Developmental Impact of NICU Exposures (DINE)

NICU 暴露 (DINE) 对发育的影响

基本信息

批准号：
9263350
负责人：
Judy Lynn Aschner
金额：
$ 166.63万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE, INC
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：
2016-09-21 至 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9263350
关键词：
Age Animal Model Behavioral Biological Markers Blood Banks Caring Chemical Exposure Chemicals Child Childhood Clinical Cognitive Cognitive deficits Cohort Studies Data Data Set Databases Development Disease Environment Environmental Exposure Environmental Health Environmental Pollution Equipment Equipment and Supplies Erythropoietin Evaluation Exposure to Funding Opportunities General Population Growth Hair Health Hospitals Individual Infant Infant Care Infant Health Lead Life Lung Manganese Measurement Measures Medical Metals Methodology Methods Motor Multicenter Studies Neonatal Intensive Care Units Neurodevelopmental Impairment Nutritional Obesity Outcome Participant Performance Perinatal Exposure Pharmaceutical Preparations Pharmacologic Substance Phase Phenotype Population Population Heterogeneity Pregnancy Premature Infant Psychological Stress Research Research Infrastructure Respiratory physiology Risk Route Saliva Severity of illness Site Source Staging Stress Techniques Testing Third Pregnancy Trimester Time Tooth structure Trace metal United States Urine Variant Work base behavioral outcome biobank clinically relevant cohort deciduous tooth early childhood early life exposure ethnic diversity experience fetal flexibility infant animal motor deficit neurobehavior neurobehavioral neurodevelopment neuroprotection neurotoxic nutrition phthalates premature programs pulmonary function reproductive resilience respiratory response surfactant urinary

项目摘要

Project Summary. Each year in the United States, over 300,000 preterm infants are admitted to neonatal intensive care units (NICUs) where they are exposed to a chemical-intensive hospital environment. Many life- saving and supportive respiratory, nutritional, hematologic and pharmaceutical therapies in the NICU expose preterm infants to potentially harmful chemicals during a life stage analogous to the third trimester of gestation. Studies in term-born infants and animal models demonstrate that third trimester in utero exposure to phthalates –ubiquitous chemicals used to make plastics flexible - is associated with maladaptive neurodevelopmental, pulmonary, reproductive, and growth phenotypes. Lead (Pb) and manganese (Mn) -- an essential trace metal administered in NICU nutrition -- can be neurotoxic in excess resulting in both cognitive and motor deficits. Non-chemical exposures including psychological stress, common in the NICU environment, are also associated with abnormal neurodevelopment. Multiple environmental exposures during the sensitive developmental period when preterm infants are in the NICU may contribute to their increased risk of adverse health and behavioral outcomes later in life. Neither the individual contribution of NICU-based phthalate, Mn, Pb or stress exposure, nor the impact of concurrent and subsequent exposures on preterm infant health, risk, resilience, or disease trajectories have been explored previously. Our research capitalizes on the infrastructure, biorepositories, and extensive clinical databases of four existing preterm cohorts to explore the scientific premise that early life exposure to phthalates, metals, and stress adversely impacts neurodevelopment, lung function, growth and adiposity, and pubertal development in childhood. As part of the ECHO Pediatric Cohorts program, we will pursue the following three specific aims: Aim 1. Identify specific sources of NICU-based phthalate exposure in a large, geographically diverse population of preterm infants. Aim 1 (UG3) will use existing NICU datasets and biorepositories to determine specific routes and sources of phthalate exposure. Aim 2. Measure the impact of NICU-based phthalate exposure on multisystem health outcomes at ages 3-10. Aim 2 (UG3/UH3) examines associations among urine biomarkers of NICU phthalate exposure and childhood measures of pulmonary function, cognitive, motor, and behavioral performance, growth and pubertal development. Aim 3. Determine the impact of and interactions among early childhood phthalate, manganese, lead and stress exposures on neurodevelopmental outcomes in preterm and term children. Aim 3 (UH3) uses tooth, hair and saliva biomarkers of exposures to investigate neurobehavioral development in children born preterm and at term. Our unique cohort offers a window for direct measurement of exposures in the “third trimester” phase of rapid development in a sensitive population. This study will facilitate exposure abatement in the NICU and provide information relevant to fetal and early childhood development.

项目摘要在美国，每年有超过 300,000 名早产儿被收治为新生儿。重症监护病房 (NICU) 暴露在化学密集的医院环境中。新生儿重症监护病房 (NICU) 中的保存和支持性呼吸、营养、血液和药物治疗早产儿在类似于妊娠晚期的生命阶段接触潜在有害的化学物质。对足月出生的婴儿和动物模型的研究表明，在子宫内的妊娠晚期接触邻苯二甲酸盐 – 用于使塑料变得柔韧的普遍化学物质 – 与适应不良的神经发育有关，铅 (Pb) 和锰 (Mn)——一种必需的微量金属。在新生儿重症监护病房（NICU）营养中施用的营养——过量可能会产生神经毒性，导致认知和运动缺陷。 NICU 环境中常见的非化学物质暴露（包括心理压力）也与敏感时期的多种环境暴露有关。早产儿在新生儿重症监护病房（NICU）的发育期可能会增加其不良反应的风险新生儿重症监护病房 (NICU) 中的邻苯二甲酸盐、锰、以及个人对以后生活的健康和行为结果都没有影响。铅或压力暴露，以及同时和随后的暴露对早产儿健康、风险、恢复力或疾病轨迹之前已被探索过。我们的研究利用了四个现有的基础设施、生物样本库和广泛的临床数据库早产儿队列探索生命早期接触邻苯二甲酸盐、金属和压力的科学前提对神经发育、肺功能、生长和肥胖以及青春期发育产生不利影响作为 ECHO 儿科队列计划的一部分，我们将追求以下三个具体目标：目标 1. 确定位于不同地理区域的新生儿重症监护病房 (NICU) 邻苯二甲酸盐暴露的具体来源目标 1 (UG3) 将使用现有的 NICU 数据集和生物库来确定早产儿人群。邻苯二甲酸盐暴露的具体途径和来源目标 2. 衡量新生儿重症监护室邻苯二甲酸盐的影响。目标 2 (UG3/UH3) 检查 3-10 岁多系统健康结果之间的关联。 NICU 邻苯二甲酸盐暴露的尿液生物标志物和儿童肺功能、认知、运动、目标 3. 确定和的影响。幼儿期邻苯二甲酸盐、锰、铅和压力暴露之间的相互作用目标 3 (UH3) 使用牙齿、头发和唾液来评估早产儿和足月儿的神经发育结果。暴露的生物标志物，用于研究早产儿和足月儿的神经行为发育。我们独特的队列提供了一个窗口，可以直接测量快速妊娠的“妊娠晚期”阶段的暴露情况这项研究将有助于减少 NICU 中的暴露并提供帮助。与胎儿和儿童早期发育相关的信息。