Chemical Exposures and Infant Outcomes in the Neonatal Intensive Care Unit

新生儿重症监护病房的化学品暴露和婴儿结局

基本信息

批准号：
8851591
负责人：
Annemarie Stroustrup
金额：
$ 14.62万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-03 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8851591
关键词：
Admission activity Affect Area Behavior Disorders Biological Markers Birth Blood Blood specimen Body Size Cadmium Caring Cataloging Catalogs Chemical Exposure Chemicals Child Child health care Childhood Clinical Databases Development Development Plans Enrollment Environment Environmental Health Evaluation Exposure to Fetus Foundations Future Growth Health Healthcare Heavy Metals Hepatic Hospitalization Hospitals Human Human Development Impairment Infant Investigation K-Series Research Career Programs Knowledge Laboratory Study Learning Longitudinal Studies Manganese Measurable Measurement Medical Mentorship Metals Methods Neonatal Neonatal Intensive Care Units Neonatology Neurologic Neurotoxins Newborn Infant Outcome Parabens Patients Phenols Pilot Projects Poison Population Recording of previous events Renal clearance function Renal function Research Research Personnel Research Project Grants Risk Risk Factors Running Sampling Source Study Subject Testing Third Pregnancy Trimester Toxic Environmental Substances Toxic effect Toxicology Training Triclosan United States Urine Very Low Birth Weight Infant Work adverse outcome base biobank career career development cohort cost effective design experience forging high risk human data in utero infancy infant outcome instrument liver function medical supply modifiable risk neonate neurobehavioral neurobehavioral test novel pediatrician phthalates premature prenatal prospective public health relevance remediation reproductive reproductive development skills social tool urinary

项目摘要

DESCRIPTION (provided by applicant): The candidate is a pediatrician and neonatologist embarking on a research career focused on the study and remediation of modifiable risk factors for adverse outcome following high-risk birth, particularly the environmental determinants of abnormal neurodevelopmental outcomes. This career development award will enable her through formal coursework and expert mentorship by Drs. Philip Landrigan, Shanna Swan, and William Fifer, to develop the knowledge and skills necessary to become an independent investigator studying the impact of hospital-based chemical exposure on infant neurobehavioral development. Many industrial chemicals are known neurotoxicants in laboratory studies, but investigations of prenatal and infant exposure to these chemicals are limited, despite the fact that the developing fetus and infant are particularly susceptible to environmental insults. With this career development award, the candidate will: 1) obtain training in the methods of exposure assessment and biomarker measurements of exposure to environmental toxicants; 2) obtain training in the use of infant neurobehavioral testing methods; and 3) apply the lessons learned to a research project examining biomarkers of exposure to phthalates, phenols, cadmium, and manganese and infant medical and neurobehavioral development. The training received through this career development award will enable the candidate to forge an academic trajectory in what is an under-examined area of study within the fields of neonatology and child health, with potential applications that extend to numerous aspects of pediatric healthcare. The proposed study will be the first comprehensive, longitudinal evaluation of chemical exposure in the neonatal intensive care unit (NICU) designed to evaluate clinical outcomes in this vulnerable, highly exposed population. The Research Strategy proposed is an outgrowth of the Hospital-Based Phthalate Exposure in Very Low Birth Weight Infants (HBPE) study, an ongoing, NICU-based pilot study of very low birth weight infants at the Mount Sinai Hospital. The candidate proposes to capitalize on her experience running the HBPE study and on the existing HBPE study biospecimen and data repositories to (1) identify prevalent and relevant NICU chemical exposures; (2) formalize and validate an exposure checklist to categorize patients by specific NICU exposures; and (3) conduct a comprehensive study of NICU chemical exposure and infant somatic and neurodevelopmental outcomes. The candidate plans to use the results of this study and the patient cohort amassed in Aim 3 as the basis for a future longitudinal study of childhood somatic, reproductive, and neurobehavioral outcomes in relation to hospital- based chemical exposures encountered in infancy.

描述（由申请人提供）：候选人是一名儿科医生和新生儿学家，从事研究职业，专注于研究和修复高风险出生后不良后果的可修改风险因素，尤其是神经发育异常的环境决定因素。该职业发展奖将使她通过DRS的正式课程和专家指导。菲利普·兰德里根（Philip Landrigan），夏娜·斯旺（Shanna Swan）和威廉·菲尔德（William Fifer），旨在发展成为研究基于医院化学的化学暴露对婴儿神经行为发展的影响所必需的知识和技能。在实验室研究中，许多工业化学物质是已知的神经毒性，但是对这些化学物质的产前和婴儿暴露的研究仍有限，尽管事实上胎儿和婴儿特别容易受到环境损害的影响。通过这项职业发展奖，候选人将：1）在暴露评估和生物标志物测量环境有毒物质的测量方法中获得培训； 2）获得使用婴儿神经行为测试方法的培训； 3）将所学的经验教训应用于研究项目，研究了暴露于邻苯二甲酸盐，苯酚，镉以及锰以及婴儿医学和神经行为发展的生物标志物。通过此职业发展奖获得的培训将使候选人能够在新生儿和儿童健康领域的一个研究领域中建立学术轨迹，并具有潜在的应用，这些应用扩展到了儿科医疗保健的许多方面。拟议的研究将是对新生儿重症监护病房（NICU）中化学暴露的首次全面，纵向评估，旨在评估这个脆弱的，高度暴露的人群中的临床结果。提出的研究策略是在非常低的出生体重婴儿（HBPE）研究中，基于医院的邻苯二甲酸酯暴露的生长，这是一项基于NICU的基于NICU的试点研究，对西奈山医院的出生体重婴儿非常低。候选人提议利用她运行HBPE研究的经验以及现有的HBPE研究生物测试和数据存储库，以（1）确定普遍且相关的NICU化学暴露；（2）正式和验证暴露清单，以通过特定的NICU暴露对患者进行分类；（3）对NICU化学暴露以及婴儿体细胞和神经发育结果进行全面研究。候选人计划使用本研究的结果，而患者队列在AIM 3中积聚为对儿童期躯体，生殖和神经行为结局的未来纵向研究的基础，这些结局与婴儿期遇到的基于医院的化学暴露有关。