Maternal n-3, n-6, and trans fatty acid profile early in pregnancy and term birth weight: a prospective cohort study

BACKGROUND: Maternal n-3, n-6, and trans fatty acids are claimed to affect fetal growth, yet evidence is limited. OBJECTIVE: We investigated the association between maternal n-3, n-6, and trans fatty acids measured early in pregnancy and fetal growth. DESIGN: Amsterdam pregnant women (n = 12 373) were invited to complete a questionnaire (response 67%) and donate blood around the 12th pregnancy week for nutrient analysis. For 4336 women, fatty acid concentrations were measured in plasma phospholipids (gas-liquid chromatography). Associations of these concentrations with birth weight and small-for-gestational-age (SGA) risk were analyzed (liveborn singleton term deliveries, n = 3704). RESULTS: Low concentrations of individual n-3 fatty acids and 20:3n-6, the precursor of arachidonic acid (20:4n-6), but high concentrations of the other n-6 fatty acids and the main dietary trans fatty acid (18:1n-9t) were associated with lower birth weight (estimated difference in univariate analysis -52 to -172 g for extreme quintile compared with middle quintile). In general, SGA risk increased accordingly. After adjustment for physiologic, lifestyle-related and sociodemographic factors, low concentrations of most n-3 fatty acids and 20:3n-6 and high concentrations of 20:4n-6 remained associated with lower birth weight (-52 to -57 g), higher SGA risk, or both (odds ratios: 1.38-1.50). Infants of the 7% of women with the most adverse fatty acid profile were on average 125 g lighter and twice as likely to be small for gestational age. CONCLUSION: An adverse maternal fatty acid profile early in pregnancy is associated with reduced fetal growth, which, if confirmed, gives perspective for the dietary prevention of lower birth weight.     

Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study

BACKGROUND: Whether the association between teenage pregnancy and adverse birth outcomes could be explained by deleterious social environment, inadequate prenatal care, or biological immaturity remains controversial. The objective of this study was to determine whether teenage pregnancy is associated with increased adverse birth outcomes independent of known confounding factors. METHODS: We carried out a retrospective cohort study of 3,886,364 nulliparous pregnant women <25 years of age with a live singleton birth during 1995 and 2000 in the United States. RESULTS: All teenage groups were associated with increased risks for pre-term delivery, low birth weight and neonatal mortality. Infants born to teenage mothers aged 17 or younger had a higher risk for low Apgar score at 5 min. Further adjustment for weight gain during pregnancy did not change the observed association. Restricting the analysis to white married mothers with age-appropriate education level, adequate prenatal care, without smoking and alcohol use during pregnancy yielded similar results. CONCLUSIONS: Teenage pregnancy increases the risk of adverse birth outcomes that is independent of important known confounders. This finding challenges the accepted opinion that adverse birth outcome associated with teenage pregnancy is attributable to low socioeconomic status, inadequate prenatal care and inadequate weight gain during pregnancy.     

How many subjects are needed in a longitudinal birth cohort study?

One of the first decisions that needs to be taken when planning a birth cohort concerns the size of the study. This in turn will depend on the research questions to be answered and thence whether environmental exposures and outcomes are measured on a continuum or as dichotomous variables. Here we describe ways in which different birth cohorts have addressed this issue and explore the advantages of smaller detailed studies over larger less-detailed studies.     

Health related quality of life after extremely preterm birth: a matched controlled cohort study

Background  

The majority of infants born before the last trimester now grow up. However, knowledge on subsequent health related quality of life (HRQoL) is scarce. We therefore aimed to compare HRQoL in children born extremely preterm with control children born at term. Furthermore, we assessed HRQoL in relation to perinatal and neonatal morbidity and to current clinical and sociodemographic characteristics.     

Vaccination and allergic disease: a birth cohort study

Objectives. We examined the effect of vaccination for diphtheria; polio; pertussis and tetanus; or measles, mumps, and rubella on the incidence of physician-diagnosed asthma and eczema.     

