151
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Threapleton DE, Snart CJP, Keeble C, Waterman AH, Taylor E, Mason D, Reid S, Azad R, Hill LJB, Meadows S, McKillion A, Alwan NA, Cade JE, Simpson NAB, Stewart PM, Zimmermann M, Wright J, Waiblinger D, Mon-Williams M, Hardie LJ, Greenwood DC. Maternal iodine status in a multi-ethnic UK birth cohort: Associations with child cognitive and educational development. Paediatr Perinat Epidemiol 2021; 35:236-246. [PMID: 32870514 DOI: 10.1111/ppe.12719] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/17/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Maternal iodine requirements increase during pregnancy to supply thyroid hormones critical for fetal neurodevelopment. Iodine insufficiency may result in poorer cognitive or child educational outcomes but current evidence is sparse and inconsistent. OBJECTIVES To quantify the association between maternal iodine status and child educational outcomes. METHODS Urinary iodine concentrations (UIC) and iodine/creatinine ratios (I:Cr) were measured in 6971 mothers at 26-28 weeks' gestation participating in the Born in Bradford cohort. Maternal iodine status was examined in relation to child school achievement (early years foundation stage (EYFS), phonics, and Key Stage 1 (KS1)), other learning outcomes, social and behavioural difficulties, and sensorimotor control in 5745 children aged 4-7 years. RESULTS Median (interquartile range) UIC was 76 µg/L (46, 120), and I:Cr was 83 µg/g (59, 121). Overall, there was no strong or consistent evidence to support associations between UIC or I:Cr and neurodevelopmental outcomes. For instance, predicted EYFS and phonics scores (primary outcomes) at the 25th vs 75th I:Cr percentiles (99% confidence intervals) were similar, with no evidence of associations: EYFS scores were 32 (99% CI 31, 33) and 33 (99% CI 32, 34), and phonics scores were 34 (99% CI 33, 35) and 35 (99% CI 34, 36), respectively. CONCLUSIONS In the largest single study of its kind, there was little evidence of detrimental neurodevelopmental outcomes in children born to pregnant women with iodine insufficiency as defined by World Health Organization-outlined thresholds. Alternative functional biomarkers for iodine status in pregnancy and focused assessment of other health outcomes may provide additional insight.
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Affiliation(s)
- Diane E Threapleton
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Charles J P Snart
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Claire Keeble
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | | | - Elizabeth Taylor
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Stephen Reid
- Earth Surface Science Institute, School of Earth and Environment, University of Leeds, Leeds, UK
| | - Rafaq Azad
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Liam J B Hill
- School of Psychology, University of Leeds, Leeds, UK
| | - Sarah Meadows
- Elsie Widdowson Laboratory, University of Cambridge, Cambridge, UK.,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Amanda McKillion
- Elsie Widdowson Laboratory, University of Cambridge, Cambridge, UK.,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Nisreen A Alwan
- Faculty of Medicine, School of Primary Care and Population Sciences, Southampton General Hospital, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - Nigel A B Simpson
- Division of Women's and Children's Health, School of Medicine, University of Leeds, Leeds, UK
| | - Paul M Stewart
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Michael Zimmermann
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zürich, Switzerland
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Laura J Hardie
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Darren C Greenwood
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
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152
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Armstrong-Carter E, Miller JG, Hill LJB, Domingue BW. Young Children's Prosocial Behavior Protects Against Academic Risk in Neighborhoods With Low Socioeconomic Status. Child Dev 2021; 92:1509-1522. [PMID: 33594683 DOI: 10.1111/cdev.13549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Children raised in neighborhoods with low socioeconomic status (SES) are at risk for low academic achievement. Identifying factors that help children from disadvantaged neighborhoods thrive is critical for reducing inequalities. We investigated whether children's prosocial behavior buffers concurrent and subsequent academic risk in disadvantaged neighborhoods in Bradford, UK. Diverse children (N = 1,175) were followed until age seven, with measurements taken at four times. We used governmental indices of neighborhood-level SES, teacher observations of prosocial behaviors, and direct assessments of academic achievement. Neighborhood SES was positively associated with academic achievement among children with low levels of prosocial behavior, but not among children with high levels of prosocial behavior. Prosocial behavior may mitigate academic risk across early childhood.
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Affiliation(s)
| | | | - Liam J B Hill
- University of Leeds.,Born in Bradford, Bradford Teaching Hospitals NHS Foundation Trust
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153
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Zylbersztejn A, Pembrey L, Goldstein H, Berbers G, Schepp R, van der Klis F, Sande C, Mason D, Wright J, Smyth R, Hardelid P. Respiratory syncytial virus in young children: community cohort study integrating serological surveys, questionnaire and electronic health records, Born in Bradford cohort, England, 2008 to 2013. ACTA ACUST UNITED AC 2021; 26. [PMID: 33573711 PMCID: PMC7879500 DOI: 10.2807/1560-7917.es.2021.26.6.2000023] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Bronchiolitis caused by respiratory syncytial virus (RSV) is a major cause of mortality and morbidity in infants. Aim To describe RSV epidemiology in children in the community in a high-income setting. Methods We used stored blood samples from the United Kingdom Born in Bradford cohort study that had been collected at birth, age 1 and 2 years old, tested for IgG RSV postfusion F antibody and linked to questionnaires and primary and hospital care records. We used finite mixture models to classify children as RSV infected/not infected according to their antibody concentrations at age 1 and 2 years. We assessed risk factors for primary RSV infection at each age using Poisson regression models. Results The study cohort included 700 children with cord blood samples; 490 had additional blood samples taken at both ages 1 and 2 years old. Of these 490 children, 258 (53%; 95% confidence interval (CI): 48–57%) were first infected with RSV at age 1, 99 of whom (38%; 95% CI: 33–43%) had been in contact with healthcare during peak RSV season (November–January). Having older siblings, birth in October–June and attending formal childcare were associated with risk of RSV infection in infancy. By age 2, a further 164 of 490 children (33%; 95% CI: 29–38%) had been infected. Conclusion Over half of children experienced RSV infection in infancy, a further one third had evidence of primary RSV infection by age 2, and one in seven remained seronegative by their second birthday. These findings will inform future analyses to assess the cost-effectiveness of RSV vaccination programmes in high-income settings.
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Affiliation(s)
- Ania Zylbersztejn
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Lucy Pembrey
- Medical Statistics Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Harvey Goldstein
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Guy Berbers
- Centre of Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Rutger Schepp
- Centre of Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Fiona van der Klis
- Centre of Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Charles Sande
- Kemri-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Rosalind Smyth
- Infection, Immunity and Inflammation Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Pia Hardelid
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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154
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Huhn S, Escher BI, Krauss M, Scholz S, Hackermüller J, Altenburger R. Unravelling the chemical exposome in cohort studies: routes explored and steps to become comprehensive. ENVIRONMENTAL SCIENCES EUROPE 2021; 33:17. [PMID: 33614387 PMCID: PMC7877320 DOI: 10.1186/s12302-020-00444-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/30/2020] [Indexed: 05/04/2023]
Abstract
Environmental factors contribute to the risk for adverse health outcomes against a background of genetic predisposition. Among these factors, chemical exposures may substantially contribute to disease risk and adverse outcomes. In fact, epidemiological cohort studies have established associations between exposure against individual chemicals and adverse health effects. Yet, in daily life individuals are exposed to complex mixtures in varying compositions. To capture the totality of environmental exposures the concept of the exposome has been developed. Here, we undertake an overview of major exposome projects, which pioneered the field of exposomics and explored the links between chemical exposure and health outcomes using cohort studies. We seek to reflect their achievements with regard to (i) capturing a comprehensive picture of the environmental chemical exposome, (ii) aggregating internal exposures using chemical and bioanalytical means of detection, and (iii) identifying associations that provide novel options for risk assessment and intervention. Various complementary approaches can be distinguished in addressing relevant exposure routes and it emerges that individual exposure histories may not easily be grouped. The number of chemicals for which human exposure can be detected is substantial and highlights the reality of mixture exposures. Yet, to a large extent it depends on targeted chemical analysis with the specific challenges to capture all relevant exposure routes and assess the chemical concentrations occurring in humans. The currently used approaches imply prior knowledge or hypotheses about relevant exposures. Typically, the number of chemicals considered in exposome projects is counted in dozens-in contrast to the several thousands of chemicals for which occurrence have been reported in human serum and urine. Furthermore, health outcomes are often still compared to single chemicals only. Moreover, explicit consideration of mixture effects and the interrelations between different outcomes to support causal relationships and identify risk drivers in complex mixtures remain underdeveloped and call for specifically designed exposome-cohort studies.
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Affiliation(s)
- Sebastian Huhn
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
- Pediatric Epidemiology, Department of Pediatrics, University of Leipzig Medical Center, Leipzig, Germany
| | - Beate I. Escher
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
- Environmental Toxicology, Center for Applied Geosciences, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
| | - Martin Krauss
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Stefan Scholz
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Jörg Hackermüller
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
| | - Rolf Altenburger
- Helmholtz Centre for Environmental Research GmbH – UFZ, Permoserstraße 15, 04318 Leipzig, Germany
- Department of Bioanalytical Ecotoxicology, RWTH-Aachen University, Aachen, Germany
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155
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Tubbs JD, Hwang LD, Luong J, Evans DM, Sham PC. Modeling Parent-Specific Genetic Nurture in Families with Missing Parental Genotypes: Application to Birthweight and BMI. Behav Genet 2021; 51:289-300. [PMID: 33454873 DOI: 10.1007/s10519-020-10040-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/15/2020] [Accepted: 12/15/2020] [Indexed: 12/25/2022]
Abstract
Disaggregation and estimation of genetic effects from offspring and parents has long been of interest to statistical geneticists. Recently, technical and methodological advances have made the genome-wide and loci-specific estimation of direct offspring and parental genetic nurture effects more possible. However, unbiased estimation using these methods requires datasets where both parents and at least one child have been genotyped, which are relatively scarce. Our group has recently developed a method and accompanying software (IMPISH; Hwang et al. in PLoS Genet 16:e1009154, 2020) which is able to impute missing parental genotypes from observed data on sibships and estimate their effects on an offspring phenotype conditional on the effects of genetic transmission. However, this method is unable to disentangle maternal and paternal effects, which may differ in magnitude and direction. Here, we introduce an extension to the original IMPISH routine which takes advantage of all available nuclear families to impute parent-specific missing genotypes and obtain asymptotically unbiased estimates of genetic effects on offspring phenotypes. We apply this this method to data from related individuals in the UK Biobank, showing concordance with previous estimates of maternal genetic effects on offspring birthweight. We also conduct the first GWAS jointly estimating offspring-, maternal-, and paternal-specific genetic effects on body-mass index.
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Affiliation(s)
- Justin D Tubbs
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Liang-Dar Hwang
- University of Queensland Diamantina Institute, University of Queensland, Brisbane, Australia
| | - Justin Luong
- University of Queensland Diamantina Institute, University of Queensland, Brisbane, Australia
| | - David M Evans
- University of Queensland Diamantina Institute, University of Queensland, Brisbane, Australia.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Pak C Sham
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China. .,Centre for PanorOmic Sciences, University of Hong Kong, Hong Kong, China. .,State Key Laboratory for Cognitive and Brain Sciences, University of Hong Kong, Hong Kong, China. .,The University of Hong Kong, 1/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, China.
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156
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Warembourg C, Nieuwenhuijsen M, Ballester F, de Castro M, Chatzi L, Esplugues A, Heude B, Maitre L, McEachan R, Robinson O, Slama R, Sunyer J, Urquiza J, Wright J, Basagaña X, Vrijheid M. Urban environment during early-life and blood pressure in young children. ENVIRONMENT INTERNATIONAL 2021; 146:106174. [PMID: 33099063 DOI: 10.1016/j.envint.2020.106174] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/21/2020] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The urban environment is characterised by many exposures that may influence hypertension development from early life onwards, but there is no systematic evaluation of their impact on child blood pressure (BP). METHODS Systolic and diastolic blood pressure were measured in 4,279 children aged 4-5 years from a multi-centre European cohort (France, Greece, Spain, and UK). Urban environment exposures were estimated during pregnancy and childhood, including air pollution, built environment, natural spaces, traffic, noise, meteorology, and socioeconomic deprivation index. Single- and multiple-exposure linear regression models and a cluster analysis were carried out. RESULTS In multiple exposure models, higher child BP, in particular diastolic BP, was observed in association with higher exposure to air pollution, noise and ambient temperature during pregnancy, and with higher exposure to air pollution and higher building density during childhood (e.g., mean change [95% confidence interval] for an interquartile range increase in prenatal NO2 = 0.7 mmHg[0.3;1.2]). Lower BP was observed in association with higher temperature and better street connectivity during childhood (e.g., temperature = -1.1[-1.6;-0.6]). Some of these associations were not robust in the sensitivity analyses. Mother-child pairs were grouped into six urban environment exposure clusters. Compared to the cluster representing the least harmful urban environment, the two clusters representing the most harmful environment (high in air pollution, traffic, noise, and low in green space) were both associated with higher diastolic BP (1.3[0.1;2.6] and 1.5[0.5;2.5]). CONCLUSION This first large systematic study suggests that living in a harmful urban environment may impact BP regulation in children. These findings reinforce the importance of designing cities that promote healthy environments to reduce long-term risk of hypertension and other cardiovascular diseases.
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Affiliation(s)
- Charline Warembourg
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Mark Nieuwenhuijsen
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ferran Ballester
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Nursing, Universitat de València, Valencia, Spain; FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Montserrat de Castro
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ana Esplugues
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Nursing, Universitat de València, Valencia, Spain; FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Barbara Heude
- Université de Paris, Center for Research in Epidemiology and StatisticS (CRESS), INSERM, INRA, F-75004 Paris, France
| | - Léa Maitre
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Oliver Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Rémy Slama
- Inserm, Univ. Grenoble Alpes, CNRS, IAB (Institute of Advanced Biosciences), Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Jordi Sunyer
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jose Urquiza
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Xavier Basagaña
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Martine Vrijheid
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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157
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Calvo-Serra B, Maitre L, Lau CHE, Siskos AP, Gützkow KB, Andrušaitytė S, Casas M, Cadiou S, Chatzi L, González JR, Grazuleviciene R, McEachan R, Slama R, Vafeiadi M, Wright J, Coen M, Vrijheid M, Keun HC, Escaramís G, Bustamante M. Urinary metabolite quantitative trait loci in children and their interaction with dietary factors. Hum Mol Genet 2020; 29:3830-3844. [PMID: 33283231 DOI: 10.1093/hmg/ddaa257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 11/14/2022] Open
Abstract
Human metabolism is influenced by genetic and environmental factors. Previous studies have identified over 23 loci associated with more than 26 urine metabolites levels in adults, which are known as urinary metabolite quantitative trait loci (metabQTLs). The aim of the present study is the identification for the first time of urinary metabQTLs in children and their interaction with dietary patterns. Association between genome-wide genotyping data and 44 urine metabolite levels measured by proton nuclear magnetic resonance spectroscopy was tested in 996 children from the Human Early Life Exposome project. Twelve statistically significant urine metabQTLs were identified, involving 11 unique loci and 10 different metabolites. Comparison with previous findings in adults revealed that six metabQTLs were already known, and one had been described in serum and three were involved the same locus as other reported metabQTLs but had different urinary metabolites. The remaining two metabQTLs represent novel urine metabolite-locus associations, which are reported for the first time in this study [single nucleotide polymorphism (SNP) rs12575496 for taurine, and the missense SNP rs2274870 for 3-hydroxyisobutyrate]. Moreover, it was found that urinary taurine levels were affected by the combined action of genetic variation and dietary patterns of meat intake as well as by the interaction of this SNP with beverage intake dietary patterns. Overall, we identified 12 urinary metabQTLs in children, including two novel associations. While a substantial part of the identified loci affected urinary metabolite levels both in children and in adults, the metabQTL for taurine seemed to be specific to children and interacted with dietary patterns.
