Testing for toxins in Mariupol.
UKRAINE: Family and Children of Ukraine
Family and Children of Ukraine is the Ukrainian component of the
European Longitudinal Study of Pregnancy and Childhood (ELSPAC). ELSPAC
was initiated by the World Health Organization, and the research protocols
were developed by the ELSPAC Coordinating Committee, which is based
in the Department of Child Health, University of Bristol, England.
ELSPAC is a prospective, geographically-based series of population
studies designed to include pregnancy and to follow the cohort of
births until the age of 7 years. Family and Children of Ukraine is
administered by a binational executive committee and is based in the
Ukrainian Institute of Pediatrics, Obstetrics, and Gynecology (IPOG),
in Kyiv. Family and Children of Ukraine was initiated, in part, with
support from NIEHS (Dr. Ruth Little and Dr. Beth Gladen) and was continued
with support from the National Center for Health Statistics (Dr. Ken
Schoendorf). With the support of our ITREOH program, IPOG established
its own Institutional Research Ethics Committee to review issues associated
with human subjects research relative to this study. ITREOH funding
also provided research training for Ukrainian scientists involved
in this research and supported the data management and analysis through
the UIC Louise Hamilton Center.
Family and Children of Ukraine recruited 8,000 pregnant women in
5 cities in Ukraine (Kyiv, Dniproderzhinsk, Mariupol, Ivano-Frankivsk,
and Krasny Louch) beginning in 1992. Information about these women
and their children was collected by means of self-completion of questionnaires
and abstraction of medical records at certain points in time. The
questionnaires used in the Family and Children of Ukraine study are
based on the ELSPAC questionnaires and are modified for use in Ukraine.
They have been translated, reverse-translated and approved by the
Coordinating Committee in Bristol. The questionnaires include:
Measuring weight in Mariupol.
- two antepartum questionnaires completed by the
- an antepartum questionnaire completed by the
- 6-week of infant age postpartum questionnaire;
- 6-month of age
- 18-month of age questionnaire;
- 3-year of age questionnaire;
- 5-year of age questionnaire; and
- 7-year of age questionnaire.
In addition, medical records are abstracted at delivery,
6 months, 18 months, 3 years, 5 years, and 7 years, at the
time of any hospitalization, and in the event of death or
miscarriage. In addition to the main study, local investigators
initiate focus studies using these cohorts that address specific
The children enrolled in this study are now approaching 7 years of age, and
we are beginning administration of the 7-year old questionnaire and medical
record abstraction this year. We are also in the process of analyzing the large
amounts of data that have been gathered to date. A major aim of the data analysis
is to identify risk factors for adverse pregnancy outcomes and childhood illness
which are amenable to clinical or public health interventions. For example,
in one of our focus studies, Environmental Pollution and Health Status of Children,
we observed that 3 y.o. children living in the city of Mariupol had urinary
1-OH pyrene levels (biomarkers of exposure to polycyclic aromatic hydrocarbons),
that were twice as high as the most polluted cities in Japan. Mariupol has
been targeted by USEPA, USAID, and the World Bank for international support
for pollution prevention.