The Norwegian Mother And Child Study: Environmental Specimen Collection

挪威母婴队列研究（MoBa）是一项正在进行的prebirt队列研究。 入组于2008年完成，研究中有106，980例妊娠。这项研究是基于母亲和父亲完成的问卷调查，并从母亲，父亲和孩子身上收集生物标本。这项研究的主要目的是找出疾病的原因。 NIEHS为这项研究提供了部分支持，并在2002年扩大了数据收集方案，包括在怀孕第17周期间从母亲那里收集更多的生物标本（额外的血清，在无微量元素容器中收集的全血标本和尿液）。 这些样本将提高研究环境暴露与儿童及其母亲各种健康结果之间关系的能力。 截至2009年4月30日，77，104例受试者提供了与NIEHS联合采集的血液和尿液。 在过去的一年里，利用MoBa数据，我们对子宫内暴露于烟草烟雾的健康影响进行了一系列研究。 一份关于与怀孕时间相关的报告正在印刷中;在那些接触过的人中，怀孕时间略长。 第二份报告是关于流产和死产的关系，正在为一家期刊进行修订;没有发现任何关联;第三份报告是关于子宫内暴露于烟草烟雾的可重复性，也正在为一家期刊进行修订;结果显示暴露报告具有高度可重复性。 我们现在正在研究子宫内暴露于烟草烟雾与代谢综合征成分的关系，并找到相关的证据。 报告这一发现的手册将在明年编写。 我们在MoBa方案中增加了一部分女性在妊娠第23周和第29周采集额外尿液标本的内容。 690名妇女有一套完整的三个尿液标本从怀孕。 我们写了一份协议来测量这些标本中有机磷农药和双酚A的代谢物水平，以确定这些水平的可重复性;这些标本现在正在分析中。 这些信息将帮助我们计划未来关于与健康结果相关性的研究。 我们还制定了一项方案，以检查MoBa队列中女性的全氟烷基与怀孕时间的关系。 今年冬天早些时候对血浆标本进行了分析。 目前正在准备人员名单。 其他人报告的与妊娠时间增加的相关性也存在于MoBa数据中，但似乎是由于研究设计的人为因素所致。 我们将使用相同的数据来确定是否有全氟化合物与出生体重和临床化学参数值的关联。 由于这项研究处于相对早期的阶段，科学报告的数量仍然有限。 在NIEHS，我们正在开发几项将嵌入MoBa的研究。 目前计划进行的研究包括：唇腭裂的危险因素，人类基因的非孟德尔传播研究，母亲在怀孕期间的体力活动和胎儿丢失，饮食摄入和糖尿病，怀孕期间的体力活动和婴儿神经发育，母体抗叶酸受体的自身抗体作为叶酸敏感性出生缺陷的危险因素，有机磷农药暴露与自闭症风险

The Norwegian Mother and Child Cohort Study (MoBa) is an ongoing prebirt cohort study. Enrollment was completed in 2008 resulting in 106,980 pregnancies in the study. The study is based on questionnaires completed by the mother and father, and biological specimens are collected from the mother, father and child. The main purpose of the study is to find causes of diseases. NIEHS is providing partial support for the study, and in 2002 expanded the data collection protocol to include collection of more biologic specimens from the mothers during the 17th week of pregnancy (additional serum, a specimen of whole blood collected in a trace-element free container, and urine). These specimens will enhance the ability to examine the relation of environmental exposures in relation to various health outcomes in the children and their mothers. As of April 30, 2009, 77,104 subjects had provided blood and urine that was collected in conjunction with NIEHS. In the past year, using the MoBa data, we have conducted a series of studies of health effects of in utero exposure to tobacco smoke. One report, on the association with time-to-pregnancy, is now in press; time-to-pregnancy was slightly longer among those who were exposed. A second report, on the association with miscarriage and stillbirth, is being revised for a journal; no association was found. A third report, on the reproducibility of reported in utero exposure to tobacco smoke, is also being revised for a journal; the results show the reports of exposure are highly reproducible. We are now examining in utero exposure to tobacco smoke in relation to components of the metabolic syndrome and find evidence of an association. Manuscripts to report this finding will be prepared in the coming year. We added to the MoBa protocol the collection additional urine specimens in pregnancy, at weeks 23 and 29, for a subset of women. 690 women have a complete set of three urine specimens from pregnancy. We wrote a protocol to measure the levels of metabolites of organophosphate pesticides and bisphenol A in these specimens, to determine how reproducibile the levels are; the specimens are now being analyzed. This information will help us plan future studies on associations with health outcomes. We also put in place a protocol to examine perfluorinated alklys in relation to time-to-pregnancy among women in the MoBa cohort. Plasma specimens were analyzed early this winter. Manuscripts are being prepared. The association with increased time-to-pregnancy reported by others was also present in the MoBa data but appears to be due to an artifact of the study design. We will use the same data to determine whether there is an association of perfluorinated compounds with birthweight and values of clincial chemistry paramters. Because the study is in a relatively early phase, the number of scientific reports is still limited. At NIEHS, we are developing several studies that will be nested within MoBa. A list of the studies currently planed includes: Risk Factors for Cleft Lip and Palate, A Search for the Non-mendelian Transmission of Human Genes, Mother's Physical Activity During Pregnancy and Fetal Loss, Dietary Intake and Gestational Diabetes, Physical Activity in Pregnancy and Infant Neurodevelopment, Maternal Autoantibodies against Folate Receptors as a Risk Factor for Folate Sensitive Birth Defects, and Organophosphate Pesticide Exposure and Risk of Autism.