Hospital-based Birth Cohort Study Research Articles

Association between diet quality during pregnancy of mothers and that of 3-year-old offspring: a prospective hospital-based birth cohort study

Association between diet quality during pregnancy of mothers and that of 3-year-old offspring: a prospective hospital-based birth cohort study

P-252 Oolemma surface area impacts human pre-implantation embryo development and usage: The Rotterdam Periconception Cohort

Abstract Study question Does oolemma area change before the 2-cell stage? Is oolemma area associated with fertilization rate, embryo usage rate and preimplantation embryo development? Summary answer Oolemma area is associated with preimplantation embryo development, the odds of fertilizing and developing into a used or discarded embryo. What is known already Current morphological grading systems are based on embryo morphology and omit oocyte morphology. Fertilization and embryo potential are largely determined by the maturation and quality of the oocyte. Oocyte quality correlates to morphology, and the very early stages of embryo development are critical to changes in oocyte size. Larger oocyte size associates with higher quality blastocyst. This suggests that oocyte size can be a morphological marker of preimplantation embryo quality and assisted reproductive treatment (ART) outcomes. Study design, size, duration This study is embedded in the Rotterdam Periconceptional Cohort, an ongoing prospective tertiary hospital-based birth cohort study. From May 2017 to July 2020, a subcohort of 378 women that underwent ART was included comprising of 124 pregnancies after in vitro fertilization (IVF) and 254 after intracytoplasmic sperm injection (ICSI). Participants/materials, setting, methods Health, lifestyle and treatment factors were collected from detailed self-reported questionnaires and medical records. Oolemma area was measured at the time of fertilization (t0), pronuclear appearance (tPNa) and fading (tPNf). Oolemma area trajectories (slope surface t0-tPNf) were calculated with linear regression. Fertilization rate, embryo usage rate, and embryo morphokinetics were analyzed in association with oolemma area and trajectories. Analyses were performed with linear mixed models, mixed effects logistic regression, and adjusted for relevant confounders. Main results and the role of chance Oolemma area decreased from t0 to tPNf for oocytes that developed into both used or discarded embryos. Oolemma area at t0 was strongly associated with the rate of area shrinking, as larger oolemma areas had faster shrinking rates (Bshrinking -12.55 µm²/hour, 95%CI -14.55; -10.55, p < 0.001). Oocytes that resulted in a usable embryo were larger and reached tPNf faster than oocytes that resulted in a discarded embryo (tPNf 9855±595 µm2 vs 9690±721 µm2, p < 0.001, 24.4±3.6 h vs 26.5±5.8 h, p < 0.001). Oolemma area at tPNf did not differ between ICSI and IVF oocytes, however ICSI oocytes reached tPNf faster than IVF oocytes (23.6±3.2h and 25.9±3.8h, p < 0.001, respectively). In ICSI only, larger oolemma area showed lower odds of a successful fertilization (t0 OR 0.57, 95%CI 0.48; 0.67, p < 0.001), but higher odds of being cryopreserved or transferred (tPNf OR 1.66, 95%CI 1.33; 2.08, p < 0.001). For IVF and ICSI, larger oolemma area at tPNF was associated with faster preimplantation development up to the morula stage (t7 B -1.41, 95%CI -2.18; -0.63, p < 0.001). Oolemma area shrinking rate was not associated with embryo morphokinetics. Limitations, reasons for caution Small number of embryos measured at the blastocyst stage, and oolemma area measurements were not possible at t0 and tPNa for IVF oocytes. Wider implications of the findings Oolemma area is a suggested morphological marker for oocyte competence and an early marker for the success of fertilization and embryo development. The relevance of oolemma area as predictor of ART success requires further research. Cryopreservation and PCOS, which influence oocyte size, could be studied in association with oolemma area. Trial registration number not applicable

Paternal characteristics associated with low birth weight among singleton births: a hospital-based birth cohort study in northern Tanzania.

Introductionlow birth weight (LBW) remains a devastating adverse pregnancy outcome in low and middle income countries (LMICs). There is evidence showing that maternal demographic and pregnancy-related characteristics are associated with LBW. Little attention is given to paternal characteristics, which may be associated with a higher risk of LBW. This study aimed to assess the effect of paternal characteristics on LBW among singleton deliveries at Kilimanjaro Christian Medical Centre (KCMC) zonal referral hospital in Kilimanjaro region, northern Tanzania.Methodsthis was a secondary analysis of a hospital-based cohort study from maternally-linked medical birth registry data at KCMC between 2000 and 2018. A total of 47,035 singleton deliveries were included in this study. Data analysis was performed using statistical package for social sciences (SPSS), version 20 (IBM Corp., Armonk, NY). Relative risk and corresponding 95% confidence intervals (CI) were used to determine association between LBW and paternal characteristics using log-binomial regression models, with robust standard errors to account for clustering of deliveries within mothers.Resultsthe proportion of LBW during the study period was 9.6%. After adjusting for maternal characteristics, higher risk of LBW was among fathers with low education level (RR=1.72, 95% CI: 1.22, 2.41, p=0.002), aged ≤24 years old (RR=1.37, 95% CI: 1.21, 1.55), and those unemployed (RR= 1.11, 95% CI: 1.01, 1.21). Lower risk of LBW was among fathers aged ≥40 years (RR=0.97, 95% CI: 0.88, 1.08), but this association was not statistically significant.Conclusionthe study confirmed paternal young age (≤24 years old), paternal low education level and unemployment as predictors for LBW. Current evidence on the effect of paternal characteristics on LBW might suggest that programs and policies should target their engagement as a key strategy for improving birth outcomes during the perinatal period. Future studies should assess how paternal factors are associated with the risk of adverse birth outcomes.