孕期甲状腺激素敏感性与出生结局关系的队列研究

目的  研究孕期妇女甲状腺激素敏感性与出生结局的关系。方法  依托武汉市大型出生队列,以符合入选标准的5 411对孕妇-新生儿为研究对象。利用孕期体检的血清三碘甲状腺素(free triiodothyronine, FT3)、游离甲状腺素(free thyroxine, FT4)和甲状腺刺激激素(thyroid stimulating hormone, TSH),计算甲状腺激素中枢敏感性的指标：促甲状腺激素指数(thyroid stimulating hormone index, TSHI)、促甲状腺激素细胞-T4抵抗指数(thyrotroph thyroxine resistance index, TT4RI)和甲状腺反馈分位数指数(thyroid feedback quantile-based index, TFQI)。结局指标包括出生体重、出生孕周、出生体重Z评分,以及低出生体重、早产和小于胎龄儿(small for gestational age, SGA)。分别利用多元线性回归、logistic回归分析模型对甲状腺指标和出生结局中的连续型变量、分类变量进行回归分析,并控制可能混杂因素。结果  FT4、TSHI、TFQI与出生体重和出生体重Z评分呈负相关(均P≤0.01);甲状腺激素敏感性指标TSHI、TT4RI、TFQI与SGA存在统计学意义的正相关(TSHI: OR=1.52, 95% CI: 1.12~2.06, P＜0.01; TT4RI: OR=1.15, 95% CI: 1.03~1.29, P=0.02; TFQI: OR=1.41, 95% CI: 1.10~1.81, P＜0.01);甲状腺功能和甲状腺激素敏感性与低出生体重、早产的差异均无统计学意义。将妊娠合并甲状腺功能减退(甲减)人群排除后进行敏感性分析,研究结果一致。结论  孕期妇女甲状腺激素敏感性受损是不良出生结局SGA的独立风险因素。     

Resistance to cadmium and parasite infection are inversely related in two strains of a freshwater gastropod

Phenotypes that are either resistant or susceptible to infection by the trematode parasite Schistosoma mansoni exist in the tropical freshwater snail Biomphalaria glabrata. We tested the hypothesis that a cost of parasite resistance in B. glabrata is greater sensitivity to cadmium toxicity, using parasite-resistant and parasite-susceptible strains exposed to cadmium in the laboratory. Survival analysis showed that time to death for cadmium was significantly shorter in eggs, juveniles, and adults of the parasite-resistant BS90 strain in comparison with the parasite-susceptible NMRI strain. Cadmium exposure increased time to hatch in both strains, but the effect was greater in BS90. Percentage hatch decreased with increased cadmium; BS90 was again more sensitive than NMRI. Comparison of the median effective concentration (EC50) for hatching and median lethal concentrations (LC50s) for survival of juveniles and adults showed that the order for cadmium resistance was adults > juveniles > eggs in NMRI and adults > eggs > juveniles in BS90. Cadmium resistance of F1 and F2 progeny of BS90/NMRI crosses was intermediate to that of parental strains. Numerical estimates indicated that a single genetic factor was responsible for the difference in cadmium resistance in the two strains. These findings were consistent with the hypothesis that greater sensitivity to cadmium is a cost of resisting parasitic infection.     

Size at birth and height in early adolescence: a prospective birth cohort study

The aim of this study was to evaluate the association between size at birth (birthweight and birth length) and height in early adolescence in a prospective birth cohort study in Pelotas, Rio Grande do Sul, Brazil. Interviews were carried out in 1993, including measurements of birthweight and length, and in 2004-2005, including measurements of weight and height. This analysis includes 4,452 individuals, with a mean age of 11.3 years (standard deviation-SD=0.3), representing a follow-up rate of 87.5%. Mean height at 11 years was 145.8 cm (SD=7.9), or 144.9 cm (SD=7.7) in boys and 146.8 cm (SD=7.9) in girls. Birthweight and birth length were positively associated with height in early adolescence in the crude analysis, but after adjustment for confounding and for each other, only the effect of birth length was still significant. A one z-score increase in birth length was associated with a 1.63 cm increase in height at 11 years. The present study shows that birth length is a strong predictor of later height, while the effect of birth weight disappears after adjustment for birth length.     

Wine consumption throughout life is inversely associated with type 2 diabetes risk,but only in overweight individuals: results from a large female French cohort study

Alcohol has previously been shown to have a U-shaped association with type 2 diabetes (T2D) risk, but less is known regarding the specific association with wine. To evaluate for the first time the associations between T2D risk and both baseline wine consumption and trajectories of wine consumption frequency throughout life, estimated using an innovative group-based trajectory modeling strategy. A total of 66,485 women from the French prospective E3N-EPIC cohort were followed between 1993 and 2007; 1,372 incident cases of T2D were diagnosed during the follow-up. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (95 % CI) for T2D risk. The average consumption of wine, among alcohol consumers, was 0.81 drinks/day (1 drink = 150 mL). Associations between wine and T2D were restricted to overweight women (P_interaction = 0.0084). Among them, wine consumption was inversely associated with T2D risk (P_trend = 0.0022). A lower risk was observed for overweight women having two or more drinks/day [HR 0.59 (0.43–0.82)] when compared with non-alcohol consumers. Women who started to drink wine early in life (around age 10–15 years) were at a significantly lower risk than lifetime abstainers. In our study, wine drinking was inversely associated with T2D risk but only in overweight women. Our results also suggest a potential beneficial, cumulative effect of moderate wine consumption throughout life for overweight women, who would already be at higher risk of T2D. We encourage other cohort studies with information on wine consumption to investigate these associations.     

