Prenatal exposure to cocaine/polydrugs has been linked to fetal growthretardation, but effects on postnatal growth are less clear. 217 cocaine exposed(CE) and 197 non-exposed (NCE), were evaluated for height (HT), weight(WT), and head circumference (HC) from birth and at 6months,1, 2, 4, 6, 9,10,11, and 12 years of age retention was 90% at 12 years. Growth curve analysestested differences, controlling for confounding variables. Significant effects ofCE predicted slower growth in HT. CE children were shorter from 4–11 years(p's< .03), with a trend to catch up at 12 years (NCE=56.1 kg vs. CE=53.2 kg,p<.09)). Alcohol, marijuana, and prenatal care also predicted HT.

There was no cocaine effect on WT although CE children were lighter.Prior to 6 years, there were no group differences in the % of childrenoverweight (15% vs. 15%). By 9 years 30% NCE were >85th percentile vs.19.8% CE, p<.03; by 11 years, 32% NCE and 22.8% CE were so classified(p<.05). By 12 years, 34% NCE and 28% CE were overweight, p=N.S. CE hada significant effect on birth HC (p=.03), diminished by 6 months.

Long-term effects of CE on stature were found. Alcohol had negativeeffects on all growth parameters, and marijuana predicted shorter statureand higher weight. Follow-up through adolescence is important to assesspersistence of drug effects on growth.

doi:10.1016/j.ntt.2009.04.036

NBTS33

An examination of the relationship between time estimation andtime production

John J. Chelonisa,b, Claire R. Gravelinb

aNational Center for Toxicological Research, Jefferson, AR, USAbThe College at Brockport, SUNY, Brockport, NY, USA

Given the importance of the ability to accurately perceive the passage oftime, it is not surprising that extensive research has been conducted on theability of toxicological and pharmacological agents to disrupt time perception.As a result, a variety of procedures have been developed to assess timeperception. Unfortunately, the use of different procedures and differentparameters has resulted in ambiguous or contradictory results across somestudies. Therefore, the purpose of this researchwas to compare performance ontime estimation and time production procedures using 12, 24 and 36 s intervalsin 89 undergraduate students. When production durations were comparedbetween the three target intervals, significant positive correlations were found.Significant positive correlations were also found when the variability ofproductions was compared across the target intervals. When estimations werecompared between the three target intervals, significant correlations were alsofound for the value and the variability of the estimation across the targetintervals. Significant negative correlations were found between the duration ofestimations and productions across the two procedures at each interval, but thecorrelation between variability across the two procedures at each interval wasnot significant. These results suggest that the perception of the rate at whichtime passes appears relatively stable across procedures. Specifically, individualswho produced larger durations typically made smaller estimations andindividuals who produced shorter durations typically made larger estimations.However, variability in one procedure does not appear to be a reliable predictorof variability in the other procedure.

doi:10.1016/j.ntt.2009.04.037

NBTS34

Environment and child health

Lizbeth Lopez CarrilloNational Institute of Public Health, Mexico

Environmental contaminants produce 40% of the global burden of environ-mental diseases among children. Children are vulnerable to environmentalexposure around the world; however, different patterns of environmentalhealth problems are observed in developed vs. developing countries. Epide-

miology and Toxicology have importantly contributed identifying environmen-tal concerns. Epidemiologic research has demonstrated many causalrelationships and potential associations between parental or childhoodenvironmental exposures and adverse pregnancy, childhood as well as adulthealth problems, while, toxicological studies have shown the biologicalplausibility and critical windows of exposure. Delayed conception, fetal growthdeficit, preterm birth, birth defects (Neural tube, cardiac, orofacial, musculo-skeletal, urinary track and genital)neuropsychological deficits (developmentalmilestones, cognitive function and problem behaviors), respiratory diseases(asthma, lung and ear infections) and childhood cancer (leukemia, lymphoma,brain, neuroblastoma, Wilms's tumor, bone, germ-cell, eye, soft tissue) areamong themany diseases that are linkedwith environmental pollutants and arethe focus of this state of the art presentation, that includes a discussion of themajor challenges and limitations of epidemiological studieswheremetals (lead,mercury, cadmium, arsenic), persistent organic compounds (PCBs, PBBs),pesticides (organophosphates, DDT etc.) and other contaminants have beenevaluated. International collaborative and transdisciplinary studies are war-ranted to improve children environmental health around the world.

