Methods to Detect Maternal Exposures and Child Outcomes

描述（由申请人提供）：本项目的总体目标是在宫内暴露的关键时期识别与儿童发育障碍和智力迟钝（DD/MR）相关的可疑有机和无机化学品。这项研究将比较个人水平的分析与新的空间和时间的统计方法，推断从集群的分析，个人的风险与时间和空间的曝光。这项研究将分为三个阶段。在第一阶段，我们将测试的假设，有集群DD/MR的婴儿中确定的母亲在怀孕期间居住。我们将使用Medicaid产前和产后医疗数据以及每月地址链接超过152，000对母婴，因此可以使用空间统计来识别DD/MR的集群。在第二阶段，我们将测试的假设，土壤样本将显示变化的毒性水平，可用于确定位置与潜在的更高浓度的可疑的有机和无机化学可能与DD/MR。这将涉及收集和分析土壤样本的集群网站和比较地区的DD/MR率不升高。此外，我们将测试的假设，汞，铬，砷，多氯联苯，和其他选定的化学污染物将被测量在较高浓度的毒性土壤样品相比，较低的毒性土壤，确定使用Microtox。我们将把高毒性和低毒性土壤的子样本送到外部分析实验室进行化学分析。在第三阶段，我们将测试的假设，即产妇住所附近的有毒废物的网站与确定的化学品暴露，在胎儿发育的关键时期，将与DD/MR在婴儿的风险较高，控制产妇和儿童的风险因素。这将涉及统计方法的发展，结合联合收割机的传统和空间程序，分析空间关系，时间暴露（怀孕月份）和土壤样本之间的关联。这些可以用来生成与DD/MR相关的特定环境暴露的假设。这项研究将是多学科和多方法的，特别强调新技术的开发，以分析环境和医疗数据的复杂关联。

DESCRIPTION (provided by applicant): The overall aim of this project is to identify suspect organic and inorganic chemicals during critical periods of intrauterine exposure that are associated with child developmental disabilities and mental retardation (DD/MR). The study will compare individual level analysis with new spatial and temporal statistical methods to infer from analysis of clusters to individuals about the risk associated with temporal and spatial exposures. The study will be divided into three phases. During Phase I we will test the hypothesis that there are clusters of DD/MR among infants identified by maternal residence during pregnancy. We will link over 152,000 maternal child pairs using Medicaid prenatal and postnatal medical data, and monthly addresses, so clusters of DD/MR can be identified using spatial statistics. During Phase II we will test the hypothesis that soil samples will show variation in toxicity levels that can be used to identify locations with potentially greater concentrations of suspect organic and inorganic chemical which may be associated with DD/MR. This will involve collecting and analyzing soil samples from cluster sites and from comparison areas where rates of DD/MR are not elevated. In addition, we will test the hypothesis that mercury, chromium, arsenic, PCBs, and other selected chemical contaminants will be measured in higher concentration in the higher toxicity soil samples compared to the lower toxicity soils, as identified using Microtox. We will send a subsample of the high and low toxicity soil for chemical analyses at an external analytical laboratory. During Phase III we will test the hypothesis that maternal residence proximal to toxic waste sites with identified chemical exposures, during critical periods of fetal development, will be associated with higher risk for DD/MR in the infant, after controlling for maternal and child risk factors. This will involve the development of statistical methods that combine traditional and spatial procedures to analyze associations between the spatial relationship, temporal exposure (month of pregnancy), and soil samples. These can be used to generate hypotheses about specific environmental exposures associated with DD/MR. This research will be both multidisciplinary and multimethod, with specific emphasis on the development of new techniques, to analyze the complex associations of environmental and medical data.