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Affiliation(s)
- Beatriz Calvo-Serra
- ISGlobal, Barcelona 08003, Spain.,Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Léa Maitre
- ISGlobal, Barcelona 08003, Spain.,Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Chung-Ho E Lau
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2AZ, UK
| | - Alexandros P Siskos
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2AZ, UK.,Cancer Metabolism and Systems Toxicology Group, Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, UK
| | - Kristine B Gützkow
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo 0213, Norway
| | - Sandra Andrušaitytė
- Department of Environmental Science, Vytautas Magnus University, Kaunas 44248, Lithuania
| | - Maribel Casas
- ISGlobal, Barcelona 08003, Spain.,Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Solène Cadiou
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble 38000, France
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles 90033, USA
| | - Juan R González
- ISGlobal, Barcelona 08003, Spain.,Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Regina Grazuleviciene
- Department of Environmental Science, Vytautas Magnus University, Kaunas 44248, Lithuania
| | | | - Rémy Slama
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble 38000, France
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion 71003, Greece
| | - John Wright
- Bradford Institute for Health Research, Bradford BD9 6RJ, UK
| | - Murieann Coen
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2AZ, UK.,Oncology Safety, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB2 0RE, UK
| | - Martine Vrijheid
- ISGlobal, Barcelona 08003, Spain.,Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Hector C Keun
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2AZ, UK.,Cancer Metabolism and Systems Toxicology Group, Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, UK
| | - Geòrgia Escaramís
- Departament de Biomedicina, Institut de Neurociències, Universitat de Barcelona (UB), Barcelona 08036, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Mariona Bustamante
- ISGlobal, Barcelona 08003, Spain.,Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
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158
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Cromie KJ, Threapleton DE, Snart CJP, Taylor E, Mason D, Wright B, Kelly B, Reid S, Azad R, Keeble C, Waterman AH, Meadows S, McKillion A, Alwan NA, Cade JE, Simpson NAB, Stewart PM, Zimmermann M, Wright J, Waiblinger D, Mon-Williams M, Hardie LJ, Greenwood DC. Maternal iodine status in a multi-ethnic UK birth cohort: associations with autism spectrum disorder. BMC Pediatr 2020; 20:544. [PMID: 33276760 PMCID: PMC7718710 DOI: 10.1186/s12887-020-02440-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 11/22/2020] [Indexed: 11/27/2022] Open
Abstract
Background Maternal iodine requirements increase during pregnancy to supply thyroid hormones essential for fetal brain development. Maternal iodine deficiency can lead to hypothyroxinemia, a reduced fetal supply of thyroid hormones which, in the first trimester, has been linked to an increased risk of autism spectrum disorder (ASD) in the child. No study to date has explored the direct link between maternal iodine deficiency and diagnosis of ASD in offspring. Methods Urinary iodine concentrations (UIC) and iodine/creatinine ratios (I:Cr) were measured in 6955 mothers at 26–28 weeks gestation participating in the Born in Bradford (BiB) cohort. Maternal iodine status was examined in relation to the probability of a Read (CTV3) code for autism being present in a child’s primary care records through a series of logistic regression models with restricted cubic splines. Results Median (inter-quartile range) UIC was 76 μg/L (46, 120) and I:Cr was 83 μg/g (59, 121) indicating a deficient population according to WHO guidelines. Ninety two children (1·3%) in our cohort had received a diagnosis of ASD by the census date. Overall, there was no evidence to support an association between I:Cr or UIC and ASD risk in children aged 8–12 years (p = 0·3). Conclusions There was no evidence of an increased clinical ASD risk in children born to mothers with mild-to-moderate iodine deficiency at 26 weeks gestation. Alternative functional biomarkers of exposure and a wider range of conditions may provide further insight.
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Affiliation(s)
- Kirsten Jade Cromie
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Diane Erin Threapleton
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Charles Jonathan Peter Snart
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Elizabeth Taylor
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Barry Wright
- The Hull York Medical School, University of York, Heslington, York, YO10 5DD, UK
| | - Brian Kelly
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Stephen Reid
- Earth Surface Science Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Rafaq Azad
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Claire Keeble
- Leeds Institute for Data Analytics, University of Leeds, Leeds, LS2 9JT, UK
| | | | - Sarah Meadows
- Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Clifford Allbutt Building, Hills Road, Cambridge, CB2 0AH, UK
| | - Amanda McKillion
- Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Clifford Allbutt Building, Hills Road, Cambridge, CB2 0AH, UK
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Janet Elizabeth Cade
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | - Nigel A B Simpson
- Division of Women's and Children's Health, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Paul M Stewart
- Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Michael Zimmermann
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, 8092, Zürich, Switzerland
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Laura J Hardie
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Darren Charles Greenwood
- Leeds Institute of Cardiovascular & Metabolic Medicine, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK. .,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
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159
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Maternal Physical Activity and Neonatal Cord Blood pH: Findings from the Born in Bradford Pregnancy Cohort. PHYSICAL ACTIVITY AND HEALTH 2020. [DOI: 10.5334/paah.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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160
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Cave SN, von Stumm S. Secondary data analysis of British population cohort studies: A practical guide for education researchers. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2020; 91:531-546. [PMID: 33231318 DOI: 10.1111/bjep.12386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/07/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Britain is rich in longitudinal population cohort studies that posit valuable data resources for social science. However, education researchers currently underutilize these resources. AIMS The current paper (1) outlines the power and benefits of secondary data analyses for educational science and (2) provides a practical guide for education researchers on the characteristics, data, and accessibility of British population cohort studies. METHODS We identified eight British population cohort studies from the past 40 years that collected scholastic performance data during primary and secondary schooling, including (1) Avon Longitudinal Study of Parents And Children (ALSPAC), (2) Twins Early Development Study (TEDS), (3) Effective Pre-School, Primary and Secondary Education Project (EPPSE), (4) Millennium Cohort Study (MCS), (5) Born in Bradford (BiB), (6) Next Steps (LYSPE1), (7) Understanding Society (US), and (8) Our Future (LYSPE2). Participants across these studies were born between 1989 and 2010, and followed up at least once and up to 68 times, over periods of 7 to 29 years. For each study, we summarize here the context and aims, review the assessed variables, and describe the process for accessing the data. CONCLUSIONS We hope this article will encourage and support education researchers to widely utilize existing population cohort studies to further advance education science in Britain and elsewhere.
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McBride N, Yousefi P, White SL, Poston L, Farrar D, Sattar N, Nelson SM, Wright J, Mason D, Suderman M, Relton C, Lawlor DA. Do nuclear magnetic resonance (NMR)-based metabolomics improve the prediction of pregnancy-related disorders? Findings from a UK birth cohort with independent validation. BMC Med 2020; 18:366. [PMID: 33222689 PMCID: PMC7681995 DOI: 10.1186/s12916-020-01819-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Prediction of pregnancy-related disorders is usually done based on established and easily measured risk factors. Recent advances in metabolomics may provide earlier and more accurate prediction of women at risk of pregnancy-related disorders. METHODS We used data collected from women in the Born in Bradford (BiB; n = 8212) and UK Pregnancies Better Eating and Activity Trial (UPBEAT; n = 859) studies to create and validate prediction models for pregnancy-related disorders. These were gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), small for gestational age (SGA), large for gestational age (LGA) and preterm birth (PTB). We used ten-fold cross-validation and penalised regression to create prediction models. We compared the predictive performance of (1) risk factors (maternal age, pregnancy smoking, body mass index (BMI), ethnicity and parity) to (2) nuclear magnetic resonance-derived metabolites (N = 156 quantified metabolites, collected at 24-28 weeks gestation) and (3) combined risk factors and metabolites. The multi-ethnic BiB cohort was used for training and testing the models, with independent validation conducted in UPBEAT, a multi-ethnic study of obese pregnant women. RESULTS Maternal age, pregnancy smoking, BMI, ethnicity and parity were retained in the combined risk factor and metabolite models for all outcomes apart from PTB, which did not include maternal age. In addition, 147, 33, 96, 51 and 14 of the 156 metabolite traits were retained in the combined risk factor and metabolite model for GDM, HDP, SGA, LGA and PTB, respectively. These include cholesterol and triglycerides in very low-density lipoproteins (VLDL) in the models predicting GDM, HDP, SGA and LGA, and monounsaturated fatty acids (MUFA), ratios of MUFA to omega 3 fatty acids and total fatty acids, and a ratio of apolipoprotein B to apolipoprotein A-1 (APOA:APOB1) were retained predictors for GDM and LGA. In BiB, discrimination for GDM, HDP, LGA and SGA was improved in the combined risk factors and metabolites models. Risk factor area under the curve (AUC 95% confidence interval (CI)): GDM (0.69 (0.64, 0.73)), HDP (0.74 (0.70, 0.78)) and LGA (0.71 (0.66, 0.75)), and SGA (0.59 (0.56, 0.63)). Combined risk factor and metabolite models AUC 95% (CI): GDM (0.78 (0.74, 0.81)), HDP (0.76 (0.73, 0.79)) and LGA (0.75 (0.70, 0.79)), and SGA (0.66 (0.63, 0.70)). For GDM, HDP and LGA, but not SGA, calibration was good for a combined risk factor and metabolite model. Prediction of PTB was poor for all models. Independent validation in UPBEAT at 24-28 weeks and 15-18 weeks gestation confirmed similar patterns of results, but AUCs were attenuated. CONCLUSIONS Our results suggest a combined risk factor and metabolite model improves prediction of GDM, HDP and LGA, and SGA, when compared to risk factors alone. They also highlight the difficulty of predicting PTB, with all models performing poorly.
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Affiliation(s)
- Nancy McBride
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK. .,NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK. .,Population Health Sciences, University of Bristol, Bristol, UK.
| | - Paul Yousefi
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Sara L White
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Lucilla Poston
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Diane Farrar
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Naveed Sattar
- NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK.,Cardiovascular and Medical Sciences, British Heart Foundation Glasgow, Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.,School of Medicine, University of Glasgow, Glasgow, UK
| | - Scott M Nelson
- NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK.,Cardiovascular and Medical Sciences, British Heart Foundation Glasgow, Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.,School of Medicine, University of Glasgow, Glasgow, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Caroline Relton
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK.,Population Health Sciences, University of Bristol, Bristol, UK
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Taylor K, McBride N, J Goulding N, Burrows K, Mason D, Pembrey L, Yang T, Azad R, Wright J, A Lawlor D. Metabolomics datasets in the Born in Bradford cohort. Wellcome Open Res 2020; 5:264. [PMID: 38778888 PMCID: PMC11109709 DOI: 10.12688/wellcomeopenres.16341.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2020] [Indexed: 05/25/2024] Open
Abstract
Metabolomics is the quantification of small molecules, commonly known as metabolites. Collectively, these metabolites and their interactions within a biological system are known as the metabolome. The metabolome is a unique area of study, capturing influences from both genotype and environment. The availability of high-throughput technologies for quantifying large numbers of metabolites, as well as lipids and lipoprotein particles, has enabled detailed investigation of human metabolism in large-scale epidemiological studies. The Born in Bradford (BiB) cohort includes 12,453 women who experienced 13,776 pregnancies recruited between 2007-2011, their partners and their offspring. In this data note, we describe the metabolomic data available in BiB, profiled during pregnancy, in cord blood and during early life in the offspring. These include two platforms of metabolomic profiling: nuclear magnetic resonance and mass spectrometry. The maternal measures, taken at 26-28 weeks' gestation, can provide insight into the metabolome during pregnancy and how it relates to maternal and offspring health. The offspring cord blood measurements provide information on the fetal metabolome. These measures, alongside maternal pregnancy measures, can be used to explore how they may influence outcomes. The infant measures (taken around ages 12 and 24 months) provide a snapshot of the early life metabolome during a key phase of nutrition, environmental exposures, growth, and development. These metabolomic data can be examined alongside the BiB cohorts' extensive phenotype data from questionnaires, medical, educational and social record linkage, and other 'omics data.
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Affiliation(s)
- Kurt Taylor
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
| | - Nancy McBride
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Bristol NIHR Biomedical Research Centre, University of Bristol, Bristol, BS1 2NT, UK
| | - Neil J Goulding
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
| | - Kimberley Burrows
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Hospitals National Health Service Trust, Bradford, BD9 6RJ, UK
| | - Lucy Pembrey
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Hospitals National Health Service Trust, Bradford, BD9 6RJ, UK
| | - Rafaq Azad
- Department of Biochemistry, Bradford Royal Infirmary, Bradford, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Hospitals National Health Service Trust, Bradford, BD9 6RJ, UK
- Wolfson Centre for Applied Health Research, Bradford Hospitals National Health Service Trust, Bradford, BD9 6RJ, UK
| | - Deborah A Lawlor
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK
- Bristol NIHR Biomedical Research Centre, University of Bristol, Bristol, BS1 2NT, UK
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163
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Taylor K, Elhakeem A, Nader JLT, Yang T, Isaevska E, Richiardi L, Vrijkotte T, de Moira AP, Murray DM, Finn D, Mason D, Wright J, Oddie S, Roeleveld N, Harris JR, Nybo Andersen AM, Caputo M, Lawlor DA. The effect of maternal pre-/early-pregnancy BMI and pregnancy smoking and alcohol on congenital heart diseases: a parental negative control study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.09.29.20203786. [PMID: 33173887 PMCID: PMC7654878 DOI: 10.1101/2020.09.29.20203786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Congenital heart diseases (CHDs) are the most common congenital anomaly. The causes of CHDs are largely unknown. Higher prenatal body mass index (BMI), smoking and alcohol consumption are associated with increased risk of CHDs. Whether these are causal is unclear. METHODS AND RESULTS Seven European birth cohorts including 232,390 offspring (2,469 CHD cases [1.1%]) were included. We applied negative exposure paternal control analyses to explore the intrauterine effects of maternal BMI, smoking and alcohol consumption during pregnancy, on offspring CHDs and CHD severity. We used logistic regression and combined estimates using a fixed-effects meta-analysis. Analyses of BMI categories resulted in similar increased odds of CHD in overweight (mothers OR: 1.15 (1.01, 1.31) and fathers 1.10 (0.96, 1.27)) and obesity (mothers OR: 1.12 (0.93, 1.36) and fathers 1.16 (0.90, 1.50)). The association of mean BMI with CHD was null. Maternal smoking was associated with increased odds of CHD (OR: 1.11 (0.97, 1.25)) but paternal smoking was not (OR: 0.96 (0.85, 1.07)). The difference increased when removing offspring with genetic/chromosomal defects (mothers OR: 1.15 (1.01, 1.32) and fathers 0.93 (0.83, 1.05)). The positive association with maternal pregnancy smoking appeared to be driven by non-severe CHD cases (OR: 1.22 (1.04, 1.44)). Associations with maternal (OR: 1.16 (0.52, 2.58)) and paternal (OR: 1.23 (0.74, 2.06)) moderate/heavy pregnancy alcohol consumption were similar. CONCLUSIONS We found evidence of an intrauterine effect for maternal smoking on offspring CHDs, but no evidence for higher maternal BMI or alcohol consumption. Our findings provide further support for why smoking cessation is important during pregnancy.
