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    1. Maternal-Infant Research on Environmental Chemicals: Maria del Pilar Vlez, M.D., M.Sc. PhD (c) Universit de Montral

    3. Participating Hospitals

    4. Objectives To obtain national-level data on maternal and neonatal exposure to priority environmental contaminants (Pb, Hg, Cd, As, Mn, phthalates, bisphenol A, OP pesticides, perfluorinated compounds, brominated flame retardants, other POPs, cotinine) To obtain Canadian data on smoking behaviour and exposure to tobacco smoke (active and passive) in pregnancy To determine if heavy metal exposure is related to elevated maternal blood pressure, hypertension, altered sex ratio and fetal growth restriction

    5. Objectives To obtain contemporary levels of priority environmental chemicals, selected nutrients and relevant immunoprotective endpoints in mature human milk To obtain contemporary levels of maternal hair-mercury To characterize dietary exposure of breastfed infants ages 2-8 weeks to allow for time-trend analyses for those analytes which were included in previous human milk surveys

    6. Study Design A National-level pregnancy cohort study,10 Clinical sites across Canada 2,000 pregnant women recruited during 1st trimester Contacts during each trimester of pregnancy, delivery, and postpartum

    8. Sources of Exposure

    9. Sources of Exposure

    11. Nutritional Data Collected First Trimester Supplements (product names) Prenatal vitamins Folic acid supplements Other supplements Beverages (milk, water, juice, tea, coffee, alcohol) Species of fish Second Trimester (take home questionnaire) Within past 24 hours Name of product, amount taken, frequency During last 30 days Name of product, amount taken, frequency

    12. Nutritional Data Collected

    13. Other Data Collected 1st and 3rd Trimesters Smoking (active and passive) Socio-demographics Obstetrical history Employment Environmental exposures (work, home) Physical activity Sunlight exposure Anthropometry Blood pressure Pregnancy outcomes

    17. Progress to Date Recruitment began in Montreal (February, 2008), and now recruiting in Hamilton, Halifax, Toronto, Vancouver, Ottawa, Sudbury, Kingston, and other cities as ethics approval received

    18. Communication Strategy Public Awareness - Websites www.hc-sc.gc.ca/ewh-semt/contaminants/mirec/index_e.html www.chemicalsubstanceschimiques.gc.ca/bio_e.html www.mirec-canada.ca - Media Government: Ministerial correspondence

    19. Communication Strategy Participant Results: Only results communicated to participants are: Those where results exceed health-based guidelines AND are scientifically proven to be significant for the health of the participant and there are preventive measures or treatments available Through physician Physicians Guidance Documents for Pb, Hg, Cd

    20. Additional and Future Research Biobank of maternal and infant biospecimens (blood, urine, meconium, cord blood, maternal hair, breast milk) At the conclusion of the study, there will be roughly 190,000 aliquots in the MIREC biobank. The MIREC biobank is housed at the Ste-Justine Hospital and is governed by a biobank management committee, which is comprised of some of the MIREC study investigators and co-investigators. Long-term storage of these valuable samples in the biobank will be used for future research on environmental chemicals and maternal and infant health.

    21. Additional and Future Research The Validation study will get underway in the next month and will target 100 MIREC participants. The goal of the study is to test the validity and repeatability of the MIREC food frequency questionnaire using the gold standard 24 hour dietary recall. This will ensure that data generated in the MIREC study is of the highest quality.

    22. Additional and Future Research MIREC-ID: Effects on Infant Development New funding from Health Canadas Chemicals Management Plan Research Fund to follow subset of infants to 6 months of age to study emerging chemicals and: Growth Sexual development Sensory development Co-PIs: Gina Muckle, Tye Arbuckle, William Fraser, Bruce Lanphear, Jean Seguin

    23. MIREC-ID

    24. MIREC-ID

    25. MIREC-ID

    26. MIREC-ID Maternal Information

    27. Looking for Opportunities to increase sample size, longer follow-up, and additional research questions (providing limited impact on participant burden)

    28. Acknowledgments Participants Principal investigators Co-investigators Site nurses and research assistants Study Coordinating Centre

    29. Thank you!