Exploring Multiple Environmental Exposures in Combination as Risk Factors for Adverse Pregnancy Outcomes

项目总结 孕妇及其发育中的胎儿特别脆弱，从而使生命进程 研究，特别是关于环境暴露的研究，非常重要。然而，传统的 妊娠期环境暴露的研究集中在一次一次暴露， 结果有限。最近，“曝光组”的概念，或对整体的测量 一个人的暴露已经出现，强调了同样多地考虑一个人的重要性 尽可能多地曝光。暴露由三个领域组成：内部、具体的外部、 和一般的外部。内部包括“组学”技术，而具体的 外部包括暴露，如环境污染物和一般外部 包括社会因素和压力。在这个项目中，我努力将多种措施结合在一起 具体的外部环境，特别是杀虫剂和空气污染，以及 总的外部环境，如社会经济地位的衡量标准以及措施 在胎儿期的绿地。我会调查这个建筑群的关联 暴露与不良妊娠结局、先兆子痫和结构性疾病的组合 先天缺陷。先兆子痫是一种影响美国5%孕妇的疾病 并且是孕产妇和新生儿死亡以及其他不良分娩结局的主要原因。在……里面 在之前的工作中，我们也观察到先兆子痫和选定的结构性疾病之间的联系。 先天缺陷。出生缺陷影响了美国约3%的新生儿，是导致出生缺陷的首要原因 婴儿死亡的可能性。先兆子痫和出生缺陷的病因大多尚不清楚， 关于两者的环境风险因素的研究有限。因此，我将利用丰富的数据 来自加利福尼亚州圣华金山谷的一个大出生队列中的一个地区 美国农业农药使用量最高的地区和空气污染物水平较高的地区，以调查 这种环境暴露与先兆子痫和 先兆子痫和出生缺陷的联合结局。

PROJECT SUMMARY Pregnant women and their developing fetuses are particularly vulnerable, making life-course research, particularly regarding environmental exposures, highly important. However, traditional research of environmental exposures during gestation focused on one exposure at a time with limited results. Recently, the concept of the “exposome,” or the measurement of the totality of one’s exposures has emerged, emphasizing the importance of considering as many of one’s exposures as possible. The exposome consists of three domains: the internal, specific external, and general external. The internal comprises the “omics” technologies while the specific external comprises exposures such as environmental contaminants and the general external comprises social factors and stress. In this project, I endeavor to combine multiple measures of the specific external environment, specifically pesticides and air pollution, with aspects of the general external environment such as measures of socioeconomic status, along with measures of greenspace, during the prenatal period. I will investigate the association of this complex combination of exposures with the adverse pregnancy outcomes, preeclampsia and structural birth defects. Preeclampsia is a condition affecting 5% of pregnant women in the United States and is a major cause of maternal and neonatal mortality and other adverse birth outcomes. In previous work, we also observed an association between preeclampsia and selected structural birth defects. Birth defects affect roughly 3% of births in the United States and are the top cause of infant death. Etiologies of both preeclampsia and birth defects remain mostly unknown and research regarding environmental risk factors of both is limited. Thus, I will utilize the rich data available in a large birth cohort from the San Joaquin Valley in California, a region of one of the highest agricultural pesticide use areas and high air pollutant levels in the US, to investigate the association between this combination of environmental exposures with preeclampsia and the joint outcome of preeclampsia and birth defects.