Columbia University researchers, in collaboration with colleagues at the Norwegian Institute of Public Health, have received a five-year, $13 million grant from the U.S. National Institutes of Health to fund one of the largest studies of neurodevelopmental disorders by tracking babies before they are born. The study, initially focused on autism, will follow up to 100,000 pregnancies from the first trimester through childhood and perhaps adulthood via access to a birth registry in Norway.
The project, led by Dr. W. Ian Lipkin, the Jerome L. and Dawn Greene Professor of Epidemiology at the Mailman School of Public Health and professor of neurology and pathology at P&S, will involve researchers at Mailman, P&S, and the Columbia Genome Center.
The investigators have nicknamed the effort the "baby Framingham" project, since its design is somewhat similar to the well-known epidemiological study in Framingham, Mass., which started tracking adults in 1948, eventually enabling researchers to identify cardiovascular and other disease risk factors.
"We are using the latest informatics and high-throughput technologies from genetics, microbiology, toxicology, functional genomics, and proteomics to examine the seeds of disease from gestation across a person's lifespan. This approach should reveal clues to chronic diseases," says Dr. Lipkin, who is also director of the Greene Infectious Disease Laboratory at Mailman. Early, generous support from Dr. Judith P. Sulzberger was critical to the project's launch. Dr. Lipkin plans to seek additional funding to extend the study beyond its initial five years.
"This interdisciplinary study is a great opportunity for Columbia and the Norwegian Institute of Public Health to rigorously examine the roots of autism and other neurodevelopmental disorders with the goal of improving global health," says Dr. Gerald D. Fischbach, executive vice president and dean.
The study will look at the influences of genes and environmental interactions through analysis of maternal and infant blood samples, questionnaires, and intensive clinical assessments. The researchers designed the study based on their previous studies that suggest environmental factors such as infections or exposure to toxins help trigger some forms of autism and other chronic diseases. They plan to look at pre- and postnatal infection, very low birth weight or other obstetric risk factors in which infections are implicated, dietary and environmental exposure to methyl mercury during pregnancy and postnatal life, and mumps-measles-rubella vaccinations.
"We need a prospective study like this to evaluate whether environmental influences interact with host response genes at critical developmental junctures to cause autism," says Dr. Mady Hornig, associate professor of epidemiology and director of translational research in the Greene lab.
Approximately 20,000 women and their babies are enrolled in the study and the researchers expect to sign up another 30,000 pregnant women each year in the next few years to reach a final enrollment of 100,000.
The collaboration with researchers in Norway evolved from discussions two years ago between two co-principal investigators in the study, Dr. Ezra Susser, professor and chairman of epidemiology (Mailman) and professor of psychiatry (P&S), and Dr. Camilla Stoltenberg, now director of the division of epidemiology at the Norwegian Institute of Public Health. Norway has one of the largest birth registries, which contains information on all births in Norway since 1967.
"This is one of the only prenatal studies of this scope to follow babies over time. There's nothing even close to it in autism research," says Dr. Susser, an expert in the epidemiology of brain disorders who has studied prenatal exposures and the risk of developing schizophrenia in adulthood.
The research team also includes Dr. Thomas Briese, associate professor of epidemiology; Dr. Pam Factor-Litvak, associate professor of clinical public health (epidemiology); Dr. Conrad Gilliam, Borne Professor of Genetics and Development, professor of psychiatry, and director of the Genome Center; Dr. Philip LaRussa, professor of clinical pediatrics; and Dr. Bruce Levin, professor and chairman of biostatistics.
"Defining the natural course of these disorders and discovering biomarkers for early detection will enable development of strategies to prevent and reduce the burden of disease for victims and their families," Dr. Lipkin says.