| Off to a Good Start: The Influence of Pre- and Periconceptional Exposures, Parental Fertility, and Nutrition on Children's Health Robert E. Chapin,1 Wendie A. Robbins,2 Laura A. Schieve,3 Anne M. Sweeney,4 Sonia A. Tabacova,5 and Kay M. Tomashek6 1Pfizer Global Research and Development, Safety Sciences, Groton, Connecticut, USA; 2UCLA Center for Occupational and Environmental Health, University of California at Los Angeles, Los Angeles, California, USA; 3Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; 4Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University System Health Science Center, Bryan, Texas, USA; 5National Center for Toxicological Research, U.S. Food and Drug Administration, Rockville, Maryland, USA; 6Maternal and Infant Health Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Abstract
The scientific community is developing a compelling body of evidence that shows the importance of the in utero environment (including chemical and hormonal levels) to the ultimate health of the child and even of the aging adult. This article summarizes the evidence that shows this impact begins with conception. Only a full life-cycle evaluation will help us understand these impacts, and only such an understanding will produce logically prioritized mitigation strategies to address the greatest threats first. Clearly, the time for analysis begins when the next generation is but a twinkle in the eye. Key words: birth defects, chemical exposure, conception, fertilization, review. Environ Health Perspect 112:69-78 (2004) . doi:10.1289/ehp.6261 available via http://dx.doi.org/ [Online 24 September 2003]
This article is part of the mini-monograph "Understanding the Determinants of Children's Health." Address correspondence to R. Chapin, Pfizer Global R&D, Safety Sciences, Eastern Point Rd., MS8274-1336, Groton, CT 06340 USA. Telephone: (860) 441-0571. Fax: (860) 715-3577. E-mail: robert_e_chapin@groton.pfizer.com All authors contributed equally and are presented in alphabetical order. In addition, we thank the members of the Fertility and Early Pregnancy Working Group, National Children's Study, for their critical review of this work. We are grateful to S. Curry for assistance with the later stages of the manuscript and to the reviewers whose suggestions improved it. The authors declare they have no competing financial interest. Received 6 February 2003 ; accepted 1 July 2003.
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