Neurobehavioral Effects of Insecticide Exposure in Pregnancy and Early Childhood

描述(由申请人提供)：这项研究的目的是检查在399名儿童队列中暴露于流行杀虫剂对神经行为结果的影响。我们将包括对新生儿期观察到的产前暴露影响的评估，以及对出生后六岁期间暴露影响的评估。目前，儿童正在参加队列研究，调查暴露在各种环境毒物中对健康、发育和行为的影响，并计划对两岁进行随访。最初的资金来自NIEHS/EPA。生物样本将用于评估产前(母亲尿液、婴儿胎粪)和产后(儿童尿液)的杀虫剂暴露情况。我们将使用新生儿重症监护病房网络神经行为量表(NNNS)，在出生后36小时内和4周后的家访期间检查新生儿的神经行为结果，以评估产前暴露于流行杀虫剂的最早影响。这项研究将扩大对这一队列的跟踪，包括4、5和6岁时的评估或发育、认知、运动技能和行为，以努力检查出生后接触杀虫剂的影响。分析将采用多变量和因果建模技术。潜在的协变量将包括母亲在怀孕期间使用药物和酒精、妊娠结局和婴儿特征、母亲的特征和家庭环境的质量、社会经济地位变量、铅和烟草暴露，以及适当的其他变量。在之前的访问中收集的生物样本和神经行为测试的数据也将可用。我们提出了以下目标：目的1用NNNS测定孕妇孕期尿液和出生后不久胎粪中收集的生物标记物，以确定产前暴露于流行杀虫剂与新生儿神经行为之间的关系。目的通过对4~6岁儿童尿液中杀虫剂的测定，确定出生后暴露于流行杀虫剂与神经行为之间的关系。我们将使用多个暴露在多个时间点的生物标志物和敏感的神经行为评估工具，从新生儿时期到五岁，仔细研究出生前和出生后接触流行杀虫剂的影响。这项研究提供了一个独特的机会，在利用已建立的队列研究的研究基础设施的同时，检查出生前和出生后接触杀虫剂对从新生儿时期到六岁的神经行为结果的早期影响。

DESCRIPTION (provided by applicant): The objective of this study is to examine the effects of exposure to prevalent insecticides on neurobehavioral outcomes in a cohort of 399 children. We will include an evaluation of prenatal exposure effects observed during the newborn period, as well as postnatal exposure effects through age six. Children are currently enrolled in cohort study investigating the health, developmental, and behavioral consequences of exposure to a variety of environmental toxicants and with planned follow-up to age two. Original funding was through NIEHS/EPA. Biological samples will be used to assess exposure to insecticides prenatally (maternal urine, infant meconium) and postnatally (child urine). We will examine newborn neurobehavioral outcomes within the first 36 hours of life and during a home visit at 4 weeks, using the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS), to assess the earliest effects of prenatal exposure to prevalent insecticides. The study will extend follow-up of this cohort to include assessments or development, cognition, motor skills, and behaviors at ages 4, 5, and 6 in an effort to examine the effects of postnatal exposure to insecticides. Analyses will employ multivariate and causal modeling techniques. Potential covariates will include maternal drug and alcohol use during pregnancy, pregnancy outcomes and infant characteristics, maternal characteristics and qualities of the home environment, socioeconomic status variables, lead and tobacco exposure, and other variables as appropriate. Data from biological samples and neurobehavioral testing collected at earlier visits will also be available. We propose the following aims: AIM 1 To characterize the association of prenatal exposure to prevalent insecticides, as determined by biomarkers collected in maternal urine during pregnancy and in meconium shortly after birth, with neurobehavior during the newborn period measured with the NNNS. Aim 2 To characterize the association of postnatal exposure to prevalent insecticides, as determined by measures of insecticides in child urine with neurobehavior at ages four to six years. We will carefully examine the effects of prenatal and postnatal exposure to prevalent insecticides using multiple biological markers of exposure at numerous time points and sensitive neurobehavioral assessment tools from the newborn period through age five years. This study offers a unique opportunity to examine the early effects of prenatal and postnatal exposure to insecticides on neurobehavioral outcomes in a trajectory from the newborn period through age six years, while utilizing the research infrastructure of an established cohort study.