Discovering Cancer Risks From Environmental Contaminants and Maternal/Child Health

Study Overview
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Brief Summary
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The DREAM Cohort is a longitudinal observational study developed to enhance our understanding of how multiple exposures to environmental chemicals and pollutants across a diverse population of pregnant women and their offspring are linked to cancer risks. Because pregnancy induces multiple maternal hormonal and physiological changes that can increase cancer susceptibility to environmental chemical exposures, this study will focus on pregnancy as a period of particular vulnerability to toxic agents.

Detailed Description
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The environmental exposures will focus on two major components: Consumer product related chemicals (including per- and polyfluoroalkyl substances (PFAS), phthalates and plasticizers, phenolic compounds, pesticides, and aromatic amines) measured via biomonitoring and prioritized based on widespread public exposure; and environmental pollutants in air and water, evaluated via geographic information system analyses of participants' residential histories. The study team will collect questionnaire data and biospecimen samples starting at the second trimester of pregnancy up until the child reaches four years of age. A Cohort Ambassador Program will also be established to invite participants across our three sites to provide continuous feedback which will be integrated into the research priorities.

Official Title
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DREAM: Discovering Cancer Risks From Environmental Contaminants And Maternal/Child Health

Conditions
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Cancer

Intervention / Treatment
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* Other: Health Questionnaires
* Other: Specimen sample collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant women, over the age of 18 years. English or Spanish-speaking. Children born of participants enrolled during pregnancy will be enrolled in the DREAM cohort. Inclusion criterion for the DREAM Cohort Ambassador Program is limited to research participants in the DREAM Cohort. Exclusion Criteria: Women under the age of 18. Women expecting the birth of multiples (twins, triplets, etc.).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pregnant women and their children<br>The DREAM cohort will recruit from University of California, San Francisco (UCSF) Mission Bay, Zuckerberg San Francisco General Hospital, and Fresno Community Medical Center locations to enroll an economically, geographically, ethnically and racially diverse cohort of pregnant women and their children for long term follow-up. | Other: Health Questionnaires<br>* A questionnaire with content developed and tested in the investigator's previous reproductive and cancer epidemiology studies as part of the NIH Environmental Influences on Child Health Outcomes (ECHO) consortium will be used to collect information on primary established and hypothesized risk factors for cancer and additional covariates.<br>Other: Specimen sample collection<br>* Collection of blood, urine, nails, hair, and saliva samples will be obtained during the participant encounters.<br>* Other names: Specimen collection;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of levels of consumer product-related chemicals | Consumer product related chemicals measured via biomonitoring of polyfluoroalkyl substances (PFAS), phthalates and other plasticizers, phenolic compounds, pesticides, and aromatic amines will be assessed. | Up to 4 years | 
| Evaluation of endocrine system disruptions | Exposures to environmental chemicals that disrupt endocrine and related biological systems during pregnancy which may predispose women and children to cancer will be evaluated. | Up to 4 years | 
| Assessment of Inflammation/Immune modulation | Measures of peripheral whole blood using a standard laboratory procedure for Complete Blood Count (CBC) panel will be calculated to assess shifts in immune cell profiles indicative of inflammation and immune modulation. | Up to 4 years | 
| Impact of geographical environmental pollutants | The environmental pollutants found in air and water, as well as pesticide use, will be evaluated via geographic information system analyses of participants' residential history. | Up to 4 years | 
| Assessment of Oxidative Stress/DNA damage | Seven oxidative stress biomarkers which reflect oxidative damage to DNA will be measured to determine overall assessment of oxidative damage to DNA: proteins and lipids (OSBs): (o,o -dityrosine (diY), 8-hydroxy-2 -deoxyguanosine (8-OHdG), malondialdehyde (MDA), and four F2-isoprostane isomers (i.e., 8-isoprostaglandinF2α [8-PGF2α], 11β-prostaglandinF2α [11-PGF2α], 15(R)-prostaglandinF2α [15-PGF2α], and 8-iso,15(R)-prostaglandinF2α [8,15-PGF2α]) in maternal urine. | Up to 4 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cancer Risk, Environmental Cancer Risk, Maternal-Child Cancer Risk, Environmental Contaminants