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。我们了解到，收集尿样时使用的防腐剂污染了游离双酚A，也使标本难以分析其他分析物，如有机磷农药代谢物。这些信息在我们计划未来的研究时将非常有用。我们今年发表了一份关于污染问题的报告。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。今年，我们与北卡罗来纳大学的斯蒂芬妮·恩格尔博士合作，进行了初步研究，确定可以分析样本中的有机磷农药代谢物和邻苯二甲酸盐，现在我们正在与她合作，全面研究这些药物与MoBA儿童注意力缺陷多动障碍的关系。在今年发表的一项关于怀孕期间测量三氯生的可靠性的研究中，我们也成功地使用了尿液。 我们还研究了母体血浆中全氟烷基物质(PFAS)浓度与MOBA队列中妇女的不同结局的关系。今年，我们发表了一篇关于PFAS和a)先兆子痫、b)血脂和)甲状腺激素的论文。另一篇基于同一组女性的论文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(正在报道中，未在下文列出)。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。我们今年的出版物由Morken等人撰写。与这个子项目有关；Morken的论文是关于怀孕期间肾功能与胎儿大小的关系。 NIEHS的科学家们正在开发几项研究，这些研究将嵌套在MoBA中。目前计划的研究清单包括：脑性瘫痪的风险因素、脐带血DNA甲基化的决定因素、有机磷农药暴露和自闭症风险，以及关于全氟化合物暴露和健康各方面的其他研究。

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. We have learned that the preservative used in the collection of the urine specimens contaminated them with free bisphenol A, and also makes the specimens difficult to analyze for other analytes such as organophosphate pesticide metabolites. This information will be of great use as we plan future studies. We published one report this year about the contamination issue. Future studies seeking to quantitate bisphenol A will need to measure total and free BPA, so that conjuated BPA can be estimated. This year, in collaboration with Dr. Stephanie Engel at UNC, we conducted pilot studies and determined that the specimens can be analyzed for organophosphate pesticide metabolites and phthalates, and we are now collaborating with her on full studies of these agents in relation to attention-deficit hyperactivity disorder in MoBa children. We also were successful in using the urines in a study of the reliability of measuring triclosan during pregnancy, which was published this year. We also have studied the maternal plasma concentration of perfluoralkyl substances (PFAS) in relation to various outcomes among women in the MoBa cohort. This year we published one paper each on PFAS and a) preeclampsia, b) lipids, and )thyroid simulating hormone. An additional paper, based on the same group of women, is about physical activity in pregnancy and plasma levels of C-reactive protein, a marker of inflammation (in press and not listed below). 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. Our publication this year by Morken et al. was related to this subproject; the Morken paper was about the relation of kidney function during pregnancy to the size of the fetus. 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, Determinants of DNA methylation in cord blood, Organophosphate Pesticide Exposure and Risk of Autism, and additional studies on perfluorinated compound exposure and various aspects of health.