doi:10.1016/j.ntt.2009.04.038

NBTS35

HIV and perinatal transmission

Clemente DiazDepartment of Pediatrics, University of Puerto Rico School of Medicine, San Juan,PR, USA

PuertoRico receivedearlyand strong impact fromtheevolvingHIV epidemicearly in the 80's decade. As early as 1984, San Juanhad evolved into an importantepicenter of HIV transmission.Women became the fastest growing group at riskfor HIV infection. This particularly affectedwomenwhowere sexual partners ofHIV infected intravenous drug using men. Consequently, vertical or mother tochild transmission of HIV, became an important mechanism of infection forinfants.During1984–85 theCenters forDisease Control andPrevention<CDC>Study of HIV Prevalence in Childbearing Women identified close to 300 HIVinfected pregnant women giving birth yearly island wide. There were 90–100HIV infected childrenborn inPR for those years.Wehave beenable to reduce theperinatal transmission rate remarkably, reducing the number of infectedchildren born in the island. For the years 2005–09 there has been one or atmost two infected children born per year. For the year 2008, there were no HIVinfected births identified. This early high impact in the previous decadesfacilitated the inclusion of the University of Puerto Rico in the NIH funded: TheWomen and Infants Transmission Study (WITS). WITS is the longest runningNorth American observational cohort study, elucidating the natural history ofHIVdiseaseprogression in infants andpregnantwomen.Wewill present data onthe successful strategies to achieve the remarkable reduction in perinatal ormother to child transmission of HIV island wide. We will also discuss the keyclinical predictors of long term disease progression in HIV infected children.Wewill discuss the factors identified from maternal, prenatal, birth and earlypostnatal characteristics that were associated with minimal or extreme(progression to AIDS and death) clinical disease progression. Some strikingassociations among key clinical, viral and immunologic predictors presentduring intrauterine development were strongly predictive of long term clinicaloutcome among infected infants. We will discuss the clinical implications ofthese associations and the need for further studies. Some of these findings willallow hypothesis formulations related to pathophysiology of progression and ofmother to child transmission.

doi:10.1016/j.ntt.2009.04.039

NBTS36

Environmental disasters and children's health

Phil LandriganMount Sinai School of Medicine, New York, NY, USA

NBTS 2009 Abstracts 245

Development of the human brain is one of themost complex processes in allbiology. In the9monthsof prenatal life the brainmust evolve froma strip of cellsalong the dorsal ectoderm of the embryo into a complex organ comprised ofbillions of precisely located, highly interconnected, highly specialised cells.Optimal brain development requires that neurons move along specifiedpathways from their points of origin to their assigned locations, that theyestablish connections with other cells near and distant, and that they learn tointercommunicate. All of these processes must take place within a tightlycontrolled time frame, in which each developmental stage must be reached incorrect sequence. Previously the placenta and the blood-brain barrier werethought to protect the developing brain against toxic exposures. Thethalidomide and Minamata episodes destroyed those myths and documentedthat the developing brain is inherently much more susceptible to injury causedby toxic agents than the brain of an adult. Chemicals and drugs now knowncapable of causing damage to the developing human brain include lead, methylmercury, PCBs, arsenic, ethyl alcohol, organophosphate pesticides, manganese,misoprostol and thalidomide. Prenatal and early postnatal exposures to thesechemicals have variously been shown to produce deficits in cognition andbehavior as well as neurodevelopmental disorders—dyslexia, mental retarda-tion, attention deficit disorder and autism. A critical unanswered question iswhether additional chemicals have potential to injure the developing brain.Approximately 1200 chemicals are known to be neurotoxic in adult humans orin animals, but have not been tested for developmental neurotoxicity.Prevention of neurodevelopmental disorders in children and adults will requiretoxicological and epidemiological assessment of these molecules. The NationalChildren's Study will provide much necessary information.

doi:10.1016/j.ntt.2009.04.040

NBTS37

Maternal and child nutrition: Long term impacts on disease in low andmiddle income countries

Linda AdairThe University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Introduction

Adult health is affected by exposure to poor nutrition during fetal andearly postnatal life. Poor early nutrition exacerbates the effects of adultoverweight or obesity on type 2 diabetes and hypertension. Rapid infantweight gain is associated with later obesity and chronic disease risk. Mostresearch in the emerging field of developmental origins of adult diseasecomes from high income countries. Less is known about the consequences ofearly nutrition in low and middle income countries.

