# Developmental Impact of NICU Exposures (DINE)

> **NIH NIH UH3** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2021 · $1,754,860

## Abstract

Project Summary. Each year in the United States, over 300,000 preterm infants are admitted to neonatal
intensive care units (NICUs) where they are exposed to a chemical-intensive hospital environment. Many life-
saving and supportive respiratory, nutritional, hematologic and pharmaceutical therapies in the NICU expose
preterm infants to potentially harmful chemicals during a life stage analogous to the third trimester of gestation.
Studies in term-born infants and animal models demonstrate that third trimester in utero exposure to phthalates
–ubiquitous chemicals used to make plastics flexible - is associated with maladaptive neurodevelopmental,
pulmonary, reproductive, and growth phenotypes. Lead (Pb) and manganese (Mn) -- an essential trace metal
administered in NICU nutrition -- can be neurotoxic in excess resulting in both cognitive and motor deficits.
Non-chemical exposures including psychological stress, common in the NICU environment, are also
associated with abnormal neurodevelopment. Multiple environmental exposures during the sensitive
developmental period when preterm infants are in the NICU may contribute to their increased risk of adverse
health and behavioral outcomes later in life. Neither the individual contribution of NICU-based phthalate, Mn,
Pb or stress exposure, nor the impact of concurrent and subsequent exposures on preterm infant health, risk,
resilience, or disease trajectories have been explored previously.
Our research capitalizes on the infrastructure, biorepositories, and extensive clinical databases of four existing
preterm cohorts to explore the scientific premise that early life exposure to phthalates, metals, and stress
adversely impacts neurodevelopment, lung function, growth and adiposity, and pubertal development in
childhood. As part of the ECHO Pediatric Cohorts program, we will pursue the following three specific aims:
Aim 1. Identify specific sources of NICU-based phthalate exposure in a large, geographically diverse
population of preterm infants. Aim 1 (UG3) will use existing NICU datasets and biorepositories to determine
specific routes and sources of phthalate exposure. Aim 2. Measure the impact of NICU-based phthalate
exposure on multisystem health outcomes at ages 3-10. Aim 2 (UG3/UH3) examines associations among
urine biomarkers of NICU phthalate exposure and childhood measures of pulmonary function, cognitive, motor,
and behavioral performance, growth and pubertal development. Aim 3. Determine the impact of and
interactions among early childhood phthalate, manganese, lead and stress exposures on
neurodevelopmental outcomes in preterm and term children. Aim 3 (UH3) uses tooth, hair and saliva
biomarkers of exposures to investigate neurobehavioral development in children born preterm and at term.
Our unique cohort offers a window for direct measurement of exposures in the “third trimester” phase of rapid
development in a sensitive population. This study will facilitate exposure abatement in the NICU an...

## Key facts

- **NIH application ID:** 10240273
- **Project number:** 5UH3OD023320-07
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** Judy Lynn Aschner
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,754,860
- **Award type:** 5
- **Project period:** 2016-09-21 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10240273

## Citation

> US National Institutes of Health, RePORTER application 10240273, Developmental Impact of NICU Exposures (DINE) (5UH3OD023320-07). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10240273. Licensed CC0.

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