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Affiliation(s)
- Kurt Taylor
- Population Health Science, Bristol Medical School, Bristol BS8 2BN, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2PS, UK
| | - Ahmed Elhakeem
- Population Health Science, Bristol Medical School, Bristol BS8 2BN, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2PS, UK
| | - Johanna Lucia Thorbjørnsrud Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK
| | - Elena Isaevska
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Tanja Vrijkotte
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Angela Pinot de Moira
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - Deirdre M Murray
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Daragh Finn
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK
| | - Sam Oddie
- Centre for Reviews and Dissemination, University of York, Heslington, York, UK
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen 6500 HB, The Netherlands
| | - Jennifer R Harris
- Division of Health Data and Digitalisation, and Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Massimo Caputo
- Translational Science, Bristol Medical School, Bristol BS2 8DZ, UK
- Bristol NIHR Biomedical Research Center, Bristol BS1 2NT, UK
| | - Deborah A. Lawlor
- Population Health Science, Bristol Medical School, Bristol BS8 2BN, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2PS, UK
- Bristol NIHR Biomedical Research Center, Bristol BS1 2NT, UK
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164
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Wilson CA, Santorelli G, Dickerson J, Ismail K, Reynolds RM, Simonoff E, Howard LM. Is there an association between anxiety and depression prior to and during pregnancy and gestational diabetes? An analysis of the Born in Bradford cohort. J Affect Disord 2020; 276:345-350. [PMID: 32741755 PMCID: PMC7477491 DOI: 10.1016/j.jad.2020.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND anxiety and depression are common in women with gestational diabetes but it is not clear whether they are more likely to precede the onset of gestational diabetes or to co-occur with it. Our aims were to compare the strength of association between common mental disorders of anxiety and depression (i) before pregnancy and (ii) during pregnancy in women with and without gestational diabetes. METHODS the sample comprised 12,239 women with 13,539 pregnancies from the UK's Born in Bradford cohort. Gestational diabetes was diagnosed by oral glucose tolerance test (OGTT). Indicators of common mental disorders were obtained from linked primary care records. Multivariable robust Poisson and logistic regression were employed. Multiple imputation by chained equations was implemented to handle missing data. Models were adjusted for maternal age, ethnicity, education and obstetric complications. Analyses of common mental disorders during pregnancy were additionally adjusted for maternal smoking, pre-pregnancy BMI, multiple pregnancy and common mental disorders prior to pregnancy. RESULTS there was no evidence for an association between common mental disorders prior to pregnancy and gestational diabetes (adjusted RR 0.96; 95% CI 0.80,1.15) or between gestational diabetes and common mental disorders during pregnancy (adjusted OR 0.91; 95% CI 0.73,1.12). LIMITATIONS high levels of deprivation and multi-ethnic composition of the cohort may limit generalisability of these findings to other populations. CONCLUSIONS routine primary care records did not identify an increased risk of gestational diabetes in women with common mental disorders prior to pregnancy or of gestational diabetes in women with common mental disorders during pregnancy.
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Affiliation(s)
- Claire A Wilson
- Section of Women's Mental Health, King's College London and South London and Maudsley NHS Foundation Trust, PO31 King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Gillian Santorelli
- Born in Bradford, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Josie Dickerson
- Born in Bradford, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Khalida Ismail
- Department of Psychological Medicine, King's College London and South London and Maudsley NHS Foundation Trust, UK
| | | | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, UK
| | - Louise M Howard
- Section of Women's Mental Health, King's College London and South London and Maudsley NHS Foundation Trust, PO31 King's College London, De Crespigny Park, London, SE5 8AF, UK
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165
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Granum B, Oftedal B, Agier L, Siroux V, Bird P, Casas M, Warembourg C, Wright J, Chatzi L, de Castro M, Donaire D, Grazuleviciene R, Småstuen Haug L, Maitre L, Robinson O, Tamayo-Uria I, Urquiza J, Nieuwenhuijsen M, Slama R, Thomsen C, Vrijheid M. Multiple environmental exposures in early-life and allergy-related outcomes in childhood. ENVIRONMENT INTERNATIONAL 2020; 144:106038. [PMID: 32854059 PMCID: PMC8768577 DOI: 10.1016/j.envint.2020.106038] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/10/2020] [Accepted: 08/03/2020] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Early onset and high prevalence of allergic diseases result in high individual and socio-economic burdens. Several studies provide evidence for possible effects of environmental factors on allergic diseases, but these are mainly single-exposure studies. The exposome provides a novel holistic approach by simultaneously studying a large set of exposures. The aim of the study was to evaluate the association between a broad range of prenatal and childhood environmental exposures and allergy-related outcomes in children. MATERIAL AND METHODS Analyses of associations between 90 prenatal and 107 childhood exposures and allergy-related outcomes (last 12 months: rhinitis and itchy rash; ever: doctor-diagnosed eczema and food allergy) in 6-11 years old children (n = 1270) from the European Human Early-Life Exposome cohort were performed. Initially, we used an exposome-wide association study (ExWAS) considering the exposures independently, followed by a deletion-substitution-addition selection (DSA) algorithm considering all exposures simultaneously. All the exposure variables selected in the DSA were included in a final multi-exposure model using binomial general linear model (GLM). RESULTS In ExWAS, no exposures were associated with the outcomes after correction for multiple comparison. In multi-exposure models for prenatal exposures, lower distance of residence to nearest road and higher di-iso-nonyl phthalate level were associated with increased risk of rhinitis, and particulate matter absorbance (PMabs) was associated with a decreased risk. Furthermore, traffic density on nearest road was associated with increased risk of itchy rash and diethyl phthalate with a reduced risk. DSA selected no associations of childhood exposures, or between prenatal exposures and eczema or food allergy. DISCUSSION This first comprehensive and systematic analysis of many environmental exposures suggests that prenatal exposure to traffic-related variables, PMabs and phthalates are associated with rhinitis and itchy rash.
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Affiliation(s)
- Berit Granum
- Norwegian Institute of Public Health, Oslo, Norway.
| | | | - Lydiane Agier
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Valerie Siroux
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Philippa Bird
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford UK
| | - Maribel Casas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Charline Warembourg
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford UK
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA; Department of Social Medicine, University of Crete, Greece; Department of Genetics & Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Donaire
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Regina Grazuleviciene
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, Kaunas, Lithuania
| | | | - Lea Maitre
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Oliver Robinson
- ISGlobal, Barcelona, Spain; MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | | | | | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Remy Slama
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | | | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Hwang LD, Tubbs JD, Luong J, Lundberg M, Moen GH, Wang G, Warrington NM, Sham PC, Cuellar-Partida G, Evans DM. Estimating indirect parental genetic effects on offspring phenotypes using virtual parental genotypes derived from sibling and half sibling pairs. PLoS Genet 2020; 16:e1009154. [PMID: 33104719 PMCID: PMC7646364 DOI: 10.1371/journal.pgen.1009154] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 11/05/2020] [Accepted: 09/28/2020] [Indexed: 02/03/2023] Open
Abstract
Indirect parental genetic effects may be defined as the influence of parental
genotypes on offspring phenotypes over and above that which results from the
transmission of genes from parents to their children. However, given the
relative paucity of large-scale family-based cohorts around the world, it is
difficult to demonstrate parental genetic effects on human traits, particularly
at individual loci. In this manuscript, we illustrate how parental genetic
effects on offspring phenotypes, including late onset conditions, can be
estimated at individual loci in principle using large-scale genome-wide
association study (GWAS) data, even in the absence of parental genotypes. Our
strategy involves creating “virtual” mothers and fathers by estimating the
genotypic dosages of parental genotypes using physically genotyped data from
relative pairs. We then utilize the expected dosages of the parents, and the
actual genotypes of the offspring relative pairs, to perform conditional genetic
association analyses to obtain asymptotically unbiased estimates of maternal,
paternal and offspring genetic effects. We apply our approach to 19066 sibling
pairs from the UK Biobank and show that a polygenic score consisting of imputed
parental educational attainment SNP dosages is strongly related to offspring
educational attainment even after correcting for offspring genotype at the same
loci. We develop a freely available web application that quantifies the power of
our approach using closed form asymptotic solutions. We implement our methods in
a user-friendly software package IMPISH (IMputing
Parental genotypes In Siblings and
Half Siblings) which allows users to quickly and efficiently
impute parental genotypes across the genome in large genome-wide datasets, and
then use these estimated dosages in downstream linear mixed model association
analyses. We conclude that imputing parental genotypes from relative pairs may
provide a useful adjunct to existing large-scale genetic studies of parents and
their offspring. Indirect parental genetic effects may be defined as the influence of parental
genotypes on offspring phenotypes over and above that which results from the
transmission of genes from parents to children. Estimating indirect parental
genetic effects on offspring outcomes at the genotype level has been challenging
because it requires large-scale, individual level genotypes from both parents
and their offspring, and there is a paucity of cohorts around the world with
this information. Here we present a new approach to estimate indirect parental
genetic effects without the requirement of physically genotyped parents. Our
method creates virtual parental genotypes based on the genotypes of offspring
pairs, and then uses these virtual genotypes in downstream genetic association
analyses. We developed a software package “IMPISH” that allows users to impute
virtual parental genotypes in their own genome-wide datasets and then use these
in downstream genome-wide association analyses, as well a series of power
calculators to estimate the power to detect indirect parental genetic effects on
offspring phenotypes. We apply our method to educational attainment data from
the UK Biobank and show that indirect parental genetic effects are related to
offspring educational attainment even after correcting for offspring genotype at
the same loci.
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Affiliation(s)
- Liang-Dar Hwang
- The University of Queensland Diamantina Institute, The University of
Queensland, Brisbane, Australia
| | - Justin D. Tubbs
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR,
China
| | - Justin Luong
- The University of Queensland Diamantina Institute, The University of
Queensland, Brisbane, Australia
| | - Mischa Lundberg
- The University of Queensland Diamantina Institute, The University of
Queensland, Brisbane, Australia
- Transformational Bioinformatics, Commonwealth Scientific and Industrial
Research Organisation, Sydney, New South Wales, Australia
| | - Gunn-Helen Moen
- The University of Queensland Diamantina Institute, The University of
Queensland, Brisbane, Australia
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo,
Oslo, Norway
- Population Health Science, Bristol Medical School, University of Bristol,
Bristol, United Kingdom
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health
and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim,
Norway
| | - Geng Wang
- The University of Queensland Diamantina Institute, The University of
Queensland, Brisbane, Australia
| | - Nicole M. Warrington
- The University of Queensland Diamantina Institute, The University of
Queensland, Brisbane, Australia
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health
and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim,
Norway
| | - Pak C. Sham
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR,
China
- Centre for PanorOmic Sciences, The University of Hong Kong, Hong Kong
SAR, China
- Centre of Brain and Cognitive Sciences, The University of Hong Kong, Hong
Kong SAR, China
| | - Gabriel Cuellar-Partida
- The University of Queensland Diamantina Institute, The University of
Queensland, Brisbane, Australia
- 23andMe Inc, Sunnyvale, California, United States of
America
| | - David M. Evans
- The University of Queensland Diamantina Institute, The University of
Queensland, Brisbane, Australia
- Medical Research Council Integrative Epidemiology Unit at the University
of Bristol, Bristol, United Kingdom
- * E-mail:
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Carson LE, Azmi B, Jewell A, Taylor CL, Flynn A, Gill C, Broadbent M, Howard L, Stewart R, Poston L. Cohort profile: the eLIXIR Partnership-a maternity-child data linkage for life course research in South London, UK. BMJ Open 2020; 10:e039583. [PMID: 33028561 PMCID: PMC7539583 DOI: 10.1136/bmjopen-2020-039583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/28/2020] [Accepted: 08/18/2020] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Linked maternity, neonatal and maternal mental health records were created to support research into the early life origins of physical and mental health, in mothers and children. The Early Life Cross Linkage in Research (eLIXIR) Partnership was developed in 2018, generating a repository of real-time, pseudonymised, structured data derived from the electronic health record systems of two acute and one Mental Health Care National Health Service (NHS) Provider in South London. We present early descriptive data for the linkage database and the robust data security and governance structures, and describe the intended expansion of the database from its original development. Additionally, we report details of the accompanying eLIXIR Research Tissue Bank of maternal and neonatal blood samples. PARTICIPANTS Descriptive data were generated from the eLIXIR database from 1 October 2018 to 30 June 2019. Over 17 000 electronic patient records were included. FINDINGS TO DATE 10 207 women accessed antenatal care from the 2 NHS maternity services, with 8405 deliveries (8772 infants). This diverse, inner-city maternity service population was born in over 170 countries with an ethnic profile of 46.1% white, 19.1% black, 7.0% Asian, 4.1% mixed and 4.1% other. Of the 10 207 women, 11.6% had a clinical record in mental health services with 3.0% being treated during their pregnancy. This first data extract included 947 infants treated in the neonatal intensive care unit, of whom 19.1% were postnatal transfers from external healthcare providers. FUTURE PLANS Electronic health records provide potentially transformative information for life course research, integrating physical and mental health disorders and outcomes in routine clinical care. The eLIXIR database will grow by ~14 000 new maternity cases annually, in addition to providing child follow-up data. Additional datasets will supplement the current linkage from other local and national resources, including primary care and hospital inpatient data for mothers and their children.
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Affiliation(s)
- Lauren E Carson
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Borscha Azmi
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Amelia Jewell
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Clare L Taylor
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Angela Flynn
- Department of Women and Children's Health, King's College London, London, UK
| | - Carolyn Gill
- Department of Women and Children's Health, King's College London, London, UK
- Women's Health Academic Centre KHP, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK
| | - Matthew Broadbent
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Louise Howard
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- Section of Women's Health, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Robert Stewart
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lucilla Poston
- Department of Women and Children's Health, King's College London, London, UK
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Sherry AP, Pearson N, Ridgers ND, Johnson W, Barber SE, Bingham DD, Nagy LC, Clemes SA. Impacts of a Standing Desk Intervention within an English Primary School Classroom: A Pilot Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197048. [PMID: 32993142 PMCID: PMC7579086 DOI: 10.3390/ijerph17197048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/19/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022]
Abstract
Traditional classroom furniture dictates that children predominantly sit during class time. This study evaluated the impact of providing standing desks within a deprived UK primary school setting over 8 months using mixed-method approaches. All children within a Year 5 class (9–10-year-olds, n = 30) received an adjustable sit–stand desk, while another Year 5 class (n = 30) in a nearby school retained traditional furniture as a control classroom. At baseline, 4 months, and 8 months, activPAL monitors (PAL Technologies, Glasgow, UK) were worn for 7 days to provide time spent sitting and standing. Behavior-related mental health, musculoskeletal discomfort surveys, and a cognitive function test battery were also completed at all three timepoints. Intervention experiences from pupils and the teacher were captured using focus groups, interviews, and classroom observations. At both 4 months and 8 months, multi-level models revealed a reduction in class time sitting in the intervention group compared to the control group ((β (95%CI) 4 months −25.3% (−32.3, −18.4); 8 months −19.9% (−27.05, −12.9)). Qualitative data revealed challenges to teaching practicalities and a gradual decline in behavior-related mental health was observed (intervention vs. control: 4 months +5.31 (+2.55, +8.08); 8 months +7.92 (+5.18, +10.66)). Larger trials within similar high-priority settings are required to determine the feasibility and cost-effectiveness of providing standing desks to every child in the classroom.
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Affiliation(s)
- Aron P. Sherry
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (N.P.); (W.J.); (S.A.C.)
- NIHR Leicester Biomedical Research Centre—Lifestyle Theme, Loughborough University, Loughborough LE11 3TU, UK
- Correspondence: ; Tel.: +44-1509-228462
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (N.P.); (W.J.); (S.A.C.)
| | - Nicola D. Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia;
| | - William Johnson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (N.P.); (W.J.); (S.A.C.)
| | - Sally E. Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (S.E.B.); (D.D.B.)
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (S.E.B.); (D.D.B.)
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK
| | - Liana C. Nagy
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0BP, UK;
| | - Stacy A. Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (N.P.); (W.J.); (S.A.C.)
- NIHR Leicester Biomedical Research Centre—Lifestyle Theme, Loughborough University, Loughborough LE11 3TU, UK
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Baluch N, Gallant M, Ellis AK. Exposomal research in the context of birth cohorts: What have they taught us? Ann Allergy Asthma Immunol 2020; 125:639-645. [PMID: 32927048 DOI: 10.1016/j.anai.2020.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To review birth cohorts with an exposomal approach and their key outcomes and challenges. Exposome encompasses all human environmental exposures from conception onward. The impact of environmental exposures is greatest in critical stages of life, including fetal and early childhood. Birth cohorts provide a good study setting to assess exposome in the sensitive periods of life. Here, we review birth cohorts with an exposomal approach and their key outcomes and challenges. DATA SOURCES MEDLINE was searched for birth cohorts that have used an exposomal approach. STUDY SELECTIONS Relevant studies in English language were selected and reviewed. RESULTS The outcomes of birth cohorts with an exposomal approach improve our understanding of the association between environmental exposures and childhood diseases. For example, results from The Canadian Healthy Infant Longitudinal Development Study suggest an association between first trimester exposure to traffic-related air pollution and increased risk of allergic sensitization at 12 months of age (P = .6). In a smaller Canadian birth cohort study, it was found that regular use of air fresheners (adjusted P = .04) and presence of mold in the residence (adjusted P < .001) were associated with early childhood wheezing and cough. The application of emerging molecular omics technologies and new analytical tools has facilitated the comprehensive assessment of exposome in birth cohorts. CONCLUSION Birth cohort studies with an exposomal approach improve our understanding of the origin of childhood diseases by examining a complex network of environmental exposures during pregnancy and years beyond birth. International collaboration is required to develop large birth cohorts for better and more extensive assessment of exposome with standardized protocols and new statistical frameworks.