Insulin-resistance and metabolic syndrome are related to executive function in women in a large family-based study

While type 2 diabetes is well-known to be associated with poorer cognitive performance, few studies have reported on the association of metabolic syndrome (MetS) and contributing factors, such as insulin-resistance (HOMA-IR), low adiponectin-, and high C-reactive protein (CRP)- levels. We studied whether these factors are related to cognitive function and which of the MetS components are independently associated. The study was embedded in an ongoing family-based cohort study in a Dutch population. All participants underwent physical examinations, biomedical measurements, and neuropsychological testing. Linear regression models were used to determine the association between MetS, HOMA-IR, adiponectin levels, CRP, and cognitive test scores. Cross-sectional analyses were performed in 1,898 subjects (mean age 48 years, 43% men). People with MetS had significantly higher HOMA-IR scores, lower adiponectin levels, and higher CRP levels. MetS and high HOMA-IR were associated with poorer executive function in women (P = 0.03 and P = 0.009). MetS and HOMA-IR are associated with poorer executive function in women.     

Perfluorooctane sulphonate (PFOS) and perfluorooctanoic acid (PFOA) in human breast milk: results of a pilot study

Perfluorinated compounds (PFC) are a large group of chemicals produced for several decades and widely used for many industrial and consumer applications. Because of their global occurrence in different environmental media, their persistence and their potential to bioaccumulate in organisms they are of toxicological and public concern. In the present study, perfluorooctane sulphonate (PFOS) and perfluorooctanoic acid (PFOA) were quantified in 70 breast milk samples. Samples were obtained from Leipzig, Germany (38 archived samples), Munich, Germany (19 fresh samples) and Gyor, Hungary (13 frozen samples). PFOS could be quantified in all 70 samples. The concentration in samples from Germany ranged between 28 and 309 ng/l (median: 119 ng/l). Samples from Hungary showed significantly higher PFOS concentrations (median 330 ng/l, range 96-639 ng/l). In only 11 of 70 samples (16%) PFOA reached the LOQ (200 ng/l); values ranged from 201 to 460 ng/l. If only those samples with PFOA values above the LOQ were considered, we found a significant correlation between the PFOS and PFOA concentrations (r=0.75, p=0.008). Based on the results of the German sample, we estimated an intake of 0.10 microg PFOS/day (using median) or 0.27 PFOS microg/day (using maximum value) via breast milk for an infant of 5 kg bodyweight. Our data suggest that fully breastfed infants are unlikely to exceed the recommended tolerable daily intake of PFC. However, more target-oriented studies are needed to identify the amount and time-trend of PFOS and PFOA in maternal blood during pregnancy, after delivery, as well as in the growing infant and in its diet (e.g., breast milk and formula).     

Size at birth and blood pressure in early adolescence: a prospective birth cohort study

Previous studies have suggested that birth size may influence blood pressure in later life. Most of these reported inverse associations only became evident after weight or body mass index at some later age was included in the regression model. In a prospective birth cohort study in Brazil, the effect of birth size on blood pressure at age 11 years was explored. Of the 5,249 cohort members, 4,452 were interviewed. Mean systolic and diastolic blood pressures were 101.9 mmHg (standard deviation, 12.3) and 63.4 mmHg (standard deviation, 9.9), respectively. Birth weight was positively associated with blood pressure in the crude analysis, but this effect was no longer significant after adjustment for confounders. When current body mass index-a possible mediating variable-was added to the model, the association between birth weight and blood pressure tended to become negative, though not quite significant. Birth length showed a positive effect on later blood pressure regardless of the adjustments made. Head circumference, gestational age, and ponderal index were not associated with blood pressure. Children born small for gestational age had lower blood pressure values. The postulated inverse association between birth weight and later blood pressure was not confirmed in this cohort. Instead, a positive effect of birth length was detected.     

