Developmental Impact of NICU Exposures (DINE) phase II

NICU 暴露 (DINE) 第二阶段的发育影响

基本信息

批准号：
10745062
负责人：
Judy Lynn Aschner
金额：
$ 128.18万
依托单位：
FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10745062
关键词：
Abate Address Adolescent Age Air Pollution Area Biological Specimen Banks Birth Bronchopulmonary Dysplasia Caring Chemical Exposure Child Child Development Child Health Child health care Childhood Asthma Clinical Clinical Research Consent Data Data Element Data Set Dedications Dermal Development Endocrine Disruptors Enrollment Environmental Exposure Exposure to Face Family Funding General Population Goals Health Health Care Costs High Prevalence Hospitalization Infant Infrastructure Inhalation Intravenous Investigation Life Life Cycle Stages Link Longterm Follow-up Lung Neonatal Intensive Care Units Outcome Participant Pediatric cohort Persons Phase Phenotype Population Pregnancy Pregnant Women Premature Birth Premature Infant Procedures Protocols documentation Research Risk Site Third Pregnancy Trimester United States Visit Work adverse outcome cohort early childhood early life exposure experience fetal infancy insight interest middle childhood novel participant enrollment participant retention pediatric health outcomes phthalates programs pulmonary function societal costs

项目摘要

Project Summary/Abstract The Environmental Influences on Child Health Outcomes (ECHO) program capitalizes on diverse pregnancy and pediatric cohorts to investigate the impact of a broad array of environmental influences on child health and development. Since 2016, the Developmental Impact of NICU Exposures (DINE) study has significant contribution of the to the ECHO mandate is a large, exquisitely phenotyped preterm birth cohort - a unique and sensitive population with a demonstrated large burden of adverse health outcomes. The DINE cohort readily combines rich existing clinical and research datasets and biospecimen repositories, existing infrastructure for long-term follow up and assessments of multiple ECHO exposure and outcome specialization areas, and a novel exposure and outcome profile that will continue high-yield contribution to ECHO program scientific goals. In this second phase of the ECHO program, we will continue to focus on the scientific premise that early life physical and chemical exposures, notably phthalates and air pollution, have long-lasting harmful effects on child health and development, and that these harmful effects are magnified in children born preterm. DINE contributes a unique and critically important population to ECHO in that preterm infants face significant dermal, inhalational and intravenous exposures to phthalates, ubiquitous organic endocrine disrupting chemicals, while hospitalized the neonatal intensive care unit (NICU). Premature infants experience a high prevalence of the adverse health effects that are associated with early life exposure to phthalates in term-born children, particularly abnormalities of pulmonary function. The contribution of environmental influences on adverse outcomes of preterm children is poorly understood. One additional central tenet of our work is that preterm infants can be studied to identify exposure-outcome links that may be more subtle in the general population. Large clinical studies like ECHO that enroll participants born over the entire preterm-to-term continuum allow rigorously study of this premise. Through the next phase of the ECHO program, we pursue the following Specific Aims in DINE: Aim 1. Leverage ECHO Cohort Protocol core data elements to compare exposure-outcome relationships in preterm compared to term populations. Aim 2. Leverage specialized data elements to address critical questions about the impact of early life chemical exposures on pulmonary development in a sensitive population, preterm infants. Aim 3. Implement procedures to maximize retention of existing participants with an emphasis on maintaining cohort diversity and protocol fidelity. Continued involvement of preterm infants in ECHO is critical not only to our cohort’s scientific imperatives, but also to the entire ECHO program as preterm infants constitute more than 10% of the United States population.

项目概要/摘要环境对儿童健康结果的影响 (ECHO) 计划利用了不同的怀孕和儿科队列研究广泛的环境影响对儿童健康和自 2016 年以来，NICU 暴露对发育的影响 (DINE) 研究具有重大意义。对 ECHO 任务的贡献是一个庞大的、表达精美的早产队列——一个独特且 DINE 队列很容易被证明具有巨大的不良健康结果负担。结合了丰富的现有临床和研究数据集以及生物样本存储库、现有基础设施对多个 ECHO 暴露和结果专业领域的长期随访和评估，以及一种新颖的曝光度和成果概况将继续为 ECHO 计划的科学目标做出高产贡献。在 ECHO 计划的第二阶段，我们将继续关注早期生命的科学前提物理和化学接触，尤其是邻苯二甲酸盐和空气污染，对儿童具有长期的有害影响健康和发育，并且这些有害影响在早产儿中会被放大。对于 ECHO 来说，这是一个独特且极其重要的人群，因为早产儿面临着严重的皮肤、吸入住院期间静脉注射邻苯二甲酸盐、普遍存在的有机内分泌干扰化学物质新生儿重症监护病房 (NICU) 的早产儿健康状况不佳的发生率很高。与足月出生的儿童生命早期接触邻苯二甲酸盐相关的影响，尤其是畸形环境影响对早产儿不良结局的影响是我们工作的另一项核心原则是可以通过研究早产儿来识别。暴露与结果的联系在一般人群中可能更加微妙，例如 ECHO 等大型临床研究。招募在整个早产到足月连续体中出生的参与者可以对这一前提进行严格的研究。通过 ECHO 计划的下一阶段，我们在 DINE 中追求以下具体目标：目标 1. 利用 ECHO 队列协议核心数据元素来比较暴露结果早产儿与足月人群的关系。目标 2. 利用专门的数据元素来解决有关早期影响的关键问题生活中化学物质暴露对敏感人群（早产儿）肺部发育的影响。目标 3. 实施程序以最大限度地保留现有参与者，重点是保持队列多样性和协议保真度。早产儿继续参与 ECHO 不仅对于我们队列的科学要求至关重要，而且由于早产儿占美国人口的 10% 以上，因此也影响到整个 ECHO 计划。