The Norwegian Mother And Child Study: Environmental Specimen Collection

挪威母子队列研究(MOBA)是一项正在进行的产前队列研究。2008年完成了登记，结果在研究中有106,980例怀孕。这项研究基于父母填写的问卷，生物标本收集自母亲、父亲和孩子。这项研究的主要目的是寻找疾病的原因。NIEHS为这项研究提供了部分支持，并在2002年扩大了数据收集方案，包括从怀孕第17周的母亲那里收集更多的生物标本(额外的血清、在无微量元素容器中收集的全血样本和尿液)。这些标本将增强检查环境暴露与儿童及其母亲的各种健康后果的关系的能力。截至2009年4月30日，77,104名受试者提供了血液和尿液，这些血液和尿液是与NIEHS一起收集的。 我们在MOBA方案中增加了在怀孕23周和29周时为一部分妇女收集额外的尿样。690名妇女有一套完整的三份怀孕尿液样本。今年，我们完成了一项研究的实验室工作，在这项研究中，我们试图测量这些样本中有机磷农药和双酚A的代谢物水平，以确定这些水平的重复性。我们了解到，收集尿样时使用的防腐剂污染了游离双酚A，使标本难以分析有机磷农药代谢物。这些信息在我们计划未来的研究时将非常有用。未来寻求双酚A定量的研究将需要测量总的和游离的双酚A，以便可以估计结合的双酚A。需要进行专门的新研究，以确定是否可以分析样本中的有机磷农药代谢物，因为标准方法不起作用。我们发表了一篇报告污染的论文，并确定了两个实验室将处理尿样，看看他们是否可以分析有机磷农药代谢物和邻苯二甲酸盐。 我们还研究了全氟烷基物质的血浆浓度与MOBA队列中女性的不同结局之间的关系。今年，我们发表了一篇关于这些化合物血浆水平决定因素的论文。我们正在完成一系列基于我们关于这些化合物血浆水平的数据的其他论文；一篇是关于先兆子痫的，两篇是关于与全氟化合物水平相关的临床化学参数值的，还有一篇是关于怀孕期间的体力活动和血浆C反应蛋白水平的，C反应蛋白是炎症的标志。我们正在计划一系列新的研究，利用手头的数据，检查a)几年内血浆水平的可靠性，b)暴露与儿童生长的关系，以及c)暴露与儿童感染的关系。由于我们对全氟烷基物质的兴趣，我们也一直在合作研究这些化合物的药代动力学，这为流行病学发现提供了洞察力。在过去的一年里，我们发表了一篇关于这些化合物的药物动力学的论文。 NIEHS的科学家们正在开发几项研究，这些研究将嵌套在MoBA中。目前计划进行的研究清单包括：脑性瘫痪的风险因素、寻找人类基因的非孟德尔传递、饮食摄入与妊娠期糖尿病、孕期和婴儿神经发育期间的体力活动、有机磷农药暴露与自闭症风险、以及关于全氟化合物暴露与健康的其他研究。

The Norwegian Mother and Child Cohort Study (MoBa) is an ongoing prebirth cohort study. Enrollment was completed in 2008 resulting in 106,980 pregnancies in the study. The study is based on questionnaires completed by the mother and father, and biological specimens are collected from the mother, father and child. The main purpose of the study is to find causes of diseases. NIEHS is providing partial support for the study, and in 2002 expanded the data collection protocol to include collection of more biologic specimens from the mothers during the 17th week of pregnancy (additional serum, a specimen of whole blood collected in a trace-element free container, and urine). These specimens will enhance the ability to examine the relation of environmental exposures in relation to various health outcomes in the children and their mothers. As of April 30, 2009, 77,104 subjects had provided blood and urine that was collected in conjunction with NIEHS. We added to the MoBa protocol the collection additional urine specimens in pregnancy, at weeks 23 and 29, for a subset of women. 690 women have a complete set of three urine specimens from pregnancy. This year the laboratory work was completed for a study in which we attempted to measure the levels of metabolites of organophosphate pesticides and bisphenol A in these specimens, to determine how reproducibile the levels were. We have learned that the preservative used in the collection of the urine specimens contaminated them with free bisphenol A, and makes the specimens difficult to analyze for organophosphate pesticide metabolites. This information will be of great use as we plan future studies. Future studies seeking to quantitate bisphenol A will need to measure total and free BPA, so that conjuated BPA can be estimated. Special new studies will be needed to see if the specimens can be analyzed for organophosphate pesticide metabolites, because the standard approach will not work. We published one paper reporting the contamination, and have identified two laboratories that will work with the urine specimens to see if they can analyze them for organophosphate pesticide metabolites and phthalates. We also have studied the plasma concentration of perfluoralkyl substances in relation to various outcomes among women in the MoBa cohort. This year we published one paper on the determinants of plasma levels of these compounds. We are completing a series of other papers based on our data on plasma levels of the compounds; one is on preeclampsia, two are on values of clinical chemistry parameters in relation to perfluorinated compound levels, and one, using the same group of women, is about physical activity in pregnancy and plasma levels of C-reactive protein, a marker of inflammation. We are planning a series of new studies, using the data in hand, to examine a) the reliability of the plasma levels over a period of several years, b) exposure in relation to child growth, and c) exposure in relation to infections in childhood. Because of our interest in perfluoroalkyl substances, we have also been collaborating on studies of the pharmacokinetics of these compounds, which provide insight into epidemiologic findings. We published one paper on the pharmacokinetics of these compounds in the past year. Scientists at NIEHS are developing several studies that will be nested within MoBa. A list of the studies currently planned includes: Risk factors for cerebral palsy, A Search for the Non-mendelian Transmission of Human Genes, Dietary Intake and Gestational Diabetes, Physical Activity in Pregnancy and Infant Neurodevelopment, Organophosphate Pesticide Exposure and Risk of Autism, and additional studies on perfluorinated compound exposure and health.