What a drop can do? Measurements using newborn dried blood spots in child health research.

Abstract

Collaborative efforts such as the Environmental influences of Child Health Outcomes (ECHO) program in the United States have provided a tremendous opportunity to address important questions on environmental determinants of growth and development in children. Nonetheless, a majority of pediatric cohorts recruit children and their families after birth, which would limit their access to maternal or neonatal biospecimens for evaluation of perinatal exposures. Newborn screening programs have revolutionized early diagnosis of childhood diseases worldwide by using dried blood spots (DBS) obtained shortly after birth. Residual DBS are commonly archived for a variable period of time and can be used to measure biomarkers of exposures to environmental factors. We share our experience from two pediatric cohorts in New York State (NYS), which used archived newborn DBS to measure an arrays of organic contaminants, immune markers, and other proteins. The Upstate KIDS cohort (recruitment: 2008-2010, NYS) and the Starting Early Program (StEP) randomized controlled trial (recruitment: 2012-2014, New York City) obtained consent from parents to access their newborns’ archived DBS for secondary analysis of chemicals and biomarkers for research purposes. Both studies reported good-to-excellent consent rates among those contacted, confirming the feasibility of this resource for population-based research. We reliably quantified concentrations of organic contaminants (i.e., organochlorine pesticides, polybrominated diphenyl ethers, and perfluoroalkyl substances), immune markers (i.e., cytokines and chemokines), and other proteins (brain-derived neurotrophic factor and adipokines) in archived DBS. We reported associations with indicators of growth and development in children. Findings regarding neonatal concentrations of perfluoroalkyl substances varied between cohorts despite identical methodology of measurement, partly explained by differences in levels of exposure and sociodemographic characteristic of participants.Archived DBS can be a valuable resource in population-based studies and in low resource settings to address important questions on the diversity of environmental exposure and their implications for child health.