Methods

The relationship of birth weight and postnatal weight gain to adult healthand development outcomes was examined birth cohorts from Brazil,Guatemala, India, The Philippines, and South Africa. In one set of analyses,data were analyzed separately in the 5 cohorts, and regression coefficientswere pooled in a meta-regression. We also pooled the data to determine howbirth weight and weight gain from birth to 12, 12–24 and 24–48 mo, relatedto adult body composition and blood pressure, and assessed whetherpostnatal weight gain related differently to BP in adults born with small(SGA) versus adequate weight-for-gestational age.

Results

Undernutrition was associated with shorter adult height, less schooling,reduced economic productivity, and lower offspring birthweight. Increasedsize at birth and in childhood were positively associated with adult body-mass index, while lower birthweight and undernutrition in childhood wererisk factors for high glucose concentrations, and blood pressure once adultBMI and height were taken into account. Weight gain in early life contributedto adult BP in proportion to its contribution to adult BMI. There was nospecific period during which faster growth contributed more to adult BP, norwas the relationship different in those born SGA.

Discussion

A high prevalence of prenatal and early child growth restriction, commonin developing countries, followed by excess postnatal weight gain, increasesthe chances that adults will have increased risk of chronic diseases. Thesefindings reinforce the importance of optimizing maternal nutrition duringpregnancy to promote healthy birth weight in the offspring, and ofpromoting optimal postnatal growth through breastfeeding and optimalyoung child feeding practices.

doi:10.1016/j.ntt.2009.04.041

NBTS38

Treating severe malaria with pre-referral artesunate saves lives andprevents CNS damage

Melba Gomes, M.A. Faiz, Jo Gyapong, M. Warsame, T. Agbenyega, A. Babiker,F. Baiden, E. Bin Yunus, F. Binka, C. Clerk, P. Folb, R. Hassan, A. Hossain,O. Kimbute, A. Kitua, S. Krishna, C. Makasi, N. Mensah, Z. Mrango, P. Olliaro,R. Peto, T.J. Peto, M.R. Rahman, I. Ribeiro, R. Samad, N.J. WhiteStudy 13 Research Group, World Health Organization, Geneva, Switzerland

Of the 2 billion people at risk of malaria annually, an estimated 270millionare newly infected and 1 million die from the disease. Approximately 90% ofinfections and deaths occur in children and pregnant women living in sub-Saharan Africa. There is increased susceptibility in pregnancy and in high-transmission areas, primigravidae are at greater risk of both uncomplicatedand severemalaria and associated hazards of abortion, prematurity and severeanaemia with consequences for low birthweight infants, neonatal and infantmortality. HIV positivity further compromises acquisition of immunity,increasing risk of high density parasitaemia and febrile illness at all gravidities.Furthermore, HIV positive pregnantwomenhave a two-fold higher HIV-1 viralconcentration during malarial infection although the consequences onmother-to-child transmission are not yet certain. Children born in thesesettingswith a daily danger of an infectivemosquito bite are initially protectedby malaria-specific antibodies, probably acquired across the placenta, butwithin 6 months they are at high risk of death until they begin to acquireimmunity by surviving repetitive malaria challenge. In most cases, effectiveoral treatment is curative. However, in some patients the infection rapidlybecomes acute, preventing ability to take oral medicines, and progression tosevere disease anddeath can occurwithin hours. In remote rural areas patientsare at considerable risk of deteriorating and dying because of considerabledistances to clinicswhere effective injectable treatment is available. Because ofits speed of action and ease of administration, the World Health Organizationundertook a drug development program to evaluate the efficacy and safety ofartesunate given rectally to provide therapeutic cover where no alternativeexists. Key hospital studies demonstrated that one dose immediately reducedparasitaemia in children and adults, to a greater extent than standardinjectable therapy with quinine. Thereafter a community-based, doubleblinded, randomized clinical trial of patients with suspected severe malariawas implemented, now completed. The trial demonstrated that for patientsnot in clinic in 6 h, pre-referral rectal artesunate reduced by about half the riskof mortality and permanent neurological sequelae—from 3.8% to 1.9% [riskratio: 0.49, (95% confidence interval: 0.32–0.77), P=0.0013].

doi:10.1016/j.ntt.2009.04.042

NBTS39

Do rodents have an IQ?A historical overview

R. Robert HolsonDepartment of Psychology, New Mexico Tech, Socorro, NM, USA

In many ways the IQ test is the crown jewel among tests for individualdifferences in humans. The concept of IQ rests upon over 400 reports of a g

NBTS 2009 Abstracts246