ENVIRONMENTAL INFLUENCES ON NEURODEVELOPMENTAL OUTCOME IN INFANTS BORN VERY PRETERM

环境对早产儿神经发育结果的影响

• 批准号: 10683573
• 负责人: Barry M. Lester
• 金额: $ 6.5万
• 依托单位: WOMEN AND INFANTS HOSPITAL-RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10683573
• 关键词: Address; Adult; Affect; Age; Algorithms; Area; Attention; Behavioral; Behavioral Genetics; Birth; Chemicals; Child; Child Health; Childhood; Chronic lung disease; Cognition; Collection; Communities; DNA Methylation; Data; Development; Developmental Course; Diagnosis; Emotional; Emotions; Environmental Exposure; Epigenetic Process; General Population; Genetic Variation; Goals; Healthcare; Impairment; In Situ; Individual; Infant; Infection; Intervention; Language; Lead; Life; Longitudinal Studies; Maps; Measures; Medical; Modeling; Motor; Neonatal; Neurodevelopmental Deficit; Outcome; Participant; Perinatal; Phase; Premature Infant; Prevalence; Prospective Studies; Protocols documentation; Public Health; Resources; Time; United States National Institutes of Health; Visit; autism spectrum disorder; base; brain abnormalities; cohort; cost; follow-up; insight; neurobehavior; neurodevelopment; personalized medicine; postnatal; prenatal; prevent; psychologic; psychosocial; retention rate; social

ABSTRACT Upwards of one-third of infants born <30 weeks postmenstrual age suffer long term neurodevelopmental deficits. The prevalence rate of Autism Spectrum Disorders (ASDs) is approximately 5 times higher in these infants than in the general population. The purpose of this Environmental Influences on Child Health Outcomes (ECHO) application is to leverage our ongoing NIH (1R01HD072267-01A) longitudinal multisite prospective study of approximately 600 infants born <30 weeks PMA from birth to age 2 entitled “Neonatal Neurobehavior and Outcomes in Very Preterm Infants.” Our long-term goal is to discern which of these infants are most likely to become developmentally impaired, a personalized medicine approach that could lead to interventions that prevent or mitigate later deficits. Our overall objective in ECHO is to follow these children through age 7 and determine potential mechanisms that lead to developmental outcome in these children. In order to do this, these children need to be studied in situ. Our hypothesis is that environmental exposures, behavioral, genetic variation and epigenetic factors are required to understand the mechanisms involved. We plan to determine how prenatal, perinatal and postnatal environmental exposures (e.g., physical, demographic, maternal psychological, medical, chemical), DNA methylation, and infant neurobehavior at NICU discharge) will be related to child measures of attention, cognition, emotion, social, language, behavioral and motor development at ages 5, 6, and 7 and ASD diagnosis. We expect genetic variation to modify the effects of environmental exposures on these child outcomes and plan to develop an algorithm to identify which individual infants will be developmentally impaired at ages 5-7. We also plan to determine the trajectories of DNA methylation and neurodevelopmental measures (attention, cognition, emotion, social, language, behavioral and motor development) over ages 4-7, determine how neurodevelopmental trajectories “track” the trajectory of DNA methylation and determine how these trajectories are modified by environmental exposures and genetic variation. Our cohort is of substantive import for the entire synthetic cohort effort of ECHO to address how pre-, peri-, and postnatal environmental exposures impact childhood development in a multitude of multi-level ways. The perspective proffered ECHO will help ECHO develop a unique model to better understand mechanisms of development, and use trajectory analysis to investigate sensitive periods and inflection points.

抽象的 超过三分之一的婴儿在月经后出生<30周的长期神经发育 缺陷。自闭症谱系障碍（ASD）的患病率高约5倍 婴儿比普通人群。这种环境对儿童健康成果的影响的目的 （ECHO）应用程序是利用我们正在进行的NIH（1R01HD072267-01A）纵向多站点的前瞻性 从出生到2岁的PMA出生的大约600名婴儿的研究，标题为“ Neonatal Neurobehavior 和非常早产的结果。”我们的长期目标是辨别哪些婴儿最有可能 为了受到开发的开发，一种个性化的医学方法可能导致干预措施 防止或减轻以后定义。我们在Echo中的总体目标是跟随这些儿童在7岁时和 确定导致这些儿童发展结果的潜在机制。为此， 这些孩子需要原位研究。我们的假设是环境暴露，行为，遗传 需要变异和表观遗传因素来了解所涉及的机制。我们计划确定 产前，围产期和产后环境暴露方式如何（例如，身体，人口统计学，母体 NICU出院时的心理学，医学，化学），DNA甲基化和婴儿神经行为将是 与儿童的关注，认知，情绪，社交，语言，行为和运动发展有关 在5、6和7岁以及ASD诊断。我们预计遗传变异会改变环境的影响 对这些儿童成果的暴露并计划开发算法，以确定哪些婴儿将是 在5-7岁时发育受损。我们还计划确定DNA甲基化的轨迹和 神经发育测量（注意，认知，情绪，社交，语言，行为和运动 开发）超过4-7岁，确定神经发育轨迹如何“轨迹” DNA的轨迹 甲基化并确定如何通过环境暴露和遗传来改变这些轨迹 变化。对于回声的整个合成队列工作，我们的队列具有实质性的进口 周期和产后环境暴露会以多层次的方式影响儿童的发展。 透视化的回声将有助于回声开发一个独特的模型，以更好地了解 开发并使用轨迹分析来研究敏感的时期和抑制点。

项目成果

Associations between maternal pre-pregnancy body mass index and neonatal neurobehavior in infants born before 30 weeks gestation.

• DOI: 10.1038/s41372-021-01308-y
• 发表时间: 2022-04
• 期刊: JOURNAL OF PERINATOLOGY
• 影响因子: 2.9
• 作者: Nosavan, Nina P.;Smith, Lynne M.;Dansereau, Lynne M.;Roberts, Mary B.;Hofheimer, Julie A.;Carter, Brian S.;Helderman, Jennifer B.;McGowan, Elisabeth C.;Neal, Charles R.;Pastyrnak, Steve;Della Grotta, Sheri A.;O'Shea, T. Michael;Lester, Barry M.
• 通讯作者: Lester, Barry M.