Prenatal factors and risk of autism in a Finnish national birth cohort

描述（由申请人提供）：在此提案中，这是先前资助的奖项的更新，我们将调查怀孕期间母亲的环境因素和芬兰国家出生队列后代的儿童自闭症风险（芬兰产前自闭症研究，FiPS-A）。以前的自闭症研究从未通过母体生物标记物检测产前因素及其与围产期并发症和婴儿头围生长速度的关系。假定的危险因素包括环境毒素（包括多氯联苯和杀虫剂）和感染（流感和沙眼衣原体）。我们的目标是在大量自闭症病例的怀孕中解决这些问题，并使用在研究过程中芬兰几乎所有怀孕中提取和储存的母体血清样本进行匹配对照。从芬兰几乎所有自闭症病例诊断的详细数据库中，已经确定了患有自闭症的儿童和与他们相匹配的对照组。这些对象已与产妇血清样本和包括围产期并发症数据在内的其他登记处联系起来。本研究将对自闭症患者和匹配对照组的母体血清样本进行这些环境因素的分析，并比较其在妊娠期间的发生情况。我们还将测试这些怀孕期间的母体环境因素是否与其他一些妊娠和分娩并发症以及婴儿时期头围速度的异常有关。这项研究有可能使我们更好地了解自闭症的潜在风险因素，以及导致该疾病的趋同或不同的发育途径。由于本研究中调查的风险因素在人群中相对普遍，因此它们的发现可能会导致孕妇采取直接的公共措施来预防自闭症病例，包括减少接触环境污染物，以及预防感染，如怀孕期间的流感和性传播疾病。这些研究还可能导致对产前侮辱改变自闭症患者产后大脑发育机制的更好理解，并与其他措施一起，潜在地针对自闭症高危婴儿进行干预。总之，拟议的工作建立在现有的国家出生队列的基础上，预计将对流行病学和临床/基础神经科学研究的新兴和潜在变革领域产生相当大的影响，并导致改进目前关于怀孕期间护理的公共卫生政策建议。

DESCRIPTION (provided by applicant): In this proposal, which is a renewal of a previously funded award, we will investigate maternal environmental factors during pregnancy and risk of childhood autism in the offspring from a national birth cohort in Finland (the Finnish Prenatal Study of Autism, FiPS-A). No previous study of autism has ever examined the proposed prenatal factors by maternal biomarkers and their relationship to perinatal complications and growth velocity of the child's head circumference during infancy. The putative risk factors include environmental toxins (including PCBs and insecticides) and infections (influenza and Chlamydia trachomatis). We aim to address these questions in pregnancies of a large sample of autism cases and matched controls using maternal serum samples that were drawn and stored in nearly all pregnancies in Finland over the course of the study. The children with autism and their matched controls have been identified from detailed databases that contain diagnoses on nearly all cases of autism in Finland. These subjects have been linked to the maternal serum samples and to other registries including data on perinatal complications. In this study, the maternal serum samples of autism cases and of matched controls will be analyzed for these environmental factors, and their occurrence during pregnancy will be compared between the cases and controls. We shall also test whether these maternal environmental factors during pregnancy are related to a select number of other pregnancy and birth complications and to abnormalities in the velocity of head circumference during infancy. This research has the potential to result in a better understanding of potential risk factors for autism and of convergen, as well as divergent, developmental pathways that lead to the illness. Since the risk factors investigated in this study are relatively common in the population, their discovery may lead to prevention of cases of autism by straightforward public measures in pregnant women, including reduction of exposure to environmental contaminants, and prevention of infections, such as influenza and sexually transmitted diseases during pregnancy. These studies could also result in an improved understanding of the mechanisms by which prenatal insults alter postnatal brain development in autism and, along with other measures, potentially target infants at high risk for the disorder for intervention. In summary, the proposed work builds on an existing national birth cohort, and is anticipated to have considerable impact on an emerging and potentially transformative area of research epidemiology and clinical/basic neuroscience, as well as lead to improvements in current public health policy recommendations for care during pregnancy.