Landrigan Philip J, Trasande Leonardo, Thorpe Lorna E, Gwynn Charon, Lioy Paul J, D'Alton Mary E, Lipkind Heather S, Swanson James, Wadhwa Pathik D, Clark Edward B, Rauh Virginia A, Perera Frederica P, Susser Ezra
Center for Children's Health and the Environment, Department of Community and Preventive Medicine, New York, New York, USA.
Pediatrics. 2006 Nov;118(5):2173-86. doi: 10.1542/peds.2006-0360.
Prospective, multiyear epidemiologic studies have proven to be highly effective in discovering preventable risk factors for chronic disease. Investigations such as the Framingham Heart Study have produced blueprints for disease prevention and saved millions of lives and billions of dollars. To discover preventable environmental risk factors for disease in children, the US Congress directed the National Institute of Child Health and Human Development, through the Children's Health Act of 2000, to conduct the National Children's Study. The National Children's Study is hypothesis-driven and will seek information on environmental risks and individual susceptibility factors for asthma, birth defects, dyslexia, attention-deficit/hyperactivity disorder, autism, schizophrenia, and obesity, as well as for adverse birth outcomes. It will be conducted in a nationally representative, prospective cohort of 100,000 US-born children. Children will be followed from conception to 21 years of age. Environmental exposures (chemical, physical, biological, and psychosocial) will be assessed repeatedly during pregnancy and throughout childhood in children's homes, schools, and communities. Chemical assays will be performed by the Centers for Disease Control and Prevention, and banks of biological and environmental samples will be established for future analyses. Genetic material will be collected on each mother and child and banked to permit study of gene-environment interactions. Recruitment is scheduled to begin in 2007 at 7 Vanguard Sites and will extend to 105 sites across the United States. The National Children's Study will generate multiple satellite studies that explore methodologic issues, etiologic questions, and potential interventions. It will provide training for the next generation of researchers and practitioners in environmental pediatrics and will link to planned and ongoing prospective birth cohort studies in other nations. Data from the National Children's Study will guide development of a comprehensive blueprint for disease prevention in children.
前瞻性的多年流行病学研究已被证明在发现慢性病的可预防风险因素方面非常有效。诸如弗雷明汉心脏研究等调查为疾病预防制定了蓝图，挽救了数百万人的生命，节省了数十亿美元。为了发现儿童疾病的可预防环境风险因素，美国国会通过2000年的《儿童健康法案》指示国家儿童健康与人类发展研究所开展全国儿童研究。全国儿童研究以假设为驱动，将寻求有关哮喘、出生缺陷、诵读困难、注意力缺陷多动障碍、自闭症、精神分裂症和肥胖症以及不良出生结局的环境风险和个体易感性因素的信息。该研究将在美国出生的10万名具有全国代表性的前瞻性队列儿童中进行。儿童将从受孕开始跟踪至21岁。在孕期以及儿童的家庭、学校和社区中，将在整个童年期间反复评估环境暴露（化学、物理、生物和心理社会方面）。化学分析将由疾病控制与预防中心进行，并将建立生物和环境样本库以供未来分析。将收集每位母亲和儿童的遗传物质并储存起来，以便研究基因与环境的相互作用。招募工作计划于2007年在7个先锋站点开始，并将扩展至美国各地的105个站点。全国儿童研究将产生多项卫星研究，以探索方法学问题、病因问题和潜在干预措施。它将为下一代环境儿科学研究人员和从业人员提供培训，并将与其他国家计划中的和正在进行的前瞻性出生队列研究建立联系。全国儿童研究的数据将指导制定儿童疾病预防的全面蓝图。
