Each year in the United States, over 300,000 newborns require admission to a neonatal intensive care unit (NICU) where they are exposed to the chemical-intensive and stressful hospital environment. Infants born preterm spend a particularly vulnerable developmental period corresponding to the “third trimester” in the NICU. It is well known that chemical and non-chemical exposures at this point in development can permanently alter neurobehavioral outcomes in healthy fetuses. Studies of pregnant women have demonstrated the measurable impact of in utero exposure to chemicals (elemental metals, organic and inorganic endocrine disrupting chemicals, air pollution) and maternal stress on the developing fetus. Infants born preterm are exposed to these same potential toxicants directly, without the benefit of the protective buffer of the womb or the nurturing home environment.
We know that NICU graduates experience neurodevelopmental abnormalities at higher rates than children born full term. Neurobehavioral disorders among NICU grads are incompletely predicted by degree of prematurity or neonatal illness. The neurobehavioral disorders that are prevalent among NICU grads are the same disorders seen following high level in utero chemical and/or stress exposure. There are no comprehensive studies focusing on children’s environmental health in the hospital setting. Specific source(s) of exposure in the NICU need to be identified and whenever possible exposures should be mitigated.
Our group studies chemical and non-chemical exposures during the NICU hospitalization, and evaluates their impact on neurobehavioral outcomes of children born preterm. Following a successful “first-of-its-kind” pilot study measuring chemical exposures and infant outcomes, we are embarking on the first ever comprehensive epidemiologic study of the environmental health impact of the NICU hospitalization on moderately preterm infants. In only a small number of study subjects, our pilot study demonstrated measurable effects of NICU-based chemical exposure on infant neurobehavior. The NICU-HEALTH (Hospital Exposures and Long-Term Health) study builds on this work to evaluate the impact of hospital-based chemical and social exposures on neurobehavioral, cognitive, and physical development through childhood.
Stroustrup A, Hsu HH, Svensson K, Schnaas L, Cantoral A, Solano González M, Torres-Calapiz M, Amarasiriwardena C, Bellinger DC, Coull BA, Téllez-Rojo MM, Wright RO, Wright RJ. Toddler temperament and prenatal exposure to lead and maternal depression. Environ Health 2016 Jun 16;15(1):71. PMID: 27312840