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Affiliation(s)
- Narges Baluch
- Department of Pediatrics, Queen's University, Kingston, Ontario, Canada
| | - Mallory Gallant
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada; Allergy Research Unit, Kingston Health Sciences Centre, Kingston General Hospital Site, Kingston, Ontario, Canada
| | - Anne K Ellis
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada; Allergy Research Unit, Kingston Health Sciences Centre, Kingston General Hospital Site, Kingston, Ontario, Canada; Division of Allergy & Immunology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.
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Insan N, Slack E, Heslehurst N, Rankin J. Antenatal depression and anxiety and early pregnancy BMI among White British and South Asian women: retrospective analysis of data from the Born in Bradford cohort. BMC Pregnancy Childbirth 2020; 20:502. [PMID: 32873239 PMCID: PMC7466782 DOI: 10.1186/s12884-020-03097-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Maternal obesity has severe physical impacts such as increased chances of pre-eclampsia and gestational diabetes. However, mental health impacts are given less attention within antenatal care. Evidence suggests that women with obesity carry increased risk of maternal depression and anxiety, however, this association is not well researched amongst South Asian women in the UK who are vulnerable to both. The aim of this study was to investigate the association between antenatal depression and anxiety and early pregnancy BMI, within and between White British and South Asian women, using data from the Born in Bradford cohort. METHODS Depression and anxiety were assessed using the General Health Questionnaire (GHQ); a GHQ score of > 0 for the depression subscale and > 6 for anxiety. Mother's BMI was stratified into six World Health Organisation BMI categories (underweight, recommended, overweight or obese class 1-3). To determine associations, univariate and multivariate logistic regression models (adjusting for maternal age, education, deprivation and smoking) were used. RESULTS There were 7824 women included (3514 White British and 4310 South Asian). South Asian women were more likely to have depression than White British (43.3% vs 36.1% p < 0.0001) and less likely to have anxiety (45.3% vs 48.4% p < 0.01). There were no significant associations between BMI and depression or anxiety in South Asian women. White British women with an overweight BMI had higher odds of anxiety compared with women with a recommended BMI (Adjusted Odds Ratio 1.25, 95% Confidence Interval 1.05-1.47). No significant associations were observed for other BMI categories. Smoking was a risk factor for antenatal depression (AOR 1.32, 95% CI 1.12-1.56; AOR 2.08, 95% CI 1.49-2.91) and anxiety (AOR 1.34, 95% CI 1.14-1.57; (AOR 2.87, 95% CI 2.02-4.07) in both White British and South Asian women, respectively. CONCLUSIONS Although South Asian women have a higher prevalence of depression than White women in this cohort, the known associations between maternal obesity and anxiety do not appear to be present. More studies are needed using validated depression tools for South Asian pregnant women. Mental health screening during antenatal care is important for South Asian women, with factors such as smoking considered.
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Affiliation(s)
- Nafisa Insan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Emma Slack
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
| | - Judith Rankin
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
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van Gelder MMHJ, Merkus PJFM, van Drongelen J, Swarts JW, van de Belt TH, Roeleveld N. The PRIDE Study: Evaluation of online methods of data collection. Paediatr Perinat Epidemiol 2020; 34:484-494. [PMID: 31868970 PMCID: PMC7496449 DOI: 10.1111/ppe.12618] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/04/2019] [Accepted: 10/09/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Large birth cohort studies are extremely valuable in assessing associations between early life exposures and long-term outcomes. Establishing new birth cohorts is challenging due to declining participation rates. Online methods of data collection may increase feasibility, but have not been evaluated thoroughly. OBJECTIVE The primary objective of the ongoing PRegnancy and Infant DEvelopment (PRIDE) Study is to identify exposures during pregnancy and in early life that may affect short-term or long-term health of mother and/or child. In this manuscript, we aimed to evaluate methods of recruitment and online data collection applied. POPULATION Dutch women aged ≥18 years in early pregnancy. DESIGN Prospective cohort study. METHODS Initially, only prenatal care providers recruited participants, but alternative recruitment methods were added as a result of disappointing participation rates, including collaboration with "Moeders voor Moeders" (organisation that visits women in early pregnancy) and Facebook advertisements. Data on demographic characteristics, obstetric history, maternal health, life style factors, occupational exposures, nutrition, pregnancy complications, and infant outcomes are primarily collected through Web-based questionnaires at multiple time points during and after pregnancy. Additional data collection components include paternal questionnaires, blood and saliva sampling, and linkage to medical records. PRELIMINARY RESULTS By September 2019, 9573 women were included in the PRIDE Study, of which 1.3% completed paper-based questionnaires. Mean age of the women analysed was 30.6 years, 71.1% had a high level of education, 57.2% were primiparae, and mean gestational age at enrolment was 9.9 (range 3, 37) weeks, with slight differences between recruitment methods. Pregnancy outcome was known for 89.8%. Retention rate at 6 months after the estimated date of delivery was estimated at 70%. Multiple validation studies conducted within the PRIDE Study indicated high data quality. CONCLUSION(S) Although challenging and time-consuming, online methods for recruitment and data collection may enable the establishment of new birth cohort studies.
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Affiliation(s)
- Marleen M. H. J. van Gelder
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands,Radboud REshape Innovation CenterRadboud University Medical CenterNijmegenThe Netherlands
| | - Peter J. F. M. Merkus
- Department of Paediatric PulmonologyRadboudumc Amalia Children's HospitalRadboud University Medical CenterNijmegenThe Netherlands
| | - Joris van Drongelen
- Department of Obstetrics and GynaecologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Jessie W. Swarts
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Tom H. van de Belt
- Radboud REshape Innovation CenterRadboud University Medical CenterNijmegenThe Netherlands,Radboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Nel Roeleveld
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
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Vives-Usano M, Hernandez-Ferrer C, Maitre L, Ruiz-Arenas C, Andrusaityte S, Borràs E, Carracedo Á, Casas M, Chatzi L, Coen M, Estivill X, González JR, Grazuleviciene R, Gutzkow KB, Keun HC, Lau CHE, Cadiou S, Lepeule J, Mason D, Quintela I, Robinson O, Sabidó E, Santorelli G, Schwarze PE, Siskos AP, Slama R, Vafeiadi M, Martí E, Vrijheid M, Bustamante M. In utero and childhood exposure to tobacco smoke and multi-layer molecular signatures in children. BMC Med 2020; 18:243. [PMID: 32811491 PMCID: PMC7437049 DOI: 10.1186/s12916-020-01686-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/29/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The adverse health effects of early life exposure to tobacco smoking have been widely reported. In spite of this, the underlying molecular mechanisms of in utero and postnatal exposure to tobacco smoke are only partially understood. Here, we aimed to identify multi-layer molecular signatures associated with exposure to tobacco smoke in these two exposure windows. METHODS We investigated the associations of maternal smoking during pregnancy and childhood secondhand smoke (SHS) exposure with molecular features measured in 1203 European children (mean age 8.1 years) from the Human Early Life Exposome (HELIX) project. Molecular features, covering 4 layers, included blood DNA methylation and gene and miRNA transcription, plasma proteins, and sera and urinary metabolites. RESULTS Maternal smoking during pregnancy was associated with DNA methylation changes at 18 loci in child blood. DNA methylation at 5 of these loci was related to expression of the nearby genes. However, the expression of these genes themselves was only weakly associated with maternal smoking. Conversely, childhood SHS was not associated with blood DNA methylation or transcription patterns, but with reduced levels of several serum metabolites and with increased plasma PAI1 (plasminogen activator inhibitor-1), a protein that inhibits fibrinolysis. Some of the in utero and childhood smoking-related molecular marks showed dose-response trends, with stronger effects with higher dose or longer duration of the exposure. CONCLUSION In this first study covering multi-layer molecular features, pregnancy and childhood exposure to tobacco smoke were associated with distinct molecular phenotypes in children. The persistent and dose-dependent changes in the methylome make CpGs good candidates to develop biomarkers of past exposure. Moreover, compared to methylation, the weak association of maternal smoking in pregnancy with gene expression suggests different reversal rates and a methylation-based memory to past exposures. Finally, certain metabolites and protein markers evidenced potential early biological effects of postnatal SHS, such as fibrinolysis.
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Affiliation(s)
- Marta Vives-Usano
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carles Hernandez-Ferrer
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Léa Maitre
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carlos Ruiz-Arenas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, K. Donelaicio Street 58, 44248, Kaunas, Lithuania
| | - Eva Borràs
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Ángel Carracedo
- Grupo de Medicina Xenómica, Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), SERGAS, Rúa Choupana s/n, 15706, Santiago de Compostela, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER) y Centro Nacional de Genotipado (CEGEN-PRB3-ISCIII), Universidade de Santiago de Compostela, Praza do Obradoiro s/n, 15782, Santiago de Compostela, Spain
| | - Maribel Casas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1540 Alcazar Street, Los Angeles, 90033, USA
| | - Muireann Coen
- Oncology Safety, Clinical Pharmacology and Safety Sciences, R&D Biopharmaceuticals, AstraZeneca, 1 Francis Crick Avenue, Cambridge, CB2 0RE, UK
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Xavier Estivill
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Quantitative Genomics Medicine Laboratories (qGenomics), Esplugues del Llobregat, Barcelona, Catalonia, Spain
| | - Juan R González
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Regina Grazuleviciene
- Department of Environmental Sciences, Vytautas Magnus University, K. Donelaicio Street 58, 44248, Kaunas, Lithuania
| | - Kristine B Gutzkow
- Department af Environmental Health, Norwegian Institute of Public Health, Lovisenberggt 6, 0456, Oslo, Norway
| | - Hector C Keun
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
- Cancer Metabolism and Systems Toxicology Group, Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London, W12 0NN, UK
| | - Chung-Ho E Lau
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Solène Cadiou
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, IAB, 38000, Grenoble, France
| | - Johanna Lepeule
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, IAB, 38000, Grenoble, France
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - Inés Quintela
- Grupo de Medicina Xenómica, Centro Nacional de Genotipado (CEGEN-PRB3-ISCIII), Universidade de Santiago de Compostela, Praza do Obradoiro s/n, 15782, Santiago de Compostela, Spain
| | - Oliver Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, St. Mary's Hospital Campus, London, W21PG, UK
| | - Eduard Sabidó
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK
| | - Per E Schwarze
- Department af Environmental Health, Norwegian Institute of Public Health, Lovisenberggt 6, 0456, Oslo, Norway
| | - Alexandros P Siskos
- Division of Systems Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
- Cancer Metabolism and Systems Toxicology Group, Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London, W12 0NN, UK
| | - Rémy Slama
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, IAB, 38000, Grenoble, France
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Eulàlia Martí
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Biomedicina, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mariona Bustamante
- ISGlobal, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Santorelli G, West J, Mason D, Cartwright C, Inamdar L, Tomes C, Wright J. Factors associated with the uptake of the UK routine childhood immunization schedule in a bi-ethnic population. Eur J Public Health 2020; 30:697-702. [PMID: 32361768 PMCID: PMC7445048 DOI: 10.1093/eurpub/ckaa069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Various factors associated with vaccination uptake in children have been identified, but no study has examined their overall immunization status and individual vaccine coverage at 1, 2 and 5 years in the UK. METHODS Data from 6977 participants in the Born in Bradford cohort were linked to primary care records. Overall immunization status and individual vaccine uptake of the UK routine childhood vaccination schedule was estimated in White British and Pakistani children born between 2007 and 2011, and factors associated with partial uptake in each ethnic group were identified using Poisson regression. RESULTS Vaccine uptake was greater in Pakistani compared with White British children at all ages and for each year examined in this study. Children of foreign-born White British women were more likely to be partially immunized and those of foreign-born Pakistani women were more likely to be fully immunized. Socio-economic factors were strongly associated with uptake, especially among White British women. CONCLUSIONS Vaccination uptake is influenced by social and economic environment, ethnicity and maternal country of birth. This suggests that current health education and service delivery may not be effective for some families, including those from different cultural and ethnic backgrounds, who may require targeted interventions to improve immunization uptake.
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Affiliation(s)
- Gillian Santorelli
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK
| | - Jane West
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK
| | - Dan Mason
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK
| | - Chris Cartwright
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK
- School of Public Health, Health Education England, Yorkshire and Humber, University of Leeds, Leeds, UK
| | - Leena Inamdar
- Yorkshire and Humber Health Protection Team, Public Health England, Blenheim House, Leeds, UK
| | - Caroline Tomes
- Department of Public Health, City of Bradford Metropolitan District Council, Britannia House, Bradford, UK
| | - John Wright
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK
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175
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Jaddoe VWV, Felix JF, Andersen AMN, Charles MA, Chatzi L, Corpeleijn E, Donner N, Elhakeem A, Eriksson JG, Foong R, Grote V, Haakma S, Hanson M, Harris JR, Heude B, Huang RC, Inskip H, Järvelin MR, Koletzko B, Lawlor DA, Lindeboom M, McEachan RRC, Mikkola TM, Nader JLT, de Moira AP, Pizzi C, Richiardi L, Sebert S, Schwalber A, Sunyer J, Swertz MA, Vafeiadi M, Vrijheid M, Wright J, Duijts L. The LifeCycle Project-EU Child Cohort Network: a federated analysis infrastructure and harmonized data of more than 250,000 children and parents. Eur J Epidemiol 2020; 35:709-724. [PMID: 32705500 PMCID: PMC7387322 DOI: 10.1007/s10654-020-00662-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/04/2020] [Indexed: 12/15/2022]
Abstract
Early life is an important window of opportunity to improve health across the full lifecycle. An accumulating body of evidence suggests that exposure to adverse stressors during early life leads to developmental adaptations, which subsequently affect disease risk in later life. Also, geographical, socio-economic, and ethnic differences are related to health inequalities from early life onwards. To address these important public health challenges, many European pregnancy and childhood cohorts have been established over the last 30 years. The enormous wealth of data of these cohorts has led to important new biological insights and important impact for health from early life onwards. The impact of these cohorts and their data could be further increased by combining data from different cohorts. Combining data will lead to the possibility of identifying smaller effect estimates, and the opportunity to better identify risk groups and risk factors leading to disease across the lifecycle across countries. Also, it enables research on better causal understanding and modelling of life course health trajectories. The EU Child Cohort Network, established by the Horizon2020-funded LifeCycle Project, brings together nineteen pregnancy and childhood cohorts, together including more than 250,000 children and their parents. A large set of variables has been harmonised and standardized across these cohorts. The harmonized data are kept within each institution and can be accessed by external researchers through a shared federated data analysis platform using the R-based platform DataSHIELD, which takes relevant national and international data regulations into account. The EU Child Cohort Network has an open character. All protocols for data harmonization and setting up the data analysis platform are available online. The EU Child Cohort Network creates great opportunities for researchers to use data from different cohorts, during and beyond the LifeCycle Project duration. It also provides a novel model for collaborative research in large research infrastructures with individual-level data. The LifeCycle Project will translate results from research using the EU Child Cohort Network into recommendations for targeted prevention strategies to improve health trajectories for current and future generations by optimizing their earliest phases of life.
