Prenatal Exposures and Child Health Outcomes: A Statewide Study

项目摘要 对许多环境暴露而言，对儿童后期健康风险最敏感的时期是怀孕期， 这些接触最好从产妇自我报告、生物标本和 在怀孕期间和出生后立即收集的客观环境数据。本研究将探讨 在这个敏感时期，测量环境污染物，营养因素和炎症， 2 000对母婴在其社会和心理环境方面的情况。我们有两支队伍 共有近1,000名妇女在怀孕早期（大多数在14周之前）登记、采访和取样 生物标本存档，现在正在扩大我们的两个队列中较大的一个全州范围内， 密歇根州医院和诊所的概率样本，以招募1,000多名孕妇。我们正在联系 超过84%的现有成员。我们将使用新生儿干血斑（NDBS）， 密歇根州新生儿生物库，以进一步量化环境暴露，检查表观基因组的变化， 通过访问孩子和母亲的新生儿地点，研究跨代环境影响。 在密歇根州弗林特，我们将研究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，我们将确定持久性 有机污染物（POP）和重金属对认知结果的影响。我们假设这些影响 毒素将通过NDBS上测量的表观遗传变化介导，并将通过授予母体的 暴露量（在母亲新生儿时测量其血斑）。我们假设最近在子宫内 根据NDBS的评估，密歇根州弗林特市的铅暴露以及暴露儿童脱落的牙齿中的铅暴露也将被 与认知功能受损有关。第二，我们将评估产妇营养和 妊娠期体重状况对认知结果和儿童肥胖的影响，特别关注低 妊娠期碘和/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的体重变化。最后，我们将评估 妊娠期病毒感染和母亲肥胖对围产期结局和行为的影响 江西篇章病毒感染和母亲肥胖的影响被假设为通过增加的 胎盘和新生儿炎症。婴儿肠道微生物组也将进行评估，因为我们预计， 可能是将营养因素和妊娠炎症与不良儿童健康联系起来的途径 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.