Pesticide Exposures and Risk of Preterm Birth

描述（由申请人提供）：早产是指在妊娠37周之前分娩。全世界每年约有1500万婴儿早产，全球患病率约为10%。美国的早产患病率约为13%，并且几十年来一直在增加。自然早产的危险因素在很大程度上仍然是一个谜。包括农药在内的一系列环境暴露已被评估为早产的潜在风险因素。在美国，农药的使用代表了每年超过20亿美元的支出，并涉及在环境中应用100亿磅的化学品。这些化合物中有许多是生殖毒物。然而，还没有大规模的研究来调查妊娠期接触农药是否会影响早产。这一重要的公共卫生假设正在进行研究，可能是由于接触数据的可得性有限，加上缺乏关于早产的良好流行病学数据。我们已经确定了弥补这种信息缺乏的必要因素。在这里，我们建议进行有史以来规模最大、最严格的以人群为基础的流行病学研究，针对多种农药化合物对早产的影响进行研究。我们提出以下目标：1)确定怀孕期间接触特定农药是否与100万名妇女过早自然分娩婴儿/胎儿有关；2)确定接触生物功能分类（如内分泌干扰物或发育毒物）和物理化学分类(如氨基甲酸酯、卤代烃、怀孕期间农药的砷含量与100万名妇女过早自然分娩婴儿/胎儿有关。利用现有的数据来源，我们提出了一个前所未有的、有效的机会来缩小这一知识差距。这项人口规模的研究将在加州圣华金河谷进行，该地区被称为“世界粮仓”和“世界上最多产的农业区”。圣华金河谷是一个农药广泛使用的地区，也是一个社会经济地位和种族/民族背景多样化的地区。我们小组已经证明有能力成功实施这个项目

DESCRIPTION (provided by applicant): Preterm birth involves deliveries before 37 weeks gestation. Approximately 15 million babies are born preterm every year in the world with a global prevalence approximating 10%. Prevalence of preterm birth in the US is approximately 13% and has increased in the US for decades. Risk factors of spontaneous preterm birth remain largely mysterious. An array of environmental exposures has been evaluated as potential risk factors for preterm birth including pesticides. Pesticide use in the US represents more than $2 billion/year in expenditures and involves the application of >100 million pounds of chemicals in the environment. Many of these chemical compounds are reproductive toxicants. However, large-scale studies have not been done to investigate whether gestational pesticide exposures influence preterm birth. This important public health hypothesis has been under studied likely owing to the limited availability of exposure data coupled with the lack of good epidemiologic data on preterm births. We have identified the necessary elements to remedy this lack of information. Here we propose the largest and most rigorous population-based epidemiologic study ever conducted that targets a breadth of pesticide compounds for their influence on preterm birth. We propose the following aims: 1) To determine whether exposures to specific pesticides during pregnancy are associated with >100,000 women spontaneously delivering infants/fetuses prematurely and 2) To determine whether exposures to biologically-functional groupings (e.g., endocrine disruptors or developmental toxicants) and physiochemical groupings (e.g., carbamates, halogenated hydrocarbons, and arsenicals) of pesticides during pregnancy are associated with >100,000 women spontaneously delivering infants/fetuses prematurely. Using existing data sources, we are proposing an unprecedented and efficient opportunity to close this knowledge gap. This population-scale study will be conducted in the California San Joaquin Valley - an area that is referred to as the "food basket of the world" and as "the most productive agricultural region in the world." The San Joaquin Valley is an area with demonstrated extensive pesticide use and an area diverse in socioeconomic status and race/ethnic background. Our group has demonstrated capability to successfully carry out this project