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Affiliation(s)
- Vincent W V Jaddoe
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, (Na 29-18), PO Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Janine F Felix
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, (Na 29-18), PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie-Aline Charles
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France.,ELFE Joint Unit, French Institute for Demographic Studies (Ined), French Institute for Medical Research and Health (INSERM), French Blood Agency, Aubervilliers, France
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Eva Corpeleijn
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nina Donner
- Concentris Research Management GmbH, Fürstenfeldbruck, Germany
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Singapore, Singapore
| | - Rachel Foong
- Telethon Kids Institute, Perth, WA, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Veit Grote
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Sido Haakma
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands
| | - Mark Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jennifer R Harris
- Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway.,Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France
| | | | - Hazel Inskip
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Marjo-Riitta Järvelin
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK.,Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland
| | - Berthold Koletzko
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Maarten Lindeboom
- Department of Economics, VU University Amsterdam, Amsterdam, The Netherlands
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Johanna L T Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Pinot de Moira
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Sylvain Sebert
- Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Ameli Schwalber
- Concentris Research Management GmbH, Fürstenfeldbruck, Germany
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Morris A Swertz
- University of Groningen, University Medical Center Groningen, Genomics Coordination Center, Groningen, The Netherlands.,Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Liesbeth Duijts
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, The Generation R Study Group, (Na 29-18), PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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176
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Waqas A, Zafar S, Lawlor DA, Wright J, Hafeez A, Ahmad I, Sikander S, Rahman A. A scientometric analysis of birth cohorts in South Asia: Way forward for Pakistan. PLoS One 2020; 15:e0235385. [PMID: 32645067 PMCID: PMC7347181 DOI: 10.1371/journal.pone.0235385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 06/15/2020] [Indexed: 11/19/2022] Open
Abstract
The present study aims to: a) systematically map the of birth cohort studies from the South Asian region b) examine the major research foci and landmark contributions from these cohorts using reproducible scientometric techniques and c) offer recommendations on establishing new birth cohorts in Pakistan, building upon the strengths, weaknesses and gaps of previous cohorts. Bibliographic records for a total of 260 articles, published during through December 2018, were retrieved from the Web of Science (core database). All data were analysed using Microsoft Excel (2013), Web of Science platform and CiteSpace. A series of network analysis were then run for each time-period using the link reduction method and pathfinder network scaling. The co-cited articles were clustered into their homogeneous research clusters. The clusters were named using the Latent Semantic Indexing (LSI) method that utilized author keywords as source of names for these clusters. The scientometric analyses of original research output from these birth cohorts also paint a pessimistic landscape in Pakistan- where Pakistani sites for birth cohorts contributed only 31 publications; a majority of these utilized the MAL-ED birth cohort data. A majority of original studies were published from birth cohorts in India (156), Bangladesh (63), and Nepal (15). Out of these contributions, 31 studies reported data from multiple countries. The three major birth cohorts include prospective and multi-country MAL-ED birth cohort and The Pakistan Early Childhood Development Scale Up Trial, and a retrospective Maternal and infant nutrition intervention cohort. In addition to these, a few small-scale birth cohorts reported findings pertaining to neonatal sepsis, intrauterine growth retardation and its effects on linear growth of children and environmental enteropathy.
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Affiliation(s)
- Ahmed Waqas
- Human Development Research Foundation, Markaz, Islamabad, Pakistan
| | - Shamsa Zafar
- Department of Gynaecology and Obstetrics, Fazaia Medical College, Islamabad, Pakistan
| | - Deborah A. Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, Bristol University, Bristol, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Assad Hafeez
- Health Services Academy, Chak Shahzad, Islamabad, Pakistan
| | - Ikhlaq Ahmad
- Human Development Research Foundation, Markaz, Islamabad, Pakistan
- Health Services Academy, Chak Shahzad, Islamabad, Pakistan
| | - Siham Sikander
- Human Development Research Foundation, Markaz, Islamabad, Pakistan
- Health Services Academy, Chak Shahzad, Islamabad, Pakistan
| | - Atif Rahman
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
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177
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Armstrong-Carter E, Trejo S, Hill LJB, Crossley KL, Mason D, Domingue BW. The Earliest Origins of Genetic Nurture: The Prenatal Environment Mediates the Association Between Maternal Genetics and Child Development. Psychol Sci 2020; 31:781-791. [PMID: 32484377 PMCID: PMC7370247 DOI: 10.1177/0956797620917209] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/17/2020] [Indexed: 01/22/2023] Open
Abstract
Observed genetic associations with educational attainment may be due to direct or indirect genetic influences. Recent work highlights genetic nurture, the potential effect of parents' genetics on their child's educational outcomes via rearing environments. To date, few mediating childhood environments have been tested. We used a large sample of genotyped mother-child dyads (N = 2,077) to investigate whether genetic nurture occurs via the prenatal environment. We found that mothers with more education-related genes are generally healthier and more financially stable during pregnancy. Further, measured prenatal conditions explain up to one third of the associations between maternal genetics and children's academic and developmental outcomes at the ages of 4 to 7 years. By providing the first evidence of prenatal genetic nurture and showing that genetic nurture is detectable in early childhood, this study broadens our understanding of how parental genetics may influence children and illustrates the challenges of within-person interpretation of existing genetic associations.
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Affiliation(s)
| | - Sam Trejo
- Graduate School of Education, Stanford University
| | - Liam J. B. Hill
- School of Psychology, University of Leeds
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust
| | - Kirsty L. Crossley
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust
| | - Dan Mason
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust
| | - Benjamin W. Domingue
- Graduate School of Education, Stanford University
- Center for Population Health Sciences, Stanford University
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178
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Sovio U, McBride N, Wood AM, Masconi KL, Cook E, Gaccioli F, Charnock-Jones DS, Lawlor DA, Smith GCS. 4-Hydroxyglutamate is a novel predictor of pre-eclampsia. Int J Epidemiol 2020; 49:301-311. [PMID: 31098639 PMCID: PMC7124498 DOI: 10.1093/ije/dyz098] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2019] [Indexed: 11/28/2022] Open
Abstract
Background Pre-term pre-eclampsia is a major cause of maternal and perinatal morbidity and mortality worldwide. A multi-centre randomized–controlled trial has shown that first-trimester screening followed by treatment of high-risk women with aspirin reduces the risk of pre-term pre-eclampsia. However, the biomarkers currently employed in risk prediction are only weakly associated with the outcome. Methods We conducted a case–cohort study within the Pregnancy Outcome Prediction study to analyse untargeted maternal serum metabolomics in samples from 12, 20, 28 and 36 weeks of gestational age (wkGA) in women with pre-eclampsia delivering at term (n = 165) and pre-term (n = 29), plus a random sample of the cohort (n = 325). We used longitudinal linear mixed models to identify candidate metabolites at 20/28 wkGA that differed by term pre-eclampsia status. Candidates were validated using measurements at 36 wkGA in the same women. We then tested the association between the 12-, 20- and 28-wkGA measurements and pre-term pre-eclampsia. We externally validated the association using 24- to 28-wkGA samples from the Born in Bradford study (25 cases and 953 controls). Results We identified 100 metabolites that differed most at 20/28 wkGA in term pre-eclampsia. Thirty-three of these were validated (P < 0.0005) at 36 wkGA. 4-Hydroxyglutamate and C-glycosyltryptophan were independently predictive at 36 wkGA of term pre-eclampsia. 4-Hydroxyglutamate was also predictive (area under the receiver operating characteristic curve, 95% confidence interval) of pre-term pre-eclampsia at 12 (0.673, 0.558–0.787), 20 (0.731, 0.657–0.806) and 28 wkGA (0.733, 0.627–0.839). The predictive ability of 4-hydroxyglutamate at 12 wkGA was stronger than two existing protein biomarkers, namely PAPP-A (0.567, 0.439–0.695) and placenta growth factor (0.589, 0.463–0.714). Finally, 4-hydroxyglutamate at 24–28 wkGA was positively associated with pre-eclampsia (term or pre-term) among women from the Born in Bradford study. Conclusions 4-hydroxyglutamate is a novel biochemical predictor of pre-eclampsia that provides better first-trimester prediction of pre-term disease than currently employed protein biomarkers.
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Affiliation(s)
- Ulla Sovio
- Department of Obstetrics and Gynaecology, University of Cambridge; NIHR Cambridge Biomedical Research Centre, Cambridge, UK.,Centre for Trophoblast Research (CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Nancy McBride
- NIHR Bristol Biomedical Research Centre, Bristol, UK.,MRC Integrative Epidemiology Unit, at the University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Angela M Wood
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Katya L Masconi
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Emma Cook
- Department of Obstetrics and Gynaecology, University of Cambridge; NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Francesca Gaccioli
- Department of Obstetrics and Gynaecology, University of Cambridge; NIHR Cambridge Biomedical Research Centre, Cambridge, UK.,Centre for Trophoblast Research (CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - D Stephen Charnock-Jones
- Department of Obstetrics and Gynaecology, University of Cambridge; NIHR Cambridge Biomedical Research Centre, Cambridge, UK.,Centre for Trophoblast Research (CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Debbie A Lawlor
- NIHR Bristol Biomedical Research Centre, Bristol, UK.,MRC Integrative Epidemiology Unit, at the University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Gordon C S Smith
- Department of Obstetrics and Gynaecology, University of Cambridge; NIHR Cambridge Biomedical Research Centre, Cambridge, UK.,Centre for Trophoblast Research (CTR), Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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179
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Snart CJP, Threapleton DE, Keeble C, Taylor E, Waiblinger D, Reid S, Alwan NA, Mason D, Azad R, Cade JE, Simpson NAB, Meadows S, McKillion A, Santorelli G, Waterman AH, Zimmermann M, Stewart PM, Wright J, Mon-Williams M, Greenwood DC, Hardie LJ. Maternal iodine status, intrauterine growth, birth outcomes and congenital anomalies in a UK birth cohort. BMC Med 2020; 18:132. [PMID: 32522280 PMCID: PMC7288513 DOI: 10.1186/s12916-020-01602-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/21/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Severe iodine insufficiency in pregnancy has significant consequences, but there is inadequate evidence to indicate what constitutes mild or moderate insufficiency, in terms of observed detrimental effects on pregnancy or birth outcomes. A limited number of studies have examined iodine status and birth outcomes, finding inconsistent evidence for specific outcomes. METHODS Maternal iodine status was estimated from spot urine samples collected at 26-28 weeks' gestation from 6971 mothers in the Born in Bradford birth cohort. Associations with outcomes were examined for both urinary iodine concentration (UIC) and iodine-to-creatinine ratio (I:Cr). Outcomes assessed included customised birthweight (primary outcome), birthweight, small for gestational age (SGA), low birthweight, head circumference and APGAR score. RESULTS There was a small positive association between I:Cr and birthweight in adjusted analyses. For a typical participant, the predicted birthweight centile at the 25th percentile of I:Cr (59 μg/g) was 2.7 percentage points lower than that at the 75th percentile of I:Cr (121 μg/g) (99% confidence interval (CI) 0.8 to 4.6), birthweight was predicted to be 41 g lower (99% CI 13 to 69) and the predicted probability of SGA was 1.9 percentage points higher (99% CI 0.0 to 3.7). There was no evidence of associations using UIC or other birth outcomes, including stillbirth, preterm birth, ultrasound growth measures or congenital anomalies. CONCLUSION Lower maternal iodine status was associated with lower birthweight and greater probability of SGA. Whilst small, the effect size for lower iodine on birthweight is comparable to environmental tobacco smoke exposure. Iodine insufficiency is avoidable, and strategies to avoid deficiency in women of reproductive age should be considered. TRIAL REGISTRATION ClinicalTrials.gov NCT03552341. Registered on June 11, 2018.
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Affiliation(s)
- Charles Jonathan Peter Snart
- Leeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Diane Erin Threapleton
- Leeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Claire Keeble
- Leeds Institute for Data Analytics, University of Leeds, Leeds, LS2 9JT, UK
| | - Elizabeth Taylor
- Leeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Stephen Reid
- Earth Surface Science Institute, School of Earth and Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Rafaq Azad
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | - Janet Elizabeth Cade
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Leeds, LS2 9JT, UK
| | - Nigel A B Simpson
- Division of Women's and Children's Health, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Sarah Meadows
- Elsie Widdowson Laboratory, University of Cambridge, Cambridge, CB1 9NL, UK.,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Clifford Allbutt Building, Hills Road, Cambridge, CB2 0AH, UK
| | - Amanda McKillion
- Elsie Widdowson Laboratory, University of Cambridge, Cambridge, CB1 9NL, UK.,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Clifford Allbutt Building, Hills Road, Cambridge, CB2 0AH, UK
| | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Michael Zimmermann
- Laboratory for Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, 8092, Zürich, Switzerland
| | - Paul M Stewart
- Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK
| | | | - Darren Charles Greenwood
- Leeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK. .,Leeds Institute for Data Analytics, University of Leeds, Leeds, LS2 9JT, UK.
| | - Laura J Hardie
- Leeds Institute of Cardiovascular & Metabolic Medicine, LIGHT Laboratories, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK.
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180
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Vrijheid M, Fossati S, Maitre L, Márquez S, Roumeliotaki T, Agier L, Andrusaityte S, Cadiou S, Casas M, de Castro M, Dedele A, Donaire-Gonzalez D, Grazuleviciene R, Haug LS, McEachan R, Meltzer HM, Papadopouplou E, Robinson O, Sakhi AK, Siroux V, Sunyer J, Schwarze PE, Tamayo-Uria I, Urquiza J, Vafeiadi M, Valentin A, Warembourg C, Wright J, Nieuwenhuijsen MJ, Thomsen C, Basagaña X, Slama R, Chatzi L. Early-Life Environmental Exposures and Childhood Obesity: An Exposome-Wide Approach. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:67009. [PMID: 32579081 PMCID: PMC7313401 DOI: 10.1289/ehp5975] [Citation(s) in RCA: 126] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND Chemical and nonchemical environmental exposures are increasingly suspected to influence the development of obesity, especially during early life, but studies mostly consider single exposure groups. OBJECTIVES Our study aimed to systematically assess the association between a wide array of early-life environmental exposures and childhood obesity, using an exposome-wide approach. METHODS The HELIX (Human Early Life Exposome) study measured child body mass index (BMI), waist circumference, skinfold thickness, and body fat mass in 1,301 children from six European birth cohorts age 6-11 y. We estimated 77 prenatal exposures and 96 childhood exposures (cross-sectionally), including indoor and outdoor air pollutants, built environment, green spaces, tobacco smoking, and biomarkers of chemical pollutants (persistent organic pollutants, metals, phthalates, phenols, and pesticides). We used an exposure-wide association study (ExWAS) to screen all exposure-outcome associations independently and used the deletion-substitution-addition (DSA) variable selection algorithm to build a final multiexposure model. RESULTS The prevalence of overweight and obesity combined was 28.8%. Maternal smoking was the only prenatal exposure variable associated with higher child BMI (z-score increase of 0.28, 95% confidence interval: 0.09, 0.48, for active vs. no smoking). For childhood exposures, the multiexposure model identified particulate and nitrogen dioxide air pollution inside the home, urine cotinine levels indicative of secondhand smoke exposure, and residence in more densely populated areas and in areas with fewer facilities to be associated with increased child BMI. Child blood levels of copper and cesium were associated with higher BMI, and levels of organochlorine pollutants, cobalt, and molybdenum were associated with lower BMI. Similar results were found for the other adiposity outcomes. DISCUSSION This first comprehensive and systematic analysis of many suspected environmental obesogens strengthens evidence for an association of smoking, air pollution exposure, and characteristics of the built environment with childhood obesity risk. Cross-sectional biomarker results may suffer from reverse causality bias, whereby obesity status influenced the biomarker concentration. https://doi.org/10.1289/EHP5975.
