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October 23, 2017

The Value of Preterm Infant Environmental Health CohortsThe Canary in the Coal Mine

Author Affiliations
  • 1Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
  • 3Department of Pediatrics, Albert Einstein College of Medicine and the Children’s Hospital at Montefiore, Bronx, New York
JAMA Pediatr. Published online October 23, 2017. doi:10.1001/jamapediatrics.2017.3230

It has long been recognized that early-life environmental exposures can alter developmental trajectories in critical and often unexpected ways that may produce clinically important outcomes years to decades later. Starting with Barker’s work in the 1960s,1 research on the developmental origins of disease has relied on exposure assessment of pregnant women and longitudinal follow-up of their offspring. Third-trimester fetal life, a critical period for neurobehavioral and pulmonary development as well as for metabolic programming, is now known to be particularly sensitive to environmental perturbations. Numerous prospective birth cohorts, often drawn from communities with high pollutant burden, have used maternal biomarkers as estimates of fetal exposure to explore the influence of chemical and social exposures during late pregnancy on long-term child health outcomes. Traditional birth cohorts explicitly exclude or minimally represent preterm children to reduce potential confounding by morbidities of prematurity.

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