Pilot Studies for Baltimore CPP/Pathways Followup

描述(由申请人提供)：对不利的围产期和早期婴儿风险因素与成年期间出现的重要疾病之间的关系的兴趣和证据，已导致联邦政府计划对100,000多名新生儿进行一项名为国家儿童研究(NCS)的队列研究。NCS与20世纪60年代S时期进行的一项名为合作围产期项目(CPP)的研究有相似之处，在该项目中，美国12所大学医学中心对58,000名活产婴儿进行了跟踪调查，直到7岁或8岁。CPP包括与怀孕和分娩有关的详细数据(包括孕妇和脐带血清，仍可供研究)；对后代身体、神经、认知和行为发育的反复观察；出生和7岁时的社会和环境特征；以及胎儿、新生儿、后来的婴儿和儿童死亡。拟议开展试点和发展工作，以支持CPP巴尔的摩队列的保健后续行动(n=4034)。在1992至1994年间，巴尔的摩CPP出生队列中的2694名婴儿及其母亲的随机抽样，在成年之路研究(PAS)中进行了调查。在这项拟议的试点研究完成时拟采取的后续行动将在该队列大约45岁时进行。需要开展试点工作，才能证明对巴尔的摩CPP采取更深入和全面的后续行动的提议是合理的。首先，我们建议通过对四组160名子女的试点研究来评估队列成员可以找到并愿意参与后续行动的程度，这四组子女的参与程度由他们参与巴尔的摩CPP和PAS项目的程度确定。其次，我们建议评估将巴尔的摩CPP硬拷贝记录中的某些数据转换为磁性形式的成本和效用。第三，我们建议比较传统和新的统计学技术，以了解特定胎儿生长轨迹的后果，并使用1700多名受访者的数据，这些数据与年轻人的两个特定结果相关：心理健康和肥胖。在这项试点和发展工作取得成功之后，将提出对巴尔的摩CPP的大样本和仔细指定的样本或可能是整个巴尔的摩CPP队列的健康后续行动的建议。健康跟进将包括家庭面谈和体检。在计划的后续行动中，我们将获取血液中的DNA和其他生物标记物。后续研究将在这一系列原因中开始研究，这些原因将早期环境风险、胎儿和婴儿发育与青壮年的障碍(如精神疾病)联系起来，再到中年起病的疾病，如糖尿病、高血压、心脏病和中风。未来的项目还将在未来十年内建立这些疾病新发风险的亚样本。巴尔的摩CPP队列得到了比任何其他CPP队列更深入的研究。这项拟议研究的数据将把NCS的数据预测近半个世纪。这些结果将产生关于一系列流行的、致残的和致命的健康状况的早期影响的新信息。

DESCRIPTION (provided by applicant): Interest in, and evidence or, the relationships between adverse perinatal and early infant risk factors, and important diseases emerging during adulthood, has led to plans by the Federal Government to conduct a cohort study called the National Children's Study (NCS) of over 100,000 births. The NCS has similarities to a study conducted during the 1960's called the Collaborative Perinatal Project (CPP), in which 58,000 live births were followed to age 7 or 8 in 12 university medical centers in the United States. The CPP included detailed data pertaining to pregnancy and birth (including maternal and cord sera, still available for study); repeated observations of the offspring's physical, neurological, cognitive, and behavioral development; social and environmental characteristics at birth and age 7; and fetal, neonatal, later infant, and child death. Pilot and developmental work is proposed in support of a health follow-up of the Baltimore cohort of the CPP (n = 4034). Between 1992 and 1994, a random sample of 2694 of the Baltimore CPP cohort of births, and their mothers, was surveyed, in the Pathways to Adulthood Study (PAS). The follow-up to be proposed at the completion of this proposed pilot study would occur when the cohort was about 45 years old. Pilot work is needed before a proposal for a more intensive and complete follow-up of the Baltimore CPP can be justified. First, we propose to assess the degree to which cohort members can be located and are willing to participate in a follow-up, by a pilot study of 160 offspring, in four groups defined by their level of participation in the Baltimore CPP and PAS projects. Second, we propose to evaluate the cost and utility of converting certain data from the Baltimore CPP hardcopy records to magnetic form. Third, we propose to compare traditional and new statistical techniques for understanding the consequences of specific fetal growth trajectories, with data on more than 1700 respondents, already in hand, relevant to two particular outcomes in young adults: mental health and obesity. Success in this pilot and developmental work will be followed by a proposal for health follow-up of a large and carefully designated sample of the Baltimore CPP, or possibly the entire Baltimore CPP cohort. The health follow-up will entail a household interview and medical examination. In the planned follow-up, we will obtain blood for DNA and other biomarkers. The follow-up will begin study in this cohort of the chain of causes linking early environmental risk, fetal, and infant development to disorders of young adulthood, such as mental conditions, through to diseases which have onset in middle age, such as diabetes, hypertension, heart disease, and stroke. The future project will also establish sub-samples at risk for new onset of these diseases in the coming decade of life. The Baltimore CPP cohort has been more intensively studied than any other CPP cohort. Data from the proposed study will anticipate those of the NCS by nearly half a century. The results will generate new information about early influences on a large range of prevalent, disabling and fatal health conditions.