000			03240nam a22003617a 4500
008			131223s20132013 xxu||||| |||| 00| 0 eng d
022			_a0269-5022
040			_aOvid MEDLINE(R)
099			_a23574410
245			_aThe exposome--exciting opportunities for discoveries in reproductive and perinatal epidemiology.
251			_aPaediatric and Perinatal Epidemiology. 27(3):229-36, 2013 May.
252			_aPaediatr Perinat Epidemiol. 27(3):229-36, 2013 May.
253			_aPaediatric and perinatal epidemiology
266			_d2013-12-24
520			_aUnderstanding the mechanisms that underlie successful human reproduction and development is an ambitious goal, given the many unique methodological challenges surrounding such study. These challenges are well understood by reproductive and perinatal epidemiologists and include its conditional nature, unobservable yet informative outcomes such as conception, multi-scale missing data, correlated or non-independent outcomes, interval censoring and a hierarchical data structure. Novel methodologies for overcoming these challenges and for answering critical data gaps are needed if we are to better understand the inefficiency that currently characterises human reproduction with the goal of improving population health. The exposome is an emerging paradigm that offers promise for understanding the natural history of human reproduction and development, and its many associated impairments that develop later in child- or adulthood. This novel paradigm recognises the need to identify and measure the totality of environmental (non-genetic) exposures from preconception through sensitive windows, and to identify patterns associated with healthy and adverse outcomes. The exposome accommodates research focusing on unique subpopulations, such as couples undergoing assisted reproductive technologies, so that methodological limitations such as unobservable and conditional outcomes can be better addressed. Reproductive and perinatal epidemiology is uniquely suited for proof-of-concept exposome research, given the intricate relations between fecundity, gravid health and later onset disease and the narrow and interrelated sensitive windows that characterise the conditional nature of human reproduction and development. Bold new conceptual frameworks such as the exposome are needed for designing research that may lead to discovery and improve population health. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
546			_aEnglish
650			_a*Environment
650			_a*Fertility/ph [Physiology]
650			_a*Reproduction/ph [Physiology]
650			_a*Reproductive Techniques, Assisted
650			_aFemale
650			_aHumans
650			_aMale
650			_aTime Factors
651			_aMedStar Washington Hospital Center
656			_aObstetrics and Gynecology, Maternal-Fetal Medicine
657			_aJournal Article
657			_aResearch Support, N.I.H., Intramural
700			_aLaughon, S Katherine
790			_aBuck Louis GM, Laughon SK, Sundaram R, Yeung E, Zhang C
856			_uhttp://dx.doi.org/10.1111/ppe.12040 _zhttp://dx.doi.org/10.1111/ppe.12040
942			_cART _dJournal article
999			_c12141 _d12141