Developmental Epidemiological Study of Children born through Reproductive Technology (DESCRT)

通过生殖技术出生的儿童的发育流行病学研究（DESCRT）

基本信息

批准号：
10165758
负责人：
MARCELLE Ivonne CEDARS
金额：
$ 63.11万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-10 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10165758
关键词：
Address Age Aging Animals Area Assisted Reproductive Technology Biometry Birth Blood Pressure Blood Vessels Child Child Health Childhood Chronology Clinical Clinical Treatment Cognitive Cohort Studies Collection Computerized Medical Record Computerized Patient Records Congenital Abnormality Consult Data Databases Detection Development Embryo Transfer Emotional Endocrinology Enrollment Environment Epidemiologic Methods Epidemiology Evaluation Family Fertilization in Vitro Future Gene Expression Glucose Growth Health Homeostasis Impairment In Vitro Infertility Injections Insulin Insulin Resistance Investigation Knowledge Laboratories Length Link Longitudinal Studies Medical Metabolic Metabolic Diseases Methodology Methods Mothers Oocytes Oral Outcome Ovarian Ovarian Stimulations Ovary Oxidative Stress Parents Patient Recruitments Patients Pattern Pharmaceutical Preparations Placenta Placentation Plasma Population Positioning Attribute Pregnancy Public Health Recommendation Reproductive Endocrinology Reproductive Health Reproductive Technology Research Risk Safety Scientist Serum Specimen Sperm Count Procedure Standardization Techniques Technology Telomere Shortening Treatment outcome Urine Uterus Woman Work adverse outcome aggressive therapy arm base behavioral outcome biobank blood glucose regulation clinically relevant cohort comparison group complex data early pregnancy electric impedance embryo cryopreservation epidemiology study glucose metabolism health data improved indexing infertility treatment interest intrauterine insemination metabolomics new technology offspring ovarian reserve patient health information patient population perinatal complications prospective recruit reproductive screening sperm cell surrogacy translational study treatment strategy

项目摘要

The number of pregnancies conceived with assisted reproductive technology (ART) has dramatically increased over the last 30 years. Additionally, techniques developed for in vitro fertilization (IVF) are now utilized without in vitro culture. These widely-used non-IVF fertility treatments (NIFT) have increased the number of children potentially at risk for adverse health effects. Increased short-term risks for perinatal complications and birth defects, following ART, are well-known. However, the risk of these adverse outcomes has been difficult to characterize as studies used different methodologies, varied age of detection, and did not have appropriate comparison groups. For example, when underlying parental factors and infertility are included in the analyses of birth defects, the association is substantially weakened or disappears completely. More importantly, while the long-term health of children born through these technologies is of critical public health interest, and of personal interest to families, only limited data exist. In order to evaluate the potential risk for long-term health of children conceived through ART and NIFT, rigorous epidemiological methods, appropriate characterization of the exposure, standardized collection of outcome data, and appropriate comparison groups are required. We propose to establish a Developmental Epidemiological Study of Children born through Reproductive Technology (DESCRT) by linking the electronic medical records (EMR) of patients treated at UCSF with birth outcomes and health data. In addition, as part of the longitudinal study, children, up to age 13, will be invited for examination and exploratory aims will investigate underlying mechanisms for increased risk. In particular, we plan to: 1) Establish an epidemiological cohort and biobank for future studies by searching the EMR from UCSF for all pregnancies achieved in patients who underwent infertility consult during 2001–2015. Laboratory and treatment data for eligible women will be linked with the data on the course of pregnancy. Families will be traced and children invited for screening. Pregnancies achieved during the course of the next 4 years (2016- 2019) will be enrolled prospectively; 2) Examine the effects of parental factors and different reproductive treatment strategies on childhood metabolic risk by analyzing the correlation between specific fertility treatments and parental factors, and parameters of glucose/insulin homeostasis and metabolomics in the offspring; and in an Exploratory Aim: Examine the effects of early uterine environment on the precursors of metabolic risk in the offspring by evaluating bio-analytes of placental function and investigating uterine vascular impedance and placental growth and function during prospectively collected pregnancies. Overall impact: The major strengths of the proposed study are the large population with complete and complex data regarding exposure risk, the formation of a valuable biobank, and the interdisciplinary team with prior research suggesting key clinical and translational areas to focus the study improving information for patients and guiding recommendations for clinicians regarding safety of fertility treatment.

通过辅助生殖技术（ART）受孕的数量急剧增加此外，在过去 30 年里，体外受精 (IVF) 技术的开发现在已无需人工干预。这些广泛使用的非 IVF 生育治疗 (NIFT) 增加了儿童数量。潜在的不良健康影响风险增加的围产期并发症和分娩的短期风险。 ART 治疗后的缺陷是众所周知的，但这些不良后果的风险却很难预测。其特点是研究使用了不同的方法、不同的检测年龄，并且没有适当的方法例如，当分析中包括潜在的父母因素和不孕症时。更重要的是，出生缺陷的相关性大大减弱或完全消失。通过这些技术出生的儿童的长期健康关系到至关重要的公共卫生利益，并且对于家庭的个人利益，只有有限的数据可以评估长期健康的潜在风险。通过 ART 和 NIFT 受孕的儿童、严格的流行病学方法、适当的特征描述需要暴露、结果数据的标准化收集和适当的比较组。建立生殖出生儿童的发展流行病学研究技术 (DESCRT)，将 UCSF 治疗的患者的电子病历 (EMR) 与出生联系起来此外，作为纵向研究的一部分，13 岁以下的儿童将被邀请。检查和探索的目的将调查风险增加的根本机制。我们计划： 1）通过搜索 EMR 建立流行病学队列和生物库以供未来研究 UCSF 实验室对 2001 年至 2015 年间接受不孕不育咨询的所有成功怀孕患者进行了分析。符合条件的妇女的治疗数据将与怀孕过程的数据联系起来。追踪并邀请儿童在未来 4 年（2016 年至）期间进行筛查。 2019）前瞻性入组；2）考察父母因素和不同生育方式的影响通过分析特定生育力之间的相关性来制定儿童代谢风险的治疗策略治疗和父母因素，以及葡萄糖/胰岛素稳态和代谢组学的参数后代；以及探索性目标：检查早期子宫环境对前体的影响通过评估胎盘功能的生物分析物和研究子宫血管来评估后代的代谢风险前瞻性收集妊娠期间的阻抗、胎盘生长和功能。拟议研究的主要优势是人口众多，拥有完整且复杂的数据暴露风险、有价值的生物样本库的形成以及具有先前研究的跨学科团队建议重点研究的临床和转化领域，改善患者信息并指导关于生育治疗安全性的建议。