Massachusetts Center for Birth Defects Research and Prevention: Birth Defects Study To Evaluate Pregnancy exposureS (BD STEPS Core and Stillbirth)

项目总结/摘要 马萨诸塞州（MA）出生缺陷研究和预防中心（MCBDRP）建议继续 它在进行病因学研究以确定结构性分娩的可改变风险因素方面的良好记录 通过参与出生缺陷研究来评估妊娠缺陷（BD-STEPS）。我们 我们将利用与本地大学的长期合作关系， 未来的出生缺陷研究者MCBDRP为BD-STEPS带来了我们的专业知识和领导力， 药物流行病学和协作利用独特的数据资源，以适用于所有三个关键 资助机会通知中指定的感兴趣领域。我们的研究将利用现有的数据， 国家出生缺陷预防研究和BD-STEPS，以及在下一次BD迭代中收集的数据- 步MCBDRP调查人员是忠诚和成功的导师和合作伙伴， 这将在BD-STEPS中继续并扩展。在三年半的资助期内，MCBDRP将 完成至少七个对公共卫生有重要意义的病因学研究项目，这将有助于咨询 妇女在考虑不太可能导致出生缺陷的接触方面的作用;这些项目包括：1） 评估已经并将继续获得FDA批准的抗肥胖药物， 越来越多的减肥手术可能会导致有益的体重减轻，尽管它 不确定潜在的营养缺乏如何影响随后的怀孕; 2）调查 注意缺陷多动障碍药物，其使用急剧增加; 3）评估 烟酰胺腺嘌呤二核苷酸途径抑制剂和补充的潜在预防作用 4）通过先天性畸形的严重程度分类来评估妊娠期间的药物使用; 5)评估多个风险因素之间的复杂关系，以进一步了解出生缺陷; 6） 检查抗病毒药物，这是预防母婴传播的关键，但很少有 了解他们在出生缺陷方面的安全性;以及7）利用MA州公共卫生 实验室的可报告疾病数据库，以探索怀孕前和怀孕期间感染对 出生缺陷的发展。通过这些活动，MCBDRP将成为BD-STEPS的重要合作伙伴 实现我们的总体目标，将研究成果转化为预防出生缺陷的有意义的举措。

Project Summary / Abstract The Massachusetts (MA) Center for Birth Defects Research and Prevention (MCBDRP) proposes to continue its strong track record of conducting etiologic research to identify modifiable risk factors for structural birth defects through its participation in the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS). We will enhance our contributions by leveraging our longstanding relationship with local universities to produce future birth defects researchers. The MCBDRP brings to BD-STEPS our expertise and leadership in pharmacoepidemiology and collaborative utilization of unique data resources to be applied to all three key areas of interest named in the Notice of Funding Opportunity. Our research will utilize existing data from the National Birth Defects Prevention Study and BD-STEPS, as well as data collected in the next iteration of BD- STEPS. The MCBDRP investigators are committed and successful mentors and collaborative partners, roles that will continue and expand within BD-STEPS. Over the three and a half year grant period, the MCBDRP will complete at least seven etiologic research projects of public health significance that will aid in counseling women in considering exposures that are less likely to result in a birth defect; these projects include: 1) Assessing anti-obesity medications that have been and will continue to be approved by FDA and assessing bariatric surgical procedures that are increasingly performed which may lead to beneficial weight loss, though it is uncertain how potential nutritional deficiencies may impact subsequent pregnancies; 2) Investigating attention deficit hyperactivity disorder medications, the use of which has increased dramatically; 3) Evaluating nicotinamide adenine dinucleotide pathway inhibitors and the potential preventive effect of supplementation with niacin; 4) Evaluating medication use during pregnancy by severity classifications of congenital anomalies; 5) Gauging the complex relationship among multiple risk factors to further our understanding of birth defects; 6) Examining anti-viral medications, which are key to preventing maternal-fetal transmission but for which little is known about their safety with respect to birth defects; and 7) Leveraging the MA State Public Health Laboratory’s reportable disease database to explore the role of infections before and during pregnancy on the development of birth defects. Through these activities, the MCBDRP will be an essential partner in BD-STEPS to achieve our overall goal of translating research findings into meaningful initiatives in birth defects prevention.