Comp A: Texas BD-STEPS III Core

项目总结 出生缺陷是导致美国婴儿死亡率、发病率和医疗费用的主要因素，但 对于大多数人来说，这些疾病的病因尚不清楚，这阻碍了 人口层面的预防战略。因此，国家出生缺陷研究议程的关键下一步是 为了更好地了解这些情况的父母和婴儿的决定因素，以确定和实施 减少出生缺陷相关发病率和死亡率的战略。作为国家诞生的创始成员 缺陷预防研究(即，评估妊娠暴露的出生缺陷研究的前身 (BD-STEPS)，德克萨斯州出生缺陷研究和预防中心帮助推进了出生缺陷 自1996年德克萨斯州出生缺陷登记处成立以来的研究和预防。该中心代表着 德克萨斯州卫生服务部德克萨斯州出生缺陷登记处之间的合作， 加州大学卫生学院公共卫生学院和贝勒医学院。将我们的地理区域添加到 BD-STEPS招聘池将允许增加多样性，特别是在墨西哥裔美国人中， 美国增长最快的种族/民族群体，通过利用美国最大的出生缺陷登记之一 在全球，我们的团队在出生缺陷监测和流行病学方面拥有丰富的经验，并且 两种出版物(N&GT；500)的卓越记录，这些出版物有助于阐明 出生缺陷的危险因素及培养下一代出生缺陷研究人员。建立在我们的 强大的基础设施用于患者招募、数据收集和流行病学分析，我们现在建议 通过与来自其他地区的长期合作伙伴合作，为BD-Steps贡献我们的经验和资源 各国通过研究和培训，推动研究的数据收集和影响。我们中心的独特之处 研究领域包括1)健康的社会决定因素(由德克萨斯州卫生部领导 服务)；2)遗传风险因素(由贝勒医学院领导)；以及3)职业暴露(领导 由德克萨斯大学卫生学院公共卫生学院提供)。因此，我们处于有利地位，至少可以进行、发布和展示 七项拟议的研究旨在确定与BD中这些和其他暴露的关系- 采取步骤，并提高对造成特定出生缺陷风险的具体机制的了解。 在其结论中，我们预计这项工作将扩大潜在的可修改的孕产妇接触清单 已知与出生缺陷风险有关的新知识，将有助于 设计降低风险的战略，并增强博士和博士后实习生和 初级教员。最重要的是，预计这些产出最终将转化为 减少出生缺陷的发生率，改善患有这些疾病的婴儿的健康状况。

PROJECT SUMMARY Birth defects are a major contributor to infant mortality, morbidity, and healthcare costs in the U.S., but the etiologies of these conditions remain unknown for most individuals, which has hindered development of population-level prevention strategies. Thus, a critical next step in the national birth defect research agenda is to better understand the parental and infant determinants of these conditions to identify and implement strategies to reduce birth defect-related morbidity and mortality. As a founding member of the National Birth Defects Prevention Study (i.e., the predecessor of the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS), the Texas Center for Birth Defects Research and Prevention has helped advance birth defects research and prevention since the founding of the Texas Birth Defects Registry in 1996. The Center represents a collaboration between the Texas Birth Defects Registry at the Texas Department of State Health Services, UTHealth School of Public Health, and Baylor College of Medicine. The addition of our geographic region to BD-STEPS recruitment pool would allow for increased diversity, particularly among Mexican Americans, one of the fastest-growing racial/ethnic groups in the U.S. By leveraging one of the largest birth defects registries in the world, our team has extensive experience in birth defects surveillance and epidemiology, and an exceptional track-record for both generating publications (N>500) that have contributed toward elucidation of birth defects risk factors and training the next generations of birth defects researchers. Building upon our strong infrastructure for patient recruitment, data collection, and epidemiologic analyses, we now propose to contribute our experience and resources to BD-STEPS by collaborating with our long-term partners from other states to advance the study’s data collection and impact, through research and training. Our Center’s particular research areas include 1) social determinants of health (led by the Texas Department of State Health Services); 2) genetic risk factors (led by Baylor College of Medicine); and 3) occupational exposures (led by UT Health School of Public Health). Thus, we are well-positioned to conduct, publish, and present at least seven proposed research studies designed to identify associations with these and other exposures in BD- STEPS and to improve understanding of the specific mechanisms that underlie risk for particular birth defects. At its conclusion, we expect this work will have expanded the list of potentially modifiable maternal exposures that are known to be associated with the risk of birth defects, contributed new knowledge that will aid in the design of risk reduction strategies, and empower the development of doctoral and post-doctoral trainees and junior faculty members. Most importantly, it is expected that these outputs will ultimately translate to a reduction in the prevalence of birth defects and improved health among infants born with these conditions.