Prenatal Exposures and Child Health Outcomes: A Statewide Study

项目摘要 对于许多环境暴露来说，对以后儿童健康最敏感的风险时期是怀孕和 围产期，这些接触最好通过母亲自我报告、生物标本和 目的收集孕期和产后即刻的环境资料。这项研究将检查 在这一敏感时期，测量环境污染物、营养因素和一些炎症因素 2,000对母婴在其社会和心理环境的背景下。我们有两个群体 共有近1000名妇女在怀孕早期登记、访谈和抽样(大多数在14周前) 已经将生物标本存档，现在正在将我们两个队列中较大的一个扩展到全州范围内 密歇根州医院和诊所的概率样本，将再招募1,000名孕妇。我们正在与 我们现有的队列成员中有84%以上。我们将使用新生儿干血点(NDBS) 密歇根新生儿生物库，进一步量化环境暴露，检查表观基因组变化，以及， 通过访问孩子和母亲的新生儿斑点，研究几代人对环境的影响。 在密歇根州的弗林特，我们将检查最近的水污染对胎儿和儿童的影响。 我们将重点关注怀孕期间的三个重要暴露。首先，我们将确定持之以恒的效果 有机污染物(POPs)和重金属对认知结果的影响。我们假设这些因素的影响 毒素将通过在NDBS上测量的表观遗传变化来调节，并将通过赠款-母体放大 暴露量(根据母亲出生时的血点测量)。我们假设最近在子宫里 在密西西比州弗林特，NDBS评估的铅暴露以及暴露儿童的脱落牙齿中的铅暴露也将是 与认知结果受损有关。第二，我们将评估母亲营养和营养的影响 孕期体重状况对认知结果和儿童肥胖的影响，特别关注低体重 孕期碘和/或铁状况，干扰甲状腺碘摄取的物质(高氯酸盐、硫氰酸盐)， 甲状腺激素功能异常和妊娠相关体重变化。最后，我们将评估影响 妊娠病毒感染和母亲肥胖对围产儿结局和自闭症相关行为的影响 频谱。病毒感染和母亲肥胖的影响被认为是通过增加 胎盘和新生儿炎症。婴儿肠道微生物组也将被评估，因为我们预计它 可能是一条将营养因素和孕期炎症与儿童健康不良联系起来的途径 结果。

Project Summary For many environmental exposures the most sensitive period of risk for later child health is pregnancy and the perinatal period, and these exposures are best ascertained from maternal self-report, biological specimens and objective environmental data collected during pregnancy and immediately after birth. This study will examine this sensitive period, measuring environmental contaminants, nutritional factors and inflammation in some 2,000 mother infant pairs in the context of their social and psychological environment. We have two cohorts totaling nearly 1,000 women enrolled, interviewed and sampled early in pregnancy (most before 14 weeks) with biological specimens archived, and are now expanding the larger of our two cohorts to a statewide probability sample of Michigan hospitals and clinics to enroll 1,000 more pregnancies. We are in contact with more than 84% of our extant cohort members. We will use newborn dried blood spots (NDBS) from the Michigan Neonatal Biobank to further quantify environmental exposures, examine epigenomic changes, and, by accessing both the child's and the mother's newborn spots, study environmental effects across generations. In Flint, MI we will examine the effects of recent water contamination on fetus and child. We will focus on three important exposures in pregnancy. First, we will determine the effects of persistent organic pollutants (POPs) and heavy metals on cognitive outcomes. We hypothesize that the effects of these toxins will be mediated by epigenetic changes measured on NDBS, and will be amplified by grant-maternal exposure (measured on mother's blood spot when she was a newborn). We hypothesize that recent in utero lead exposure in Flint, MI, as assessed in NDBS, and in the shed teeth of exposed children, will also be associated with impaired cognitive outcomes. Second, we will assess the effect of maternal nutritional and weight status in pregnancy on cognitive outcomes and childhood obesity, with a special focus on low pregnancy iodine and/or iron status, agents interfering with thyroid iodine uptake (perchlorate, thiocyanate), abnormal thyroid hormone function and pregnancy-related weight changes. Finally, we will assess the effects of pregnancy viral infection and maternal obesity on perinatal outcomes and behavior related to the autism spectrum. The effects of viral infections and maternal obesity are hypothesized to be mediated by increased placental and neonatal inflammation. The infant gut microbiome will also be assessed, as we anticipate that it may be a pathway linking both nutritional factors and pregnancy inflammation to adverse child health outcomes.