TY - JOUR
T1 - CoNaMad-Cohorte de Nacimiento de Madre de Dios/madre de dios birth cohort to study effects of in-utero trace metals exposure in the southern peruvian amazon
AU - Pan, William K.
AU - Weinhouse, Caren
AU - Ortiz, Ernesto J.
AU - Berky, Axel J.
AU - Fixsen, Emma
AU - Mallipudi, Andres
AU - Feingold, Beth J.
AU - Navio, Suzy
AU - Rivera, Nelson A.
AU - Hsu-Kim, Heileen
AU - Miranda, J. Jaime
N1 - Funding Information:
Funding: NIEHS (1R21ES026960), Fogarty International Center (1K01TW011478) Doris Duke Clinical International Research Fellowship, Duke Center for Latin American and Caribbean Studies (CLACS), NIEHS Superfund Research Program (P42ES010356) and the Josiah Charles Trent Memorial Foundation Endowment Fund (Grant #17-23). CW was supported by a Duke Global Health Postdoctoral Fellowship at the time of the study. We thank Josh Grubbs for assistance with processing samples for trace metals analysis, all the mothers and their families who participated in this study, the Instituto de Investigaciones de la Amazonia Peruana (IIAP) and CINCIA for providing office and laboratory space, and support from the Madre de Dios Regional Health Directorate
Funding Information:
NIEHS (1R21ES026960), Fogarty International Center (1K01TW011478) Doris Duke Clinical International Research Fellowship, Duke Center for Latin American and Caribbean Studies (CLACS), NIEHS Superfund Research Program (P42ES010356) and the Josiah Charles Trent Memorial Foundation Endowment Fund (Grant #17-23). CW was supported by a Duke Global Health Postdoctoral Fellowship at the time of the study. We thank Josh Grubbs for assistance with processing samples for trace metals analysis, all the mothers and their families who participated in this study, the Instituto de Investigaciones de la Amazonia Peruana (IIAP) and CINCIA for providing office and laboratory space, and support from the Madre de Dios Regional Health Directorate.
Funding Information:
In November 2016, we initiated a birth cohort to enable assessment of peri-conceptional, late gestation and early life stages as potential critical windows of developmental exposure to MeHg. The study is in Madre de Dios, Peru, a southwestern region of the Amazon (Figure 1). The population of Madre de Dios has high exposure incidence to dietary mercury due to ASGM-related mercury pollution and consumption of high trophic level fish [23–25]. In addition, there is high prevalence of malnutrition among women of child-bearing age compared to other regions where developmental MeHg exposure effects were studied, such as in the Seychelles [26, 27] and Faroe Islands [28]. The study is named CONAMAD, or Cohorte de Nacimiento de Madre de Dios (Birth Cohort of Madre de Dios), which roughly translates as “with mothers” in Spanish. NIEHS (1R21ES026960) provided the primary funding for the design and data collection for this study. Funding for data collection was also provided by the Doris Duke Clinical International Research Fellowship and the Duke Center for Latin American and Caribbean Studies. Additional funding for data processing was provided by the NIEHS Superfund Research Program (P42ES010356) and the Josiah Charles Trent Memorial Foundation Endowment Fund (Grant #17-23). The 36–48-month follow-up is funded by the State University of New York-Albany. The study was motivated by the 2016 El Niño event for which we hypothesized that large-scale flooding from El Niño would increase mercury methylation and bioaccumulation, resulting in higher dietary mercury exposure. We specified three hypotheses:
Publisher Copyright:
© 2021 The Author(s).
PY - 2021
Y1 - 2021
N2 - Background: In-utero exposure to mercury and other trace metals pose a significant threat to child health and development, but exposures and health impacts in artisanal and small-scale gold mining (ASGM) environments are poorly defined. Objectives: We describe the CONAMAD study design, a prospective birth cohort consisting of multiparous women (18 and over) living in rural and peri-urban Peruvian Amazon communities exposed to ASGM. Methods: Pregnant women are enrolled from health posts across four zones of Madre de Dios, Peru. Data are collected at enrollment, childbirth, and (planned) 36-48 months. At enrollment, hair samples for mercury assessment, demographic and clinical data are obtained. At birth, we obtain venous and cord blood, placenta, hair, toenails, and saliva. Findings: Two hundred seventy mothers were enrolled at an average 20 weeks gestational age with no differences in maternal characteristics across zones. Two hundred fifteen mothers were successfully followed at birth. We obtained 214 maternal and cord blood samples, 211 maternal and 212 infant hair samples, 212 placenta samples, 210 infant saliva samples, and 214 infant dried blood spots. Data collected will allow for testing our primary hypotheses of maternal malnutrition modifying ratios of cord: maternal blood total mercury (tHg), cord blood: maternal hair tHg, and infant: maternal hair tHg, and whether chemical mixtures (Hg, Pb, Cd) have synergistic effects on infant neurodevelopment. Conclusions: CONAMAD is designed to collect and store samples for future processing and hypothesis testing associated with in-utero mercury exposure and child development. We have completed the exposure assessments and will conduct a follow-up of mothers to evaluate early child development outcomes, including developmental delay and growth. These data offer insights into disease mechanisms, exposure prevention, and policy guidance for countries where ASGM is prevalent.
AB - Background: In-utero exposure to mercury and other trace metals pose a significant threat to child health and development, but exposures and health impacts in artisanal and small-scale gold mining (ASGM) environments are poorly defined. Objectives: We describe the CONAMAD study design, a prospective birth cohort consisting of multiparous women (18 and over) living in rural and peri-urban Peruvian Amazon communities exposed to ASGM. Methods: Pregnant women are enrolled from health posts across four zones of Madre de Dios, Peru. Data are collected at enrollment, childbirth, and (planned) 36-48 months. At enrollment, hair samples for mercury assessment, demographic and clinical data are obtained. At birth, we obtain venous and cord blood, placenta, hair, toenails, and saliva. Findings: Two hundred seventy mothers were enrolled at an average 20 weeks gestational age with no differences in maternal characteristics across zones. Two hundred fifteen mothers were successfully followed at birth. We obtained 214 maternal and cord blood samples, 211 maternal and 212 infant hair samples, 212 placenta samples, 210 infant saliva samples, and 214 infant dried blood spots. Data collected will allow for testing our primary hypotheses of maternal malnutrition modifying ratios of cord: maternal blood total mercury (tHg), cord blood: maternal hair tHg, and infant: maternal hair tHg, and whether chemical mixtures (Hg, Pb, Cd) have synergistic effects on infant neurodevelopment. Conclusions: CONAMAD is designed to collect and store samples for future processing and hypothesis testing associated with in-utero mercury exposure and child development. We have completed the exposure assessments and will conduct a follow-up of mothers to evaluate early child development outcomes, including developmental delay and growth. These data offer insights into disease mechanisms, exposure prevention, and policy guidance for countries where ASGM is prevalent.
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U2 - 10.5334/aogh.3152
DO - 10.5334/aogh.3152
M3 - Article
C2 - 34327116
AN - SCOPUS:85111410022
SN - 0027-2507
VL - 87
JO - Mount Sinai Journal of Medicine
JF - Mount Sinai Journal of Medicine
IS - 1
M1 - 69
ER -