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

描述（由申请人提供）：本申请是为了响应申请请求（RFA-HD-10-018）进行社区相关研究，以调查产前酒精暴露在小婴儿猝死症、死产和FASD风险中的作用，并确定这些不同的结果是如何相互关联的，拟议的研究将由产前酒精、小婴儿猝死症和死产（PASS）研究网络的研究者与NICHD和NIAAA合作协议进行。本研究涉及以下合作：1)两个综合性临床站点，服务于产前酒精暴露、小岛屿发展中国家和死产的高风险人群，即北部平原的美洲印第安人和南非开普敦的开普有色人种；2)发育生物学和病理学中心（DBPC）；3)中央数据协调与分析中心（DCAC）；4)中央生理评估中心（PAC）；5) NICHD和NIAAA的项目科学家和官员。我们网站的任务是通过招募和登记7000名妇女，以及所有涉及母/胎儿的假设驱动的研究方案的表现，来完成安全通道研究的9个具体目标。SCCS正在监督具体目标3的表现和分析。目的是利用胎儿超声、婴儿面部成像和标准化特征评估，确定产前酒精暴露（可能受到其他环境、遗传和胎盘因素的影响）对胎儿和婴儿面部特征、躯体生长和神经/大脑发育的影响。我们将测试以下假设：1)产前酒精暴露对人类胎儿面部、身体和/或大脑发育有不利影响，早在20-24妊娠周，即我们研究的最早时间点；2)产前酒精暴露与面部畸形有关，面部畸形早在20-24周时就可以通过面部成像识别出来，并在出生后1个月和12个月时仍然存在；3)这种酒精毒性受到其他环境和胎盘因素的影响，如母体营养、母体吸烟和胎盘灌注衰竭。

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.