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Affiliation(s)
- Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Léa Maitre
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Sandra Márquez
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Lydiane Agier
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Solène Cadiou
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Maribel Casas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Audrius Dedele
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - David Donaire-Gonzalez
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | | | - Line S Haug
- Norwegian Institute of Public Health, Oslo, Norway
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | | | - Oliver Robinson
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | | | - Valerie Siroux
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Ibon Tamayo-Uria
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Division of Immunology and Immunotherapy, CIMA, Universidad de Navarra, and Instituto de Investigación Sanitaria de Navarra (IdISNA), Pamplona, Spain
| | - Jose Urquiza
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Antonia Valentin
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Charline Warembourg
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Rémy Slama
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Abstract
Context: Population-based cohort studies have been pivotal in establishing a number of nutrition-health interactions, especially in high-income settings. Less research is available from low- and middle-income countries due to the lack of detailed longitudinal data. Objective: To describe the use of prospectively collected longitudinal data from the rural West Kiang region of The Gambia to explore nutrition-health interactions in a rural sub-Saharan African context. Methods: Demographic records initiated in 1947, coupled with data on maternal and child health, have been used to explore nutrition-health relationships. Results: An analysis of the longitudinal demographic data demonstrated a highly significant association between season of birth and infection-related adult mortality in this context. Additionally, using routine data on childhood anthropometry, it has been shown that, despite a significant decline in child undernutrition, rates remain unacceptably high, likely reflecting the very high socio-economic threshold required to eliminate undernutrition. Conclusion: The foresight to establish demographic data collection over seventy years ago has supported a wealth of novel research within a traditional African context. The availability of detailed clinical records on maternal and child health is helping to unravel the factors driving child undernutrition in rural Africa, and to identify targets for interventions to improve health in this context.
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Affiliation(s)
- Sophie E Moore
- Department of Women & Children's Health, King's College, London, UK.,MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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182
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson C, McEachan R, Tolfrey K, Cale L, Richardson G, Fray M, Altunkaya J, Bandelow S, Jaicim NB, Barber SE. Sit–stand desks to reduce sedentary behaviour in 9- to 10-year-olds: the Stand Out in Class pilot cluster RCT. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background
Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. The school classroom represents an ideal setting for environmental change through the provision of sit–stand desks.
Objectives
The aim of this study was to undertake a pilot cluster randomised controlled trial of the introduction of sit–stand desks in primary school classrooms, to inform a definitive trial. Objectives included providing information on school and participant recruitment and retention, acceptability of the intervention, and outcome measures. A preliminary estimate of the intervention’s effectiveness on the proposed primary outcome (change in weekday sitting time) for inclusion in a definitive trial was calculated, along with a preliminary assessment of potential cost-effectiveness. A full process evaluation was also undertaken.
Design
A two-armed pilot cluster randomised controlled trial with economic and qualitative evaluations. Schools were randomised on a 1 : 1 basis to the intervention (n = 4) or control (n = 4) trial arms.
Setting
Primary schools in Bradford, West Yorkshire, UK.
Participants
Children in Year 5 (i.e. aged 9–10 years).
Intervention
Six sit–stand desks replaced three standard desks (sitting six children) in the intervention classrooms for 4.5 months. Teachers were encouraged to ensure that all pupils were exposed to the sit–stand desks for at least 1 hour per day, on average, using a rotation system. Schools assigned to the control arm continued with their usual practice.
Main outcome measures
Trial feasibility outcomes included school and participant recruitment and attrition, acceptability of the intervention, and acceptability of and compliance with the proposed outcome measures [including weekday sitting measured using activPAL™ (PAL Technologies Ltd, Glasgow, UK) accelerometers, physical activity, adiposity, blood pressure, cognitive function, musculoskeletal comfort, academic progress, engagement and behaviour].
Results
Thirty-three per cent of schools approached and 75% (n = 176) of eligible children took part. At the 7-month follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63% to 97%. A preliminary estimate of intervention effectiveness, from a weighted linear regression model (adjusting for baseline sitting time and wear time) revealed a mean difference in change in sitting of –30.6 minutes per day (95% confidence interval –56.42 to –4.84 minutes per day) between the intervention and control trial arms. The process evaluation revealed that the intervention, recruitment and evaluation procedures were acceptable to teachers and children, with the exception of minor issues around activPAL attachment. A preliminary within-trial economic analysis revealed no difference between intervention and control trial arms in health and education resource use or outcomes. Long-term modelling estimated an unadjusted incremental cost-effectiveness ratio of Stand Out in Class of £78,986 per quality-adjusted life-year gained.
Conclusion
This study has provided evidence of the acceptability and feasibility of the Stand Out in Class intervention and evaluation methods. Preliminary evidence suggests that the intervention may have a positive direction of effect on weekday sitting time, which warrants testing in a full cluster randomised controlled trial. Lessons learnt from this trial will inform the planning of a definitive trial.
Trial registration
Current Controlled Trials ISRCTN12915848.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 8. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte Edwardson
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Mike Fray
- Loughborough Design School, Loughborough University, Loughborough, UK
| | | | - Stephan Bandelow
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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183
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Cadiou S, Bustamante M, Agier L, Andrusaityte S, Basagaña X, Carracedo A, Chatzi L, Grazuleviciene R, Gonzalez JR, Gutzkow KB, Maitre L, Mason D, Millot F, Nieuwenhuijsen M, Papadopoulou E, Santorelli G, Saulnier PJ, Vives M, Wright J, Vrijheid M, Slama R. Using methylome data to inform exposome-health association studies: An application to the identification of environmental drivers of child body mass index. ENVIRONMENT INTERNATIONAL 2020; 138:105622. [PMID: 32179316 PMCID: PMC8713647 DOI: 10.1016/j.envint.2020.105622] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND The exposome is defined as encompassing all environmental exposures one undergoes from conception onwards. Challenges of the application of this concept to environmental-health association studies include a possibly high false-positive rate. OBJECTIVES We aimed to reduce the dimension of the exposome using information from DNA methylation as a way to more efficiently characterize the relation between exposome and child body mass index (BMI). METHODS Among 1,173 mother-child pairs from HELIX cohort, 216 exposures ("whole exposome") were characterized. BMI and DNA methylation from immune cells of peripheral blood were assessed in children at age 6-10 years. A priori reduction of the methylome to preselect BMI-relevant CpGs was performed using biological pathways. We then implemented a tailored Meet-in-the-Middle approach to identify from these CpGs candidate mediators in the exposome-BMI association, using univariate linear regression models corrected for multiple testing: this allowed to point out exposures most likely to be associated with BMI ("reduced exposome"). Associations of this reduced exposome with BMI were finally tested. The approach was compared to an agnostic exposome-wide association study (ExWAS) ignoring the methylome. RESULTS Among the 2284 preselected CpGs (0.6% of the assessed CpGs), 62 were associated with BMI. Four factors (3 postnatal and 1 prenatal) of the exposome were associated with at least one of these CpGs, among which postnatal blood level of copper and PFOS were directly associated with BMI, with respectively positive and negative estimated effects. The agnostic ExWAS identified 18 additional postnatal exposures, including many persistent pollutants, generally unexpectedly associated with decreased BMI. DISCUSSION Our approach incorporating a priori information identified fewer significant associations than an agnostic approach. We hypothesize that this smaller number corresponds to a higher specificity (and possibly lower sensitivity), compared to the agnostic approach. Indeed, the latter cannot distinguish causal relations from reverse causation, e.g. for persistent compounds stored in fat, whose circulating level is influenced by BMI.
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Affiliation(s)
- Solène Cadiou
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Mariona Bustamante
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Lydiane Agier
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Xavier Basagaña
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Angel Carracedo
- Fundación Pública Galega de Medicina Xenómica (SERGAS), IDIS, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), CIMUS, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | | | - Juan R Gonzalez
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Léa Maitre
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Frédéric Millot
- CHU Poitiers, Clinical Investigation Centre, CIC 1402, Poitiers, France; Poitiers University, Clinical Investigation Centre CIC 1402, Poitiers, France
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Pierre-Jean Saulnier
- CHU Poitiers, Clinical Investigation Centre, CIC 1402, Poitiers, France; Poitiers University, Clinical Investigation Centre CIC 1402, Poitiers, France; INSERM, CIC 1402, F-86000 Poitiers, France; CHU Poitiers, Endocrinology, Diabetology, Nutrition Service, Poitiers, France
| | - Marta Vives
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Martine Vrijheid
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Rémy Slama
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France.
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184
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Clemes SA, Bingham DD, Pearson N, Chen YL, Edwardson CL, McEachan RRC, Tolfrey K, Cale L, Richardson G, Fray M, Altunkaya J, Bandelow S, Jaicim NB, Salmon J, Dunstan DW, Barber SE. Stand Out in Class: restructuring the classroom environment to reduce sitting time - findings from a pilot cluster randomised controlled trial. Int J Behav Nutr Phys Act 2020; 17:55. [PMID: 32349761 PMCID: PMC7189432 DOI: 10.1186/s12966-020-00958-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/15/2020] [Indexed: 12/01/2022] Open
Abstract
Background Excessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children’s sitting time. The primary aim of this study was to examine the feasibility of conducting a cluster randomised controlled trial (RCT) of a sit-stand desk intervention within primary school classrooms. Methods We conducted a two-armed pilot cluster RCT involving 8 primary schools in Bradford, United Kingdom. Schools were randomised on a 1:1 basis to the intervention or usual practice control arm. All children (aged 9–10 years) in participating classes were eligible to take part. Six sit-stand desks replaced three standard desks (sitting 6 children) in the intervention classrooms for 4.5-months. Teachers were encouraged to use a rotation system to ensure all pupils were exposed to the sit-stand desks for > 1 h/day on average. Trial feasibility outcomes (assessed using quantitative and qualitative measures) included school and participant recruitment and attrition, intervention and outcome measure completion rates, acceptability, and preliminary effectiveness of the intervention for reducing sitting time. A weighted linear regression model compared changes in weekday sitting time (assessed using the activPAL accelerometer) between trial arms. Results School and child recruitment rates were 33% (n = 8) and 75% (n = 176). At follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63 to 97%. A preliminary estimate of intervention effectiveness revealed a mean difference in change in sitting of − 30.6 min/day (95% CI: − 56.42 to − 4.84) in favour of the intervention group, after adjusting for baseline sitting and wear time. Qualitative measures revealed the intervention and evaluation procedures were acceptable to teachers and children, except for some problems with activPAL attachment. Conclusion This study provides evidence of the acceptability and feasibility of a sit-stand desk intervention and evaluation methods. Preliminary evidence suggests the intervention showed potential in reducing children’s weekday sitting but some adaptations to the desk rotation system are needed to maximize exposure. Lessons learnt from this trial will inform the planning of a definitive trial. Trial registration ISRCTN12915848 (registered: 09/11/16).
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Affiliation(s)
- Stacy A Clemes
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. .,NIHR Leicester Biomedical Research Centre, Leicester, UK.
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Natalie Pearson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yu-Ling Chen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte L Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester, UK.,Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - Keith Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Lorraine Cale
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gerry Richardson
- Centre for Health Economics, University of York, Heslington, York, UK
| | - Mike Fray
- Loughborough Design School, Loughborough University, Loughborough, UK
| | - James Altunkaya
- Centre for Health Economics, University of York, Heslington, York, UK
| | - Stephan Bandelow
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Department of Physiology, Neuroscience and Behavioral Sciences, St. George's University, West Indies, Grenada
| | | | - Jo Salmon
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
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185
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Uphoff EP, Small N, Pickett KE. Using Birth Cohort Data to Assess the Impact of the UK 2008-2010 Economic Recession on Smoking During Pregnancy. Nicotine Tob Res 2020; 21:1021-1026. [PMID: 29741730 DOI: 10.1093/ntr/nty083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 05/07/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Despite the well-known link between stress and smoking, evidence for associations between economic recession, financial stress, and smoking is contradictory. In this study, we assess whether women were more likely to continue smoking during pregnancy if they were exposed to the UK 2008-2010 economic recession during pregnancy than those who were unexposed, and whether this relationship is mediated by financial stress. METHODS We used cross-sectional data on 2775 pregnant women who were regular smokers before pregnancy and who were enrolled in the UK Born in Bradford cohort study between March 2007 and December 2010. The cutoff date for exposure to recession was set as August 1, 2008, based on local and national economic data. Multivariable logistic regression analysis included potential confounders: maternal age, parity, cohabitation, ethnicity, and maternal age. The mediating role of financial stress was analyzed using "worse off financially" and a "difficult financial situation" as indicators of financial stress in Sobel-Goodman mediation tests with bootstrap resampling. RESULTS After taking into account potential confounders, exposure to recession was associated with continued smoking during pregnancy (OR = 1.19, 95% CI = 1.01 to 1.41, p = 0.03). A worse financial situation and a difficult financial situation were identified as mediators, explaining 8.4% and 17.6%, respectively, of the relationship between exposure to recession and smoking during pregnancy. CONCLUSIONS Smoking during pregnancy is associated with exposure to the UK 2008-2010 economic recession during pregnancy, and this relationship is partly mediated by financial stress. IMPLICATIONS Health inequalities in smoking during pregnancy are affected by economic recession, as those who are most likely to smoke are also most likely to experience the financial stress resulting from economic recession. Socioeconomic conditions at the societal and individual level are important targets when aiming to reduce rates of smoking during pregnancy.
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Affiliation(s)
- Eleonora P Uphoff
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford, UK.,Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, UK
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Kate E Pickett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, UK
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186
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Evans DM, Moen GH, Hwang LD, Lawlor DA, Warrington NM. Elucidating the role of maternal environmental exposures on offspring health and disease using two-sample Mendelian randomization. Int J Epidemiol 2020; 48:861-875. [PMID: 30815700 PMCID: PMC6659380 DOI: 10.1093/ije/dyz019] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is considerable interest in estimating the causal effect of a range of maternal environmental exposures on offspring health-related outcomes. Previous attempts to do this using Mendelian randomization methodologies have been hampered by the paucity of epidemiological cohorts with large numbers of genotyped mother-offspring pairs. METHODS We describe a new statistical model that we have created which can be used to estimate the effect of maternal genotypes on offspring outcomes conditional on offspring genotype, using both individual-level and summary-results data, even when the extent of sample overlap is unknown. RESULTS We describe how the estimates obtained from our method can subsequently be used in large-scale two-sample Mendelian randomization studies to investigate the causal effect of maternal environmental exposures on offspring outcomes. This includes studies that aim to assess the causal effect of in utero exposures related to fetal growth restriction on future risk of disease in offspring. We illustrate our framework using examples related to offspring birthweight and cardiometabolic disease, although the general principles we espouse are relevant for many other offspring phenotypes. CONCLUSIONS We advocate for the establishment of large-scale international genetics consortia that are focused on the identification of maternal genetic effects and committed to the public sharing of genome-wide summary-results data from such efforts. This information will facilitate the application of powerful two-sample Mendelian randomization studies of maternal exposures and offspring outcomes.
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Affiliation(s)
- David M Evans
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia.,Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gunn-Helen Moen
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Liang-Dar Hwang
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
| | - Debbie A Lawlor
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - Nicole M Warrington
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
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187
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Osorio-Yáñez C, Clemente DBP, Maitre L, Vives-Usano M, Bustamante M, Martinez D, Casas M, Alexander J, Thomsen C, Chatzi L, Gützkow KB, Grazuleviciene R, Martens DS, Plusquin M, Slama R, McEachan RC, Wright J, Yang TC, Urquiza J, Tamayo I, Sunyer J, Vafeiadi M, Nawrot TS, Vrijheid M. Early life tobacco exposure and children's telomere length: The HELIX project. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 711:135028. [PMID: 32000334 DOI: 10.1016/j.scitotenv.2019.135028] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
Telomere length and mitochondrial DNA content are considered biomarkers of cellular aging, oxidative stress, and inflammation, but there is almost no information on their association with tobacco smoke exposure in fetal and early life. The aim of this study was to assess whether prenatal and childhood tobacco exposure were associated with leukocyte telomere length (LTL) and mitochondrial DNA (mtDNA) content in children. As part of a multi-centre European birth cohort study HELIX (Human Early-Life Exposome) (n = 1396) we assessed maternal smoking status during pregnancy through questionnaires, and through urinary cotinine levels that were then used to classify women as not exposed to smoking (<10 µg/L), exposed to secondhand smoke (SHS) (10-50 µg/L) and active smokers (>50 µg/L). When the children were around 8 years of age (range: 5.4-12.0 years), childhood SHS tobacco smoke exposure was assessed through an extensive questionnaire and through measurements of urinary cotinine (<3.03 µg/L non-detected, >3.03 µg/L detected). Leukocyte mtDNA content and LTL were measured in the children at 8 years employing real time polymerase chain reaction (qPCR). Effect estimates were calculated using multivariate linear regression models for prenatal and childhood exposures adjusted for potential confounders. Maternal cotinine levels indicative of SHS exposure during pregnancy were associated with a decrease of 3.90% in LTL in children (95% CI: -6.68, -0.91), compared with non-smoking, whereas the association for maternal cotinine levels indicative of active smoking did not reach statistical significance (-3.24%; 95% CI: -6.59, 0.21). Childhood SHS tobacco exposure was not associated with LTL in children. Global SHS exposure during childhood was associated with an increase of 3.51% (95% CI: 0.78, 6.27) in mtDNA content. Our findings suggest that tobacco smoke exposure during pregnancy, even at SHS levels, may accelerate telomere shortening in children and thus induce biological aging from an early age.