Rapid home-based human immunodeficiency virus testing to reduce costs in a large tuberculosis cohort study

To reduce costs in a large tuberculosis household contact cohort study in Lima, Peru, we replaced laboratory-based human immunodeficiency virus (HIV) testing with home-based rapid HIV testing. We developed a protocol and training course to prepare staff for the new strategy; these included role-playing for home-based deployment of the Determine^® HIV 1/2 Ag/Ac Combo HIV test. Although the rapid HIV test produced more false-positives, the overall cost per participant tested, refusal rate and time to confirmatory HIV testing were lower with the home-based rapid testing strategy compared to the original approach. Rapid testing could be used in similar research or routine care settings.     

Early predictors of adult drinking: a birth cohort study

Few studies have explored early predictors of problem drinking in youth, and fewer still have simultaneously considered the role of biologic, familial, and intrapersonal factors. The present study explored early life course and later life course predictors of alcohol abuse and dependence in young adulthood. Data were taken from a cohort of 2,551 mothers and their children recruited as part of the longitudinal Mater University Study of Pregnancy and its outcomes (MUSP) carried out in Brisbane, Australia, from 1981 to 1984. Data were collected prenatally and then postnatally at 6 months and at 5, 14, and 21 years. A range of biologic, familial, and intrapersonal factors was considered. A series of logistic regression models with inverse probability weighting was used to explore pathways to problem drinking from adolescence to early adulthood. For males and females, no association was found between either birth factors or childhood factors and a lifetime diagnosis of alcohol disorders at age 21 years. Externalizing symptoms and maternal factors at age 14 years were significantly associated with alcohol problems. For youth aged 14 years, maternal moderate alcohol consumption accounted for the highest percentage of attributable risk among those exposed. Results show that exposure to maternal drinking in adolescence is a strong risk factor for the development of alcohol problems in early adulthood.     

早产影响因素的前瞻性队列研究

目的  分析中国早产的流行现状及危险因素,为早产的预防提供参考依据。 方法  本研究数据来源于中国孕产妇队列研究·协和项目(Chinese Pregnant Women Cohort Study, CPWCS),通过问卷调查和医院信息系统(hospital information system, HIS)收集孕妇基本情况和分娩结局。采用SPSS 26.0软件进行χ²检验和多因素Logistic回归分析模型分析。 结果  5 671名孕妇中发生早产的例数为295例,占5.2%,不同地区早产率差异无统计学意义(χ² =0.591, P=0.771)。多因素分析结果显示：高龄、糖尿病史、早产史、胎盘早剥、胎膜早破、胎儿宫内窘迫、妊娠期高血压以及双胎是早产的危险因素(均有P < 0.05),而在自然分娩的孕妇中,高龄(OR=2.90, 95% CI: 1.67~5.06, P < 0.001)、胎膜早破(OR=6.17, 95% CI: 4.21~9.06, P < 0.001)、双胎(OR=17.72, 95% CI: 3.23~97.25, P=0.001)是早产的主要危险因素。 结论  早产的影响因素较多,准确识别危险因素,为孕妇提供科学合理的健康教育和个性化的防治措施是预防早产的重要手段。     

Physical fitness is inversely related to heart disease risk: a factor analytic study.

We measured cardiorespiratory endurance, muscular strength and endurance, anaerobic run time, coronary risk factors, and dietary habits in male fire fighters (n = 779, ages 18 to 64 years) and performed factor analysis to determine the interrelationships and underlying factor structure of the data set. Principal component analysis produced nine factors (eigenvalues greater than 1.0) accounting for 61% of the total variance. However, the variable loadings were inconsistent, preventing a meaningful interpretation of the factor solution. These problems were solved through the principal axis method of common factor analysis, which revealed three factors (eigenvalues greater than 1.0) accounting for 29% of the total variance. Orthogonal rotation (varimax method), showed Factors 1, 2, and 3 accounting for 52%, 29%, and 19%, respectively, of the common variance. Factor 1, labeled physical fitness capacity (PFC), included age, situps, treadmill performance time, pushups, maximum exercise heart rate, and anaerobic run time. Factor 2, designated coronary risk status (CRS), included body mass index, resting systolic and diastolic blood pressure, triglycerides, and the total cholesterol-high density lipoprotein cholesterol ratio. Factor 3, termed food frequency intake (FFI), included the weekly intake of fried foods, beef, pork, eggs, caffeine, and cheese. Percentage body fat loaded on both PFC and CRS. Measures such as blood pressure, grip strength, resting heart rate, maximum exercise systolic blood pressure, cigarettes smoked per day, and weekly frequency of milk, fish, fowl, and alcohol intake contributed little to the factor solution. Correlation coefficients after oblique rotation showed PFC to be inversely related to CRS (r = -0.48). However, FFI was independent of PFC (r = 0.07) and CRS (r = -0.10).(ABSTRACT TRUNCATED AT 250 WORDS)