Disease due to environmental exposure to chemicals is a common and growing problem, particularly in low-income countries. Children are particularly vulnerable with exposure particularly in the prenatal period. This is due to their inability to control their environment and because the effects of early exposure to environmental toxicants can persist through to adulthood including congenital anomalies, cognitive and neurodevelopmental problems, endocrine disorders, allergic diseases and other non-communicable diseases. Mechanisms of disease are complex and heterogeneous including epigenetic changes with inheritance by descendants but there is much that is not yet understood. In Thailand, toxicants of concern include pesticides widely used in agricultural activity, air pollution with particulate matter (PM) 5 in urban area, volatile organic compounds from industry and heavy metal contamination from informal sectors. The burden, types and causes of disease related to environmental exposure in Thailand are not clear leading to paucity of evidence to guide paediatric environmental health policy for disease prevention.
A Thai maternal-child birth cohort study is being conducted to augment the knowledge on environmentally related diseases by helping to establish novel mechanisms and biomarkers linking environmental exposures in early life to disease development or exacerbation in early childhood that might further translate to help predict disease later life public health. It is designed to collect data from first trimester pregnant women and their children up to age 2 years. The aims are to 1) measure levels of biomarkers of concerning chemical exposure in utero and in infants in blood and urine; 2) find associations between environmental chemical exposures during pregnancy with the development of adverse outcomes among pregnant women such as abortion, preterm labour, hypertension, eclampsia, or diabetes; 3) find associations between in utero or early life (0-2 years old) environmental chemical exposures and the development and/or exacerbation of environmental related disease in infants (0-2 years. (Diseases comprise adverse perinatal outcome, growth or developmental disorder, behavioral abnormality, or allergic disease.); and 4) identify potential mechanisms of allergic disease caused by environmental chemical exposures identified under the primary objective in a relevant in vitro model system, by measurement of plasma IgE, cytokines, and plasma microRNA, plasma and urine metabolome, and mucosal swab microbiome.