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Affiliation(s)
- Citlalli Osorio-Yáñez
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), México DF, Mexico
| | - Diana B P Clemente
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Center for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Lea Maitre
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Martha Vives-Usano
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Mariona Bustamante
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - David Martinez
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Maribel Casas
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | | | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | | | - Dries S Martens
- Center for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Michelle Plusquin
- Center for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Remy Slama
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, CNRS, Grenoble, France
| | - Rosemary C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Tiffany C Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Jose Urquiza
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ibon Tamayo
- ISGlobal, Institute for Global Health, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, MA, USA
| | - Jordi Sunyer
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Tim S Nawrot
- Center for Environmental Sciences, Hasselt University, Hasselt, Belgium; Department of Public Health & Primary Care, Unit Environment & Health, Leuven University, Leuven, Belgium
| | - Martine Vrijheid
- ISGlobal, Institute for Global Health, Barcelona, Spain; Univeristat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
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188
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Kirby N, Wright B, Allgar V. Child mental health and resilience in the context of socioeconomic disadvantage: results from the Born in Bradford cohort study. Eur Child Adolesc Psychiatry 2020; 29:467-477. [PMID: 31243580 PMCID: PMC7103573 DOI: 10.1007/s00787-019-01348-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/03/2019] [Indexed: 01/05/2023]
Abstract
Socioeconomic disadvantage has been linked to mental health difficulties in children and adolescents, although many children appear to do well despite exposure to financial adversity in childhood. Our study looked at the effects of family financial difficulty on children's mental health outcomes (n = 636) at 4-5 years in a multi-ethnic UK cohort, the Born in Bradford cohort. We considered potential parent and child variables promoting resilience in this population. Univariate linear regression was used to identify associations between family financial difficulty measured antenatally and child mental health difficulties measured by teacher-rated Strengths and Difficulties (SDQ) scores at 4-5 years. Hierarchical multivariate regression was used to test for potential moderating effects of parent and child factors. Mothers completed the General Health Questionnaire-28, Kessler-6 Questionnaire and questions related to parenting warmth, hostility and confidence. Parent-rated Infant Characteristic Questionnaires and teacher-rated Early Years Foundation Stage scores provided information on child temperament, literacy and physical development as potential moderators. Financial difficulty was associated with worse mental health outcomes in children. High parent warmth, high child literacy scores and physical development scores were all associated with positive child mental health outcomes at 4-5 years. In terms of protective effects, only maternal warmth was found to significantly moderate the relationship between financial difficulty and child mental health difficulties. The current study demonstrates that family financial difficulty is associated with poorer child mental health outcomes in a UK cohort of mothers and their school-aged children. It provides evidence of the positive relationships between warm parenting, child literacy and child physical development with mental health in young children. The study supports the finding that warm parenting moderates the relationship between family financial difficulty and interventions supporting this aspect of parenting may therefore provide particular benefit to children growing up in this context.
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Affiliation(s)
- Natalie Kirby
- Hull York Medical School, University of York, York, UK.
- Tees Esk and Wear Valleys Foundation Trust, York, UK.
| | - Barry Wright
- Hull York Medical School, University of York, York, UK
- Leeds and York Partnership Foundation Trust, York, UK
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189
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Shire K, Andrews E, Barber S, Bruce A, Corkett J, Hill LJB, Kelly B, McEachan R, Mon-Williams M, Tracey L, Waterman AH, Wright J. Starting School: a large-scale start of school assessment within the ‘Born in Bradford’ longitudinal cohort. Wellcome Open Res 2020. [DOI: 10.12688/wellcomeopenres.15610.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Born in Bradford (BiB) cohort of 13,776 children born between 2007-2011 and their parents provides a rich data resource for researchers exploring protective and risk factors influencing long-term developmental and health outcomes. Educational attainment is a critical factor related to later health. Literacy and communication, fine motor skills and social and emotional health are key ‘early’ predictors of educational attainment and can be used to identify children in need of additional support. We describe our BiB ‘Starting School’ data collection protocol which assessed literacy and communication, fine motor skills and social and emotional health on 3,444 BiB children aged 4-5 years old. These measures supplement the existing dataset, and complement the routine educational, health and social care data available for the cohort.
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190
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A maternal serum metabolite ratio predicts fetal growth restriction at term. Nat Med 2020; 26:348-353. [PMID: 32161413 DOI: 10.1038/s41591-020-0804-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 01/30/2020] [Indexed: 11/08/2022]
Abstract
Fetal growth restriction (FGR) is the major single cause of stillbirth1 and is also associated with neonatal morbidity and mortality2,3, impaired health and educational achievement in childhood4,5 and with a range of diseases in later life6. Effective screening and intervention for FGR is an unmet clinical need. Here, we performed ultrahigh performance liquid chromatography-tandem mass spectroscopy (UPLC-MS/MS) metabolomics on maternal serum at 12, 20 and 28 weeks of gestational age (wkGA) using 175 cases of term FGR and 299 controls from the Pregnancy Outcome Prediction (POP) study, conducted in Cambridge, UK, to identify predictive metabolites. Internal validation using 36 wkGA samples demonstrated that a ratio of the products of the relative concentrations of two positively associated metabolites (1-(1-enyl-stearoyl)-2-oleoyl-GPC (P-18:0/18:1) and 1,5-anhydroglucitol) to the product of the relative concentrations of two negatively associated metabolites (5α-androstan-3α,17α-diol disulfate and N1,N12-diacetylspermine) predicted FGR at term. The ratio had approximately double the discrimination as compared to a previously developed angiogenic biomarker7, the soluble fms-like tyrosine kinase 1:placental growth factor (sFLT1:PlGF) ratio (AUC 0.78 versus 0.64, P = 0.0001). We validated the predictive performance of the metabolite ratio in two sub-samples of a demographically dissimilar cohort, Born in Bradford (BiB), conducted in Bradford, UK (P = 0.0002). Screening and intervention using this metabolite ratio in conjunction with ultrasonic imaging at around 36 wkGA could plausibly prevent adverse events through enhanced fetal monitoring and targeted induction of labor.
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191
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Collings PJ, Farrar D, Gibson J, West J, Barber SE, Wright J. Associations of Pregnancy Physical Activity with Maternal Cardiometabolic Health, Neonatal Delivery Outcomes and Body Composition in a Biethnic Cohort of 7305 Mother-Child Pairs: The Born in Bradford Study. Sports Med 2020; 50:615-628. [PMID: 31559566 PMCID: PMC7018786 DOI: 10.1007/s40279-019-01193-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Physical activity is advocated for a range of benefits to the uncomplicated pregnancy. We investigated associations of mid-pregnancy physical activity with maternal and neonatal health in white British and Pakistani-origin women from a deprived urban setting. METHODS The study was performed in 6921 pregnant women (53% Pakistani-origin) who contributed data for 7305 singleton births. At 26-28 weeks gestation, women were grouped into four activity levels (inactive/somewhat active/moderately active/active) based on their self-reported physical activity. Linear regression with robust standard errors was used to calculate adjusted mean differences in health markers between the four groups of physical activity (reference group: inactive). RESULTS Three-quarters (74%) of Pakistani-origin women and 39% of white British women were inactive. Trend-tests revealed that more active white British women tended to be less adipose, had lower fasting and postload glucose levels, lower triglyceride concentrations, and their babies were less adipose (smaller triceps and subscapular skinfolds) than less active white British women. Somewhat active Pakistani-origin women exhibited lower triglyceride concentrations and systolic blood pressure, higher high-density lipoprotein cholesterol levels, and their babies were less adipose (smaller mid-upper arm and abdominal circumferences; lower cord-blood leptin concentration) compared to inactive Pakistani-origin women. No associations were observed for gestational age or birth weight. CONCLUSIONS Physical activity performed mid-pregnancy was beneficially associated with maternal cardiometabolic health and neonatal adiposity, without influencing gestational age or birth weight. Associations were dose-dependent in white British women, and even a small amount of mid-pregnancy physical activity appeared to benefit some health markers in Pakistani-origin women.
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Affiliation(s)
- Paul J Collings
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
- Department of Health Sciences, University of York, York, UK.
| | - Diane Farrar
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Joanna Gibson
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Jane West
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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192
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Paediatric emergency department utilisation rates and maternal migration status in the Born in Bradford cohort: A cross-sectional study. PLoS Med 2020; 17:e1003043. [PMID: 32126079 PMCID: PMC7053707 DOI: 10.1371/journal.pmed.1003043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/29/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Globally, international migration is increasing. Population growth, along with other demographic changes, may be expected to put new pressures on healthcare systems. Some studies across Europe suggest that emergency departments (EDs) are used more, and differently, by migrants compared to non-migrant populations, which may be a result of unfamiliarity with the healthcare systems and difficulties accessing primary healthcare. However, little evidence exists to understand how migrant parents, who are typically young and of childbearing age, utilise EDs for their children. This study aimed to examine the association between paediatric ED utilisation in the first 5 years of life and maternal migration status in the Born in Bradford (BiB) cohort study. METHODS AND FINDINGS We analysed linked data from the BiB study-an ongoing, multi-ethnic prospective birth cohort study in Bradford. Bradford is a large, ethnically diverse city in the north of England. In 2017, more than a third of births in Bradford were to mothers who were born outside the UK. Between March 2007 and December 2010, pregnant women were recruited to BiB during routine antenatal care, and the children born to these mothers have been, and continue to be, followed over time to assess how social, genetic, environmental, and behavioural factors impact on health from childhood to adulthood. Data analysed in this study included baseline questionnaire data from BiB mothers, and Bradford Royal Infirmary ED episode data for their children. Main outcomes were likelihood of paediatric ED use (no visits versus at least 1 ED visit in the first 5 years of life) and ED utilisation rates (number and frequency of ED visits) for children who have accessed the ED. The main explanatory variable was mother's migrant status (foreign-born versus UK/Irish-born). Multivariable analyses (logistic and zero-truncated negative binomial regression) were conducted adjusting for socio-demographic and socio-economic factors. The final dataset included 10,168 children born between April 2007 and June 2011, of whom 35.6% were born to migrant mothers. Foreign-born mothers originated from South Asia (28.6%), Europe/Central Asia (3.2%), Africa (2.1%), East Asia/Pacific (1.1%), and the Middle East (0.6%). At recruitment the mothers ranged in age from 15 to 49 years old. Overall, 3,104 (30.5%) children had at least 1 ED visit in the first 5 years of life, with the highest proportion of visits being in the first year of life (36.7%). The proportion of children who visited the ED at least once was lower for children of migrant mothers as compared to children of non-migrant mothers (29.4% versus 31.2%). Children of migrant mothers were found to be less likely to visit the ED (odds ratio 0.88 [95% CI 0.80 to 0.97], p = 0.012). However, among children who visited the ED, the utilisation rate was significantly higher for children of migrant mothers (incidence rate ratio [IRR] 1.19 [95% CI 1.01 to 1.40], p = 0.040). Utilisation rates were higher for children born to mothers from Europe (IRR 1.71 [95% CI 1.07 to 2.71], p = 0.024) and established migrants (≥5 years living in UK) (IRR 1.24 [95% CI 1.02 to 1.51], p = 0.032) compared to UK/Irish-born mothers. Important limitations include being unable to measure children's underlying health status and the urgency of ED attendance, as well as the analysis being limited by missing data. CONCLUSIONS In this study we observed that there is no higher likelihood of first paediatric ED attendance in the first 5 years of life for children in the BiB cohort for migrant mothers. However, among ED users, children of migrant mothers attend the service more frequently than children of UK/Irish-born mothers. Our findings show that patterns of ED utilisation differ by mother's region of origin and time since arrival in the UK.
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193
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Fuertes E, Sunyer J, Gehring U, Porta D, Forastiere F, Cesaroni G, Vrijheid M, Guxens M, Annesi-Maesano I, Slama R, Maier D, Kogevinas M, Bousquet J, Chatzi L, Lertxundi A, Basterrechea M, Esplugues A, Ferrero A, Wright J, Mason D, McEachan R, Garcia-Aymerich J, Jacquemin B. Associations between air pollution and pediatric eczema, rhinoconjunctivitis and asthma: A meta-analysis of European birth cohorts. ENVIRONMENT INTERNATIONAL 2020; 136:105474. [PMID: 31962272 DOI: 10.1016/j.envint.2020.105474] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/20/2019] [Accepted: 01/06/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Uncertainly continues to exist regarding the role of air pollution on pediatric asthma and allergic conditions, especially as air pollution levels have started to decrease in recent decades. OBJECTIVE We examined associations of long-term air pollution levels at the home address with pediatric eczema, rhinoconjunctivitis and asthma prevalences in five birth cohorts (BIB, EDEN, GASPII, RHEA and INMA) from seven areas in five European countries. METHODS Current eczema, rhinoconjunctivitis and asthma were assessed in children aged four (N = 6527) and eight years (N = 2489). A multi-morbidity outcome (≥2 conditions versus none) was also defined. Individual outdoor levels of nitrogen dioxide (NO2), nitrogen oxides, mass of particulate matter with an aerodynamic diameter <10 μm (PM10), 10-2.5 μm (PMcoarse) and <2.5 μm (PM2.5), and PM2.5 absorbance were assigned to the birth, four- and eight-year home addresses using highly defined spatial air pollution exposure models. Cohort-specific cross-sectional associations were assessed using logistic regression models adjusted for demographic and environmental covariates and combined in a random effects meta-analysis. RESULTS The overall prevalence of pediatric eczema, rhinoconjunctivitis and asthma at four years was 15.4%, 5.9% and 12.4%. We found no increase in the prevalence of these outcomes at four or eight years with increasing air pollution exposure. For example, the meta-analysis adjusted odds ratios (95% confidence intervals) for eczema, rhinoconjunctivitis and asthma at four years were 0.94 (0.81, 1.09), 0.90 (0.75, 1.09), and 0.91 (0.74, 1.11), respectively, per 10 μg/m3 increase in NO2 at the birth address, and 1.00 (0.81, 1.23), 0.70 (0.49, 1.00) and 0.88 (0.54, 1.45), respectively, per 5 μg/m3 increase in PM2.5 at the birth address. DISCUSSION In this large meta-analysis of five birth cohorts, we found no indication of adverse effects of long-term air pollution exposure on the prevalence of current pediatric eczema, rhinoconjunctivitis or asthma.
