PRENATAL ALCOHOL IN SUDDEN INFANT DEATH SYNDROME AND STILLBIRTH (PASS)

描述(由申请人提供)：本申请是为了回应申请(RFA-HD-10-018)的申请，该申请旨在进行社区联动研究，以调查产前酒精暴露在小岛屿发展中国家、死产和FASD风险中的作用，并确定这些不同结果如何相互关联，拟议的研究将由研究人员与NICHD和NIAAA合作协议，由产前酒精、小岛屿发展中国家和死胎(PASS)研究网络进行。这项研究涉及以下各方的合作：1)两个综合性临床网站，服务于产前酒精暴露、小岛屿发展中国家和死产的高危人群，即南非开普敦北部平原和开普敦有色人种的美洲印第安人；2)一个中央发育生物学和病理学中心(DBPC)；3)一个中央数据协调和分析中心(DCAC)；4)一个中央生理学评估中心(PAC)；以及5)NICHD和NIAAA的项目科学家和官员。我们网站的使命是通过招募和招募7,000名女性，并执行所有涉及母婴二联体的假设驱动的研究方案，实现安全通道研究的9个具体目标。SCCS正在监督具体目标3的执行和分析。这一目标是利用胎儿超声和婴儿面部成像和标准化特征评估，确定可能被其他环境、遗传和胎盘因素改变的产前酒精暴露对胎儿和婴儿的面部特征、躯体生长和神经/大脑发育的作用。我们将检验如下假设：1)产前酒精暴露对人类胎儿早在20-24孕周时，即我们检查的最早时间点，就会对面部、躯体和/或大脑的发育造成不利影响；2)产前酒精暴露与面部畸形有关，最早在20-24周时通过面部成像确定，并在出生后1个月和12个月仍然存在；3)这种酒精毒性可被其他环境和胎盘因素改变，如母亲营养、母亲吸烟和胎盘灌注力衰竭。

DESCRIPTION (provided by applicant): This application is in response to a Request for Application (RFA-HD-10-018) to conduct community-linked studies to investigate the role of prenatal alcohol exposure in the risk for SIDS, stillbirth and FASD, and to determine how these different outcomes are inter-related, The proposed research will be conducted by the investigators the Prenatal Alcohol, SIDS and Stillbirth (PASS) Research Network in a cooperative agreement with NICHD and NIAAA. This research involves the collaboration of: 1) two comprehensive clinical sites serving populations that are high risk for prenatal alcohol exposure, SIDS, and stillbirth, i.e. the American Indians in the Northern Plains and the Cape Coloured in Cape Town, South Africa; 2) a central Developmental Biology and Pathology Centre (DBPC); 3) a central Data Coordinating and Analysis Center (DCAC); 4) a central Physiology Assessment Center (PAC); and 5) program scientists and officers at the NICHD and NIAAA. The mission of our site is to accomplish the 9 Specific Aims of the Safe Passage Study through the recruitment and enrollment of 7,000 women and the performance of all of the hypothesis-driven study protocols involving the maternal/fetal dyads. The SCCS is overseeing the performance and analysis of Specific Aim 3. This aim is to determine the role of prenatal alcohol exposure, as potentially modified by other environmental, genetic, and placental factors, upon the facial features, somatic growth, and neurological/brain development in the fetus and infant utilizing fetal ultrasonography and infant facial imaging and standardized feature assessment. We will test the hypotheses that: 1) prenatal alcohol exposure adversely impacts facial, somatic, and/or brain growth in the human fetus as early as 20-24 gestational weeks, i.e., the earliest time-point examined by us; 2) prenatal alcohol exposure is associated with facial dysmorphology that is identified by imaging of the face as early as 20-24 weeks and remains present at 1 postnatal month and 12 postnatal months; and 3) this alcohol toxicity is modified by other environmental and placental factors, such as maternal nutrition, maternal smoking, and placental perfusion failure.