Tracking a New Generation

by Claudia Kalb

American kids are about to get some much-needed attention. Next month, after 10 years of strategizing, researchers will finally start recruiting participants for the largest long-term study of children’s health ever conducted in this country. The National Children’s Study, led by the National Institute of Child Health and Human Development, plans to track 100,000 kids from the womb (a mother’s health during pregnancy will provide early clues) to the age of 21, hunting down answers to critical questions about how the complex interplay of genes and environment affects kids: Do pesticides increase the risk of learning disabilities? Can an early infection lead to juvenile diabetes?

The last major long-term children’s study took place between 1959 and 1974. Research conducted since has provided plenty of clues and hypotheses about how and why kids get sick. But many of the studies have focused on a single association–a poor diet leads to obesity–and not all have been large enough to provide firm answers. The prevalence of disorders like asthma, autism and diabetes, meanwhile, have increased. Scientists say the new study will help them pinpoint what goes wrong so they can create a blueprint for prevention.

First, they need volunteers. Staffers will knock on doors in seven locations around the country in 2009 (98 additional sites are slated to join over the next several years), looking for women who are pregnant or may become pregnant over the course of the study’s four-year enrollment period. The sample will be socioeconomically, ethnically and geographically diverse. Duplin County, N.C., much of it farm country, will be combed for participants. And so will Queens, N.Y., where posters in 10 different languages, including Mandarin, Russian and Urdu, are already educating residents about the study in community centers and doctors’ offices. Dr. Philip Landrigan, of Mount Sinai Medical Center and principal investigator for the Queens site, says his team will appeal to people’s altruism and patriotism. “Here’s a chance for you to do something for your country,” says Landrigan, “not just your own children.”

Women who say yes will have to answer questions about their own health, what they eat, the medicines they take. Their weight and blood pressure will be measured. They’ll hand over specimens of blood, urine and hair. Even their saliva will be tested for stress hormones. At the baby’s birth, umbilical cord blood and a piece of placenta will be collected. And from that day forward until the child’s 21st birthday, researchers will gather medical information through questionnaires and in-home visits: Did the baby receive her vaccines? Has she been diagnosed with anything? Autism? Asthma?

Researchers will measure air quality, dust, pet allergens and lead in the childrens’ homes. They’ll assess their neighborhoods, too. A cohesive community often means better playgrounds (good for exercise) and less crime (fewer injuries). And they’ll compare demographics like family income and race. All of these factors, separately or together, could have an impact on health. And any one of them could interact with a child’s genes, putting one subset of kids at risk, while keeping another out of harm’s way.

Government funding for the $3.2 billion study, allocated annually, has been threatened in the past. But just six conditions affecting kids–obesity, injury, asthma, diabetes, neurobehavioral disorders and low birth weight– cost an estimated $758 billion a year. If we can make an impact on any one of these, says study director Dr. Peter Scheidt, “the savings in one year would more than pay for the total cost of the study.” Sounds like money well spent.