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Affiliation(s)
- Elaine Fuertes
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Daniela Porta
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Isabella Annesi-Maesano
- Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Paris, France
| | - Rémy Slama
- Institute for Advanced Biosciences (IAB), INSERM U1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France
| | | | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Jean Bousquet
- Hopital Arnaud de Villeneuve University Hospital and Inserm, Montpellier, France
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Aitana Lertxundi
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Preventive Medicine and Public Health Department, University of Basque Country (UPV/EHU), Spain; Health Research Institute-BIODONOSTIA, Basque Country, Spain
| | - Mikel Basterrechea
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Health Research Institute-BIODONOSTIA, Basque Country, Spain; Public Health Division of Gipuzkoa, San Sebastián, Spain
| | - Ana Esplugues
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, 46020 València, Spain; Faculty of Nursing, University of Valencia, València, Spain
| | - Amparo Ferrero
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, 46020 València, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Dan Mason
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Rosie McEachan
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Bénédicte Jacquemin
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France; Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; Université Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
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194
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Mallicoat B, P Uphoff E, E Pickett K. Estimating Social Gradients in Health for UK Mothers and Infants of Pakistani Origin: Do Latent Class Measures of Socioeconomic Position Help? J Immigr Minor Health 2020; 22:1255-1264. [PMID: 32100223 DOI: 10.1007/s10903-020-00977-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The social gradients in health typically seen in the whole UK population are attenuated/non-existent in some minority ethnic groups. This study aims to compare latent class measures to conventional measures of socioeconomic position (SEP) in the estimation of social gradients in health for women and infants of Pakistani origin in the Born in Bradford cohort. We compare social gradients in birth outcomes, smoking during pregnancy, and maternal mental health using various measures of SEP (including latent class analysis groups) with multivariate regression models. Social gradients in maternal mental health and low birth weight were more clearly defined than before. Otherwise, the latent class SEP variables did not reveal social gradients in health that were not obvious before. This study adds to the evidence that there are weak, if any, social gradients in maternal and child health among UK women and infants of Pakistani origin when measured with these SEP variables.
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Affiliation(s)
- Benjamin Mallicoat
- College of Medicine, University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN, 38163, USA.
| | - Eleonora P Uphoff
- Department of Health Sciences, University of York, York, YO10 5DD, USA
| | - Kate E Pickett
- Department of Health Sciences, University of York, York, YO10 5DD, USA
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195
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Maternal Physical Activity and Neonatal Cord Blood Lipid Levels: Findings From a Prospective Pregnancy Cohort. J Phys Act Health 2020; 17:236-241. [PMID: 31945742 DOI: 10.1123/jpah.2019-0550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 11/25/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Physical activity performed while pregnant is beneficially associated with maternal cardiovascular health. It is unknown if benefits extend to neonatal cardiovascular health. This study investigated associations of maternal physical activity with neonatal cord blood lipid and lipoprotein concentrations. METHODS Cord blood lipids were measured at birth in a pseudorandomly selected subgroup of Born in Bradford birth cohort participants (N = 1634). Pregnant women were grouped into 4 activity categories (inactive/somewhat active/moderately active/active) based on their self-reported physical activity at 26- to 28-weeks gestation. Regression was used to calculate adjusted mean differences in neonatal cord blood lipid concentrations among the 4 groups of physical activity. RESULTS Maternal physical activity was associated with higher neonatal cord blood high-density lipoprotein cholesterol. Cord blood high-density lipoprotein cholesterol was higher in neonates of women who were somewhat and moderately active compared with neonates of women who were inactive. There were no associations of pregnancy physical activity with triglycerides, low-density lipoprotein, very low-density lipoprotein cholesterol, or adiponectin levels. CONCLUSIONS Maternal physical activity is favorably associated with neonatal cord blood high-density lipoprotein cholesterol levels. This novel beneficial finding highlights the potential for physical activity in pregnancy to aid the early prevention of cardiovascular disease.
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196
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Pettinger KJ, Kelly B, Sheldon TA, Mon-Williams M, Wright J, Hill LJB. Starting school: educational development as a function of age of entry and prematurity. Arch Dis Child 2020; 105:160-165. [PMID: 31409594 PMCID: PMC7025727 DOI: 10.1136/archdischild-2019-317124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/16/2019] [Accepted: 06/24/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To estimate the impact on early development of prematurity and summer birth and the potential 'double disadvantage' created by starting school a year earlier than anticipated during pregnancy, due to being born preterm. DESIGN, SETTING AND PATIENTS We investigated the impact of gestational and school-entry age on the likelihood of failing to achieve a 'Good Level of Development' (GLD) on the Early Years Foundation Stage Profile in 5-year-old children born moderate-to-late preterm using data from the Born in Bradford longitudinal birth cohort. We used hierarchical logistic regression to control for chronological maturity, and perinatal and socioeconomic factors. RESULTS Gestational age and school-entry age were significant predictors of attaining a GLD in the 10 337 children who entered school in the correct academic year given their estimated date of delivery. The odds of not attaining a GLD increased by 1.09 (95% CI 1.06 to 1.11) for each successive week born early and by 1.17 for each month younger within the year group (95% CI 1.16 to 1.18). There was no interaction between these two effects. Children starting school a year earlier than anticipated during pregnancy were less likely to achieve a GLD compared with (1) other children born preterm (fully adjusted OR 5.51 (2.85-14.25)); (2) term summer births (3.02 (1.49-6.79)); and (3) preterm summer births who remained within their anticipated school-entry year (3.64 (1.27-11.48)). CONCLUSIONS These results confirm the developmental risks faced by children born moderate-to-late preterm, and-for the first time-illustrate the increased risk associated with 'double disadvantage'.
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Affiliation(s)
| | - Brian Kelly
- Bradford Institute for Health Research, Bradford, UK
| | - Trevor A Sheldon
- Bradford Institute for Health Research, Bradford, UK,Department of Health Sciences, University of York, York, UK
| | - Mark Mon-Williams
- Bradford Institute for Health Research, Bradford, UK,School of Psychology, University of Leeds, Leeds, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford, UK
| | - Liam J B Hill
- Bradford Institute for Health Research, Bradford, UK,School of Psychology, University of Leeds, Leeds, UK
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Collings PJ, Dogra SA, Costa S, Bingham DD, Barber SE. Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors. BMC Public Health 2020; 20:109. [PMID: 31992249 PMCID: PMC6986109 DOI: 10.1186/s12889-019-8132-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/30/2019] [Indexed: 12/26/2022] Open
Abstract
Background Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location. Methods This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3181 valid days of triaxial accelerometry (Actigraph GT3X+). Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 min of total physical activity including ≥60 min moderate-to-vigorous physical activity (MVPA) per day). Results There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher on weekends compared to weekdays. In South Asian children, sedentary time was lower on weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys. Conclusions Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels. Trial registration The Pre-schoolers in the Playground (PiP) pilot randomized controlled trial is registered with the ISRCTN (ISRCTN54165860; http://www.isrctn.com).
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Affiliation(s)
- Paul J Collings
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. .,Department of Health Sciences, University of York, York, UK.
| | - Sufyan A Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Silvia Costa
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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198
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McEachan RRC, Dickerson J, Bridges S, Bryant M, Cartwright C, Islam S, Lockyer B, Rahman A, Sheard L, West J, Lawlor DA, Sheldon TA, Wright J, Pickett KE. The Born in Bradford COVID-19 Research Study: Protocol for an adaptive mixed methods research study to gather actionable intelligence on the impact of COVID-19 on health inequalities amongst families living in Bradford. Wellcome Open Res 2020; 5:191. [PMID: 33029561 PMCID: PMC7523536 DOI: 10.12688/wellcomeopenres.16129.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/20/2022] Open
Abstract
The UK COVID-19 lockdown has included restricting social movement and interaction to slow the spread of disease and reduce demand on NHS acute services. It is likely that the impacts of restrictions will hit the least advantaged disproportionately and will worsen existing structural inequalities amongst deprived and ethnic minority groups. The aim of this study is to deliver rapid intelligence to enable an effective COVID-19 response, including co-production of interventions, that address key issues in the City of Bradford, UK, and nationally. In the longer term we aim to understand the impacts of the response on health trajectories and inequalities in these. In this paper we describe our approach and protocol. We plan an adaptive longitudinal mixed methods approach embedded with Born in Bradford (BiB) birth cohorts which have rich existing data (including questionnaire, routine health and biobank). All work packages (WP) interact and are ongoing. WP1 uses co-production and engagement methods with communities, decision-makers and researchers to continuously set (changing) research priorities and will, longer-term, co-produce interventions to aid the City's recovery. In WP2 repeated quantitative surveys will be administered during lockdown (April-June 2020), with three repeat surveys until 12 months post-lockdown with an ethnically diverse pool of BiB participants (parents, children aged 9-13 years, pregnant women: total sample pool N=7,652, N=5,154, N=1,800). A range of health, social, economic and education outcomes will be assessed. In WP3 priority topics identified in WP1 and WP2 will be explored qualitatively. Initial priority topics include children's mental wellbeing, health beliefs and the peri/post-natal period. Feedback loops will ensure findings are fed directly to decision-makers and communities (via WP1) to enable co-production of acceptable interventions and identify future priority topic areas. Findings will be used to aid development of local and national policy to support recovery from the pandemic and minimise health inequalities.
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Affiliation(s)
- Rosemary R C McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Josie Dickerson
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Sally Bridges
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Maria Bryant
- Leeds Clinical Trials Research Unit, University of Leeds, Leeds, LS2 9JT, UK
- Department of Health Sciences, University of York, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK
- Hull York Medical School, University of York, Heslington, YO10 5DD, UK
| | - Christopher Cartwright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Shahid Islam
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Bridget Lockyer
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Aamnah Rahman
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Laura Sheard
- Department of Health Sciences, University of York, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK
| | - Jane West
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Deborah A Lawlor
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Trevor A Sheldon
- Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Kate E Pickett
- Department of Health Sciences, University of York, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK
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199
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Population reference and healthy standard blood pressure range charts in pregnancy: findings from the Born in Bradford cohort study. Sci Rep 2019; 9:18847. [PMID: 31827184 PMCID: PMC6906473 DOI: 10.1038/s41598-019-55324-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/25/2019] [Indexed: 01/01/2023] Open
Abstract
Women who develop gestational hypertension are at increased risk of adverse perinatal and longer-term outcomes. Reference charts may aid early detection of raised blood pressure (BP) and in doing so reduce adverse outcome risk. We used repeated BP measurements to produce ‘reference’ (whole population) and ‘standard’ (healthy pregnancies only) gestational-age-specific BP charts for all pregnant women (irrespective of ethnicity) and for White British (WB) and Pakistani (P) women. We included 9218 women recruited to the Born in Bradford study with 74,770 BPs. 19% of the whole population, 11% and 25% of WB and P women respectively were defined as healthy pregnancies. For reference and standard charts, for all women and each ethnic group, SBP/DBP at 12 and 20 weeks gestation was similar before rising at 37 weeks. DBP/SBP of reference charts for all women and for each ethnic group were higher than those of the corresponding standard charts. Compared to WB, P women had lower SBP/DBP at 12, 20 and 37 weeks gestation. To conclude; maternal population BP reference charts are higher compared to standard charts (healthy pregnancies) and are influenced by ethnicity.
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200
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Clemente DBP, Maitre L, Bustamante M, Chatzi L, Roumeliotaki T, Fossati S, Grazuleviciene R, Gützkow KB, Lepeule J, Martens DS, McEachan RRC, Meltzer HM, Petraviciene I, Slama R, Tamayo-Uria I, Urquiza J, Vafeiadi M, Wright J, Nawrot TS, Vrijheid M. Obesity is associated with shorter telomeres in 8 year-old children. Sci Rep 2019; 9:18739. [PMID: 31822763 PMCID: PMC6904465 DOI: 10.1038/s41598-019-55283-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 11/21/2019] [Indexed: 11/16/2022] Open
Abstract
Telomere length is considered a biomarker of biological aging. Shorter telomeres and obesity have both been associated with age-related diseases. To evaluate the association between various indices of obesity with leukocyte telomere length (LTL) in childhood, data from 1,396 mother-child pairs of the multi-centre European birth cohort study HELIX were used. Maternal pre-pregnancy body mass index (BMI) and 4 adiposity markers in children at age 8 (6–11) years were assessed: BMI, fat mass, waist circumference, and skinfold thickness. Relative LTL was obtained. Associations of LTL with each adiposity marker were calculated using linear mixed models with a random cohort effect. For each 1 kg/m² increment in maternal pre-pregnancy BMI, the child’s LTL was 0.23% shorter (95%CI: 0.01,0.46%). Each unit increase in child BMI z-score was associated with 1.21% (95%CI: 0.30,2.11%) shorter LTL. Inverse associations were observed between waist circumference and LTL (−0.96% per z-score unit; 95%CI: −2.06,0.16%), and skinfold thickness and LTL (−0.10% per z-score unit; 95%CI: −0.23,0.02%). In conclusion, this large multicentric study suggests that higher child adiposity indicators are associated with short telomeres in children, and that associations are stronger for child BMI than for maternal pre-pregnancy BMI.
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Affiliation(s)
- Diana B P Clemente
- ISGlobal, Institute for Global Health Barcelona, C/ Doctor Aiguader 88, 08003, Barcelona, Spain.,Center for Environmental Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.,Universitat Pompeu Fabra, Plaça de la Mercè, 10, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Madrid, Spain
| | - Lea Maitre
- ISGlobal, Institute for Global Health Barcelona, C/ Doctor Aiguader 88, 08003, Barcelona, Spain.,Universitat Pompeu Fabra, Plaça de la Mercè, 10, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Madrid, Spain
| | - Mariona Bustamante
- ISGlobal, Institute for Global Health Barcelona, C/ Doctor Aiguader 88, 08003, Barcelona, Spain.,Universitat Pompeu Fabra, Plaça de la Mercè, 10, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Madrid, Spain.,Bioinformatics and Genomics Program, Centre for Genomic Regulation (CRG), C/ Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, University of Southern California, University Park Campus, 90089-0911, Los Angeles, USA.,Department of Social Medicine, University of Crete, Andrea Kalokerinou 13, 715 00, Crete, Greece
| | - Theano Roumeliotaki
- Department of Social Medicine, University of Crete, Andrea Kalokerinou 13, 715 00, Crete, Greece
| | - Serena Fossati
- ISGlobal, Institute for Global Health Barcelona, C/ Doctor Aiguader 88, 08003, Barcelona, Spain.,Universitat Pompeu Fabra, Plaça de la Mercè, 10, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Madrid, Spain
| | - Regina Grazuleviciene
- Department of Environmental Science, Vytautas Magnus University, Donelaičio 58, 44248, Kaunas, Lithuania
| | - Kristine B Gützkow
- Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, NO-0403, Oslo, Norway
| | - Johanna Lepeule
- Inserm and University Grenoble-Alpes, U1209, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, 110 Rue de la Chimie, 38400, Saint-Martin-d'Hères, France
| | - Dries S Martens
- Center for Environmental Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Rosie R C McEachan
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD9 6RJ, Bradford, UK
| | - Helle M Meltzer
- Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, NO-0403, Oslo, Norway
| | - Inga Petraviciene
- Department of Environmental Science, Vytautas Magnus University, Donelaičio 58, 44248, Kaunas, Lithuania
| | - Rémy Slama
- Inserm and University Grenoble-Alpes, U1209, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, 110 Rue de la Chimie, 38400, Saint-Martin-d'Hères, France
| | - Ibon Tamayo-Uria
- ISGlobal, Institute for Global Health Barcelona, C/ Doctor Aiguader 88, 08003, Barcelona, Spain.,Center for Environmental Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.,Universitat Pompeu Fabra, Plaça de la Mercè, 10, 08002, Barcelona, Spain.,Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, 02138, Massachusetts, USA
| | - Jose Urquiza
- ISGlobal, Institute for Global Health Barcelona, C/ Doctor Aiguader 88, 08003, Barcelona, Spain.,Universitat Pompeu Fabra, Plaça de la Mercè, 10, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Madrid, Spain
| | - Marina Vafeiadi
- Department of Social Medicine, University of Crete, Andrea Kalokerinou 13, 715 00, Crete, Greece
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD9 6RJ, Bradford, UK
| | - Tim S Nawrot
- Center for Environmental Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.,Department of Public Health & Primary Care, Unit Environment & Health, Leuven University, Oude Markt 13, 3000, Leuven, Belgium
| | - Martine Vrijheid
- ISGlobal, Institute for Global Health Barcelona, C/ Doctor Aiguader 88, 08003, Barcelona, Spain. .,Universitat Pompeu Fabra, Plaça de la Mercè, 10, 08002, Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Madrid, Spain.
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