Endocrine Disruption in Pregnant Women:Thyroid Disruption and Infant Development

描述（由申请人提供）：孕妇正常的甲状腺功能对其孩子的大脑发育至关重要。最近的数据表明，即使是无症状的亚临床甲状腺功能减退妇女，其后代的智力也会受到影响。NICHD的母胎医学单位（MFMU）网络目前正在一项多中心随机试验中前瞻性评估患有亚临床疾病的妇女甲状腺激素替代是否能改善其子女的预后。美国国家研究委员会的一个专家小组报告说，3%的发育障碍是暴露于环境的直接结果，而更大的比例是环境因素和个人遗传易感性之间的相互作用造成的。人类广泛接触工业化学品多溴二苯醚和高氯酸盐，这些内分泌干扰物已被证明会干扰动物的甲状腺功能。我们计划调查这些药物是否也会干扰孕妇的甲状腺功能，并评估对产前暴露儿童神经发育的潜在影响。在与哥伦比亚大学环境健康科学家的合作下，我们打算从MFMU试验中招募孕妇进行辅助研究，以评估多溴二苯醚和高氯酸盐的水平，并确定这些内分泌干扰物是否对母体甲状腺功能测试有可测量的影响。这些怀孕的孩子将在一岁时进行初步评估，以评估贝利发展商数评估结果的潜在差异。如果多溴二苯醚或高氯酸盐暴露与甲状腺功能之间的关系是明显的，我们将寻求额外的资金来研究儿童发育的潜在差异，直到5岁。公共卫生相关性：孕妇正常的甲状腺功能对胎儿大脑发育至关重要。人类广泛接触工业化学品多溴二苯醚和高氯酸盐，这些内分泌干扰物已被证明会干扰动物的甲状腺功能。我们计划调查这些药物是否会干扰孕妇的甲状腺功能，并评估它们是否对产前暴露的儿童的神经发育有不良影响。

DESCRIPTION (provided by applicant): Normal thyroid function in pregnant women is essential to brain development in their children. Recent data suggests that even in asymptomatic women with subclinical hypothyroidism, intelligence of their offspring is affected. The Maternal-Fetal Medicine Units (MFMU) Network of the NICHD is currently prospectively evaluating in a multicenter randomized trial whether thyroid hormone replacement for women with subclinical disease improves outcomes for their children. An expert panel from the U.S. National Research Council reports that 3 percent of developmental disabilities are a direct result of exposure to environmental exposures, and a greater percentage arise from interactions between environmental agents and individual genetic susceptibility. There is widespread human exposure to the industrial chemicals PBDE and perchlorate, endocrine disruptors which have been shown to interfere with thyroid function in animals. We plan to investigate whether these agents also interfere with thyroid function in pregnant women and assess potential effects on neurological development of prenatally exposed children. In collaboration with the environmental health scientists at Columbia University, we intend to recruit pregnant women from the MFMU trial into an ancillary study to assess levels of PBDE and perchlorate and determine whether these endocrine disruptors have a measurable affect on maternal thyroid function tests. Children from these pregnancies would be assessed initially at one year of age to evaluate potential differences in outcomes as assessed by the Bayley's Developmental Quotient. If a relationship between PBDE or perchlorate exposure and thyroid function were evident, we would seek additional funding to study potential differences in childhood development until age five. PUBLIC HEALTH RELEVANCE: Normal thyroid function in pregnant women is essential to fetal brain development. There is widespread human exposure to the industrial chemicals PBDE and perchlorate, endocrine disruptors which have been shown to interfere with thyroid function in animals. We plan to investigate whether these agents interfere with thyroid function in pregnant women and assess whether they have adverse effects on neurodevelopment in prenatally exposed children.