The exposome--exciting opportunities for discoveries in reproductive and perinatal epidemiology.
The exposome--exciting opportunities for discoveries in reproductive and perinatal epidemiology.
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DOI：
10.1111/ppe.12040
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发表时间：
2013-05
影响因子：
2.8
通讯作者：
Zhang C
中科院分区：
文献类型：
--
作者：
Buck Louis GM;Yeung E;Sundaram R;Laughon SK;Zhang C
考虑到围绕这类研究的许多独特的方法论挑战，理解成功的人类繁殖和发展的机制是一个雄心勃勃的目标。生殖和围产期流行病学家非常了解这些挑战，包括其条件性、不可观察但信息丰富的结果，如受孕、多尺度缺失数据、相关或非独立结果、间隔审查和分层数据结构。如果我们要更好地理解目前以改善人口健康为目标的人类生殖效率低下的特点，就需要采用新的方法来克服这些挑战和弥补关键的数据差距。这是一种新兴的范式，它为理解人类生殖和发展的自然历史以及后来在儿童或成人时期发展起来的许多相关损伤提供了希望。这一新的范式认识到有必要通过敏感窗口确定和衡量因先入为主的环境(非遗传)暴露的总体，并确定与健康和不利结果相关的模式。暴露组容纳了专注于独特亚群的研究，例如接受辅助生殖技术的夫妇，这样就可以更好地解决方法限制，如不可观察和有条件的结果。生殖和围产期流行病学特别适合于概念验证暴露研究，因为生育力、孕妇健康和晚发性疾病之间存在错综复杂的关系，而且人类生殖和发育的条件性质具有狭窄和相互关联的敏感窗口。需要像Exposome这样大胆的新概念框架来设计可能导致发现和改善人口健康的研究。
Understanding the mechanisms that underlie successful human reproduction and development is an ambitious goal, given the many unique methodologic challenges surrounding such study. These challenges are well understood by reproductive and perinatal epidemiologists and include its conditional nature, unobservable yet informative outcomes such as conception, multi-scale missing data, correlated or non-independent outcomes, interval censoring, and a hierarchical data structure. Novel methodologies for overcoming these challenges and for answering critical data gaps are needed if we are to better understand the inefficiency that currently characterizes human reproduction with the goal of improving population health. The exposome is an emerging paradigm that offers promise for understanding the natural history of human reproduction and development, and its many associated impairments that develop later in child- or adult-hood. This novel paradigm recognizes the need to identify and measure the totality of environmental (non-genetic) exposures from preconception through sensitive windows, and to identify patterns associated with healthy and adverse outcomes. The exposome accommodates research focusing on unique subpopulations, such as couples undergoing assisted reproductive technologies, so that methodologic limitations such as unobservable and conditional outcomes can be better addressed. Reproductive and perinatal epidemiology is uniquely suited for proof-of-concept exposome research, given the intricate relations between fecundity, gravid health and later onset disease and the narrow and interrelated sensitive windows that characterize the conditional nature of human reproduction and development. Bold new conceptual frameworks such as the exposome are needed for designing research that may lead to discovery and improve population health.
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影响因子：
6.1
作者：
Brouwers, MM;Feitz, WFJ;Roeleveld, N
通讯作者：
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10.1016/s0002-9378(97)70550-7
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1997-03-01
影响因子：
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通讯作者：
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影响因子：
6.1
作者：
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