Climate Change, Reproductive Health and Environmental Contaminants. A Child Cohort Study in three Regions of India.

Three regional birth registries will be established; one in the capital of New Delhi, another in the Nagpur District and the third in Shivgar. The Nagpur district is a rural area in central India whereas Shivgar is located in the rural district of Rae Bar eli of Uttar Pradesh state in Northern India, close to the Nepali border. INCLEN Trust, the Indian partner of this project has ongoing collaboration with health clinics in these two rural areas. Three birth cohorts, with approximately 500 newborn children , selected from the regional birth registries, will be established. Women will be recruited to the survey at their first visit to the health clinic. All women will have to sign an informed consent and fill out a detail questionnaire regarding their curren t health status, lifestyle and diet. Information regarding pregnancy and delivery outcomes will be collected from medical journals. Blood samples from the delivering women and cord blood samples will be collected. Five and ten years after the delivery, th e children and their mothers will again donate a blood sample. The children will be followed up at 6, 12 and 18 months, 3 years and 5 years. Parameters of interest will be growth patterns for weight, height, caput circumference and discovered malformation s. Cognitive and neurological development will be evaluated based on a defined protocol. The blood samples at delivery and at 5 and 10 years after delivery will be analyzed for environmental pollutants. Analytes of concern will be determined from the pilo t study of 150 samples from the first year of the project (the current proposal) but will cover heavy metals, persistent organic pollutants, current used pesticides and emerging organic contaminants. Temporal changes in contaminant concentrations will be linked to changing climate. Temperature and precipitation measurements will be provided from local weather stations. The results will be basis for a long term scientific, strategic, and public health project.