Pregnancy Exposures to Chemical Mixtures and Later Metabolic Health and Endocrine Function Among Women in the Puerto Rico PROTECT Cohort

波多黎各 PROTECT 队列中女性怀孕期接触化学混合物以及后期代谢健康和内分泌功能

• 批准号: 10245293
• 负责人: Carrie Anne Karvonen-Gutierrez
• 金额: $ 39.77万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-21 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10245293
• 关键词: Aromatic Polycyclic Hydrocarbons; Biological Markers; Blood; Blood Glucose; Blood Pressure; Body Composition; Body Size; Breast Feeding; Chemicals; Child Development; Child Health; Cholesterol; Cohort Studies; Data; Data Collection; Data Set; Education; Endocrine; Endocrine disruption; Environmental Exposure; Environmental Impact; Estradiol; Estrogens; Exposure to; Fetal Growth; Follicle Stimulating Hormone; Gestational Diabetes; Glucose; Glycosylated hemoglobin A; Hand Strength; Health; Health Status; Health behavior; Hormonal; Hormones; Income; Individual; Influentials; Insulin; Knowledge; LDL Cholesterol Lipoproteins; Life; Life Experience; Lipids; Longterm Follow-up; Maternal Exposure; Maternal Health; Measures; Menopause; Mental Depression; Metabolic; Metabolic Marker; Metals; Modification; Morbidity - disease rate; Mothers; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Outcome Study; Parabens; Participant; Pattern; Phenols; Physical activity; Polycystic Ovary Syndrome; Population; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Puerto Rico; Questionnaires; Recording of previous events; Research; Risk Factors; Sampling; Sex Hormone-Binding Globulin; Social support; Socioeconomic Status; Stress; Testosterone; Time; Urine; Visit; Woman; Women Status; Women' s Health; Work; adverse pregnancy outcome; blood lipid; clinical Diagnosis; cohort; design; diabetes risk; environmental chemical; experience; exposed human population; follow up assessment; follow-up; health of the mother; health record; high risk; middle age; mullerian-inhibiting hormone; phthalates; pollutant; recruit; sample collection; social determinants; social factors; sociodemographics; urinary

A rapidly growing body of research shows that exposure to common environmental chemicals can disrupt endocrine and metabolic function, and negatively impact pregnancy outcomes and child development. Studies also demonstrate that certain pregnancy conditions (e.g., preeclampsia) and outcomes (e.g., preterm birth) are associated with adverse health later in the life of the mother. However, research is lacking on the relationships between exposures in pregnancy and later health of the mother, and how pregnancy outcomes impact those associations. Puerto Rico suffers from elevated rates of numerous morbidities compared to the mainland U.S., including preterm birth and Type II diabetes. Puerto Rico also has a history of extensive contamination with increased human exposure to a range of pollutants. We established the PROTECT cohort in the northern coast of Puerto Rico to study the impacts of exposure to an array of environmental chemicals during gestation and adverse pregnancy outcomes. We have developed an incredibly rich dataset on exposures, biomarkers of intermediate effects, questionnaires, and health record information. PROTECT is also a participating cohort within the newly established US-wide ECHO study, following the development of children born into PROTECT. We propose building upon this vast dataset and continued recruitment in PROTECT, along with the repeated participant contact during the ECHO follow-up visits, to investigate status and longitudinal trajectories of maternal metabolic health and endocrine function for up to five years following pregnancy among 1000 women in Puerto Rico. We have exposure biomarker data from repeated samples collected in pregnancy on urinary phthalate metabolites, phenols/parabens, and PAH metabolites, as well as 17 metals measured in both urine and blood. In this study, with new data and sample collection on PROTECT mothers at 6 months, 1 year, 2 years, and 5 years following delivery, we aim to: 1) Determine whether maternal exposures during pregnancy are associated with measures and trajectories of metabolic health (i.e., body size, body composition, physical strength, clinical diagnoses, blood pressure, and blood glucose, insulin, lipids, HbA1c) in short- and long-term follow-up assessments after delivery; 2) Investigate the relationships between maternal exposures during pregnancy and longitudinal measures of endocrine function (e.g., estradiol, testosterone, SHBG, FSH and AMH) in the follow-up assessments after delivery; and 3) Explore effect modification of the associations between pregnancy exposures and later women’s health from the first two aims by pregnancy complications (gestational diabetes, preeclampsia, preterm birth), and/or by social determinants (socioeconomic status, social support, depression, stress, life experiences, and others) and other physical determinants of health (body size, physical activity, breast feeding, polycystic ovarian syndrome, menstrual patterns, and others). The expected outcomes of this study are to provide new and much needed information on the impacts of pregnancy exposures, pregnancy outcomes, and social factors on women’s health.

快速增长的研究表明，暴露于常见环境化学物质会破坏 内分泌和代谢功能，并对妊娠结局和儿童发育产生负面影响。研究 还表明某些妊娠状况（例如，先兆子痫）和结果（例如早产）是 与母亲生命后期的不良健康有关。但是，缺乏关系的研究 在怀孕的暴露与母亲后来的健康之间，以及怀孕结果如何影响那些 协会。与美国大陆相比 包括早产和II型糖尿病。波多黎各也有广泛污染的历史 人类接触到各种污染物。我们在北海岸建立了保护队列 波多黎各研究在妊娠期间接触一系列环境化学物质的影响 不良怀孕结果。我们已经开发了一个关于暴露，生物标志物的非常丰富的数据集 中级效果，问卷和健康记录信息。保护也是参与的队列 在新成立的美国回声研究中，随着儿童的发展为保护。 我们建议在这个庞大的数据集上建立建立，并继续招募保护，并重复 回声随访期间的参与者接触，调查状态和纵向轨迹 1000名妇女怀孕后，孕产妇的代谢健康和内分泌功能长达五年 在波多黎各。我们从尿中收集的重复样品中有暴露的生物标志物数据 邻苯二甲酸酯代谢产物，苯酚/对羟基苯甲酸酯和PAH代谢产物，以及在两种尿液中测得的17个金属 和鲜血。在这项研究中，随着6个月，1年，2的新数据和样本收集2 分娩后的几年和5年，我们的目标是：1）确定怀孕期间的孕产妇暴露是否会发生 与代谢健康的测量和轨迹有关（即体型，身体成分，物理 短期和长期的强度，临床诊断，血压和血糖，胰岛素，脂质，HBA1C） 交付后的后续评估； 2）研究在 内分泌功能的怀孕和纵向测量（例如雌二醇，睾丸激素，SHBG，FSH和FSH和 AMH）在交付后的后续评估中； 3）探索关联的效果修改 在怀孕的前两个目标中，怀孕的疫苗暴露与后来的妇女健康 （妊娠糖尿病，先兆子痫，早产）和/或社会决定者（社会经济地位， 社会支持，抑郁，压力，生活经历以及其他人）和其他身体决定者 （体型，体育锻炼，母乳喂养，多囊卵巢综合征，月经模式等）。 这项研究的预期结果是提供有关有关影响的新的急需信息 怀孕暴露，怀孕结果和有关妇女健康的社会因素。