supply; modifiable risk; neonate; neurobehavioral; neurobehavioral test; novel; pediatrician; phthalates; premature; prenatal; prospective; public health relevance; remediation; reproductive; reproductive development; skills; social; tool; urinary

DESCRIPTION (provided by applicant): The candidate is a pediatrician and neonatologist embarking on a research career focused on the study and remediation of modifiable risk factors for adverse outcome following high-risk birth, particularly the environmental determinants of abnormal neurodevelopmental outcomes. This career development award will enable her through formal coursework and expert mentorship by Drs. Philip Landrigan, Shanna Swan, and William Fifer, to develop the knowledge and skills necessary to become an independent investigator studying the impact of hospital-based chemical exposure on infant neurobehavioral development. Many industrial chemicals are known neurotoxicants in laboratory studies, but investigations of prenatal and infant exposure to these chemicals are limited, despite the fact that the developing fetus and infant are particularly susceptible to environmental insults. With this career development award, the candidate will: 1) obtain training in the methods of exposure assessment and biomarker measurements of exposure to environmental toxicants; 2) obtain training in the use of infant neurobehavioral testing methods; and 3) apply the lessons learned to a research project examining biomarkers of exposure to phthalates, phenols, cadmium, and manganese and infant medical and neurobehavioral development. The training received through this career development award will enable the candidate to forge an academic trajectory in what is an under-examined area of study within the fields of neonatology and child health, with potential applications that extend to numerous aspects of pediatric healthcare. The proposed study will be the first comprehensive, longitudinal evaluation of chemical exposure in the neonatal intensive care unit (NICU) designed to evaluate clinical outcomes in this vulnerable, highly exposed population. The Research Strategy proposed is an outgrowth of the Hospital-Based Phthalate Exposure in Very Low Birth Weight Infants (HBPE) study, an ongoing, NICU-based pilot study of very low birth weight infants at the Mount Sinai Hospital. The candidate proposes to capitalize on her experience running the HBPE study and on the existing HBPE study biospecimen and data repositories to (1) identify prevalent and relevant NICU chemical exposures; (2) formalize and validate an exposure checklist to categorize patients by specific NICU exposures; and (3) conduct a comprehensive study of NICU chemical exposure and infant somatic and neurodevelopmental outcomes. The candidate plans to use the results of this study and the patient cohort amassed in Aim 3 as the basis for a future longitudinal study of childhood somatic, reproductive, and neurobehavioral outcomes in relation to hospital- based chemical exposures encountered in infancy.

应聘者描述(由申请人提供)：应聘者是一名儿科医生和新生儿科医生，从事的研究重点是研究和补救高危分娩后不良结局的可改变的危险因素，特别是异常神经发育结局的环境决定因素。这项职业发展奖将使她能够通过菲利普·兰德里根、莎娜·斯旺和威廉·菲弗博士的正式课程和专家指导，发展必要的知识和技能，成为一名研究医院化学品暴露对婴儿神经行为发育影响的独立调查员。许多工业化学品在实验室研究中是已知的神经毒物，但对产前和婴儿接触这些化学品的调查有限，尽管发育中的胎儿和婴儿特别容易受到环境侮辱的影响。有了这个职业发展奖，候选人将：1)获得环境毒物暴露评估和生物标记物测量方法方面的培训；2)获得使用婴儿神经行为测试方法的培训；3)将学到的经验应用于一个研究项目，检查邻苯二甲酸盐、酚、镉和锰暴露的生物标记物以及婴儿的医疗和神经行为发育。通过该职业发展奖获得的培训将使应聘者能够在新生儿学和儿童健康领域中未得到充分审查的研究领域形成学术轨迹，潜在的应用将延伸到儿科保健的许多方面。这项拟议的研究将是对新生儿重症监护病房(NICU)中化学物质暴露的第一次全面、纵向评估，旨在评估这一脆弱、高度暴露人群的临床结果。建议的研究战略是基于医院的极低出生体重婴儿邻苯二甲酸盐暴露(HBPE)研究的结果，该研究是西奈山医院正在进行的一项以NICU为基础的极低出生体重婴儿的试点研究。候选人建议利用她管理HBPE研究的经验和现有的HBPE研究生物样本和数据库来(1)确定普遍和相关的NICU化学暴露；(2)正式并验证暴露清单，根据特定的NICU暴露对患者进行分类；(3)对NICU化学暴露与婴儿躯体和神经发育结果进行综合研究。候选人计划使用这项研究的结果和在目标3中积累的患者队列作为未来纵向研究的基础，研究儿童时期的躯体、生殖和神经行为结果与婴儿期医院化学品暴露的关系。