Maternal vegetable intake in early pregnancy and wheeze in offspring at the age of 2 years.

Vegetable intake during childhood may reduce the risk of subsequent asthma. We verified the effect of maternal intake during pregnancy on asthma risk in offspring, which has rarely been studied. In a hospital-based birth cohort study conducted in Tokyo, we administered a food frequency questionnaire at two periods during the respondents' pregnancy: early and mid to late periods. In addition, a questionnaire including the International Study of Asthma and Allergies in Childhood questionnaire was conducted when the offspring were 2 years old. Multivariate Poisson regression adjusting for maternal baseline demographics was used to elucidate the association between maternal vegetable intake and the incidence of wheeze in the offspring. Among 310 singletons, 82 (26.5%) experienced wheeze at 2 years of age. Women with the highest intake of cruciferous, and folate-rich vegetables during early pregnancy reported a significantly lower prevalence of wheeze in their child at 2 years of age in comparison with those who reported the lowest intake (adjusted risk ratio: 0.48 and 0.47, 95% confidence interval: 0.26-0.89, and 0.25-0.87, respectively). In trend analysis, a higher maternal intake of cruciferous, folate-rich vegetables, and total vegetables during early pregnancy was less likely to be associated with wheeze in the offspring at 2 years old (p for trend: 0.038, <0.001, and 0.028, respectively). Maternal vegetable intake during mid to late pregnancy was not associated with wheeze in the offspring. Maternal vegetable intake during early pregnancy may have a protective effect against asthma in offspring at 2 years of age.

Dietary n-3 Polyunsaturated Fatty Acids in Late Pregnancy and Postpartum Depressive Symptom among Japanese Women.

The use of n-3 polyunsaturated fatty acids (n-3PUFA) in preventive or therapeutic modalities for postpartum depression, especially long-chain types such as eicosapentaenoic acid (EPA) and a docosahexaenoic acid (DHA), is of considerable interest. High n-3PUFA consumption has been reported among pregnant Japanese women. Therefore, analysis of this group could provide important insights into the relationship between postpartum depression and dietary n-3PUFA consumption. To further examine the relationship between the risk of postpartum depression and n-3PUFA consumption, we conducted a prospective hospital-based birth cohort study in Japan. Our prospective birth cohort study was performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan. Dietary n-3PUFA intake during late pregnancy was assessed by a semi-quantitative food questionnaire and participants were categorized by quintile distributions of n-3PUFA intake. A Japanese translation of the Edinburgh Postnatal Depression Scale was used to screen women for postpartum depression at 1 month after delivery (967 women) and at 6 months after delivery (710 women). We performed logistic regression analysis to examine the relationship between the risk of postpartum depression and n-3PUFA consumption after adjusting for confounding factors. Significant associations between EPA, DHA, and n-3PUFA intakes in late pregnancy and postpartum depression at both 1 and 6 months after delivery were not observed. This prospective study indicated that EPA, DHA, and n-3PUFA intake during late pregnancy was not associated with the risk of postpartum depression.

Beta-2 receptor agonist exposure in the uterus associated with subsequent risk of childhood asthma.

Although the beta-2 receptor agonist (B2RA) is occasionally prescribed in the prenatal period for women with preterm labor, few studies have referred to the long-term effects of intrauterine exposure to B2RA on fetus. We examined the association between intrauterine exposure to B2RA and asthma in the offspring. We obtained data from a hospital-based birth cohort study conducted in Tokyo, Japan. The outcomes of interest were three indicators, consisting of current wheeze, current asthma, and ever asthma at 5years of age, based on the International Study of Asthma and Allergies in Childhood questionnaire. Logistic regression analysis was used to evaluate the association between intrauterine B2RA exposure and outcomes. To evaluate dose-dependent risk, we categorized children into three groups according to both the cumulative dose and duration (days) and conducted trend analysis. Of 1158 children, 94 (8.1%) were exposed to B2RA in utero, and 191 (16.5%), 111 (9.6%), and 168 (14.5%) children experienced current wheeze, current asthma, and ever asthma, respectively. After adjusting for confounders, we found an increased risk of current asthma caused by B2RA exposure with an adjusted odds ratio of 2.04 (95% confidence interval: 1.02-4.05). Trend analysis showed that B2RA exposure in utero was associated with a dose-dependent increased risk of current asthma in terms of both cumulative dose and duration (P values for trend were .015 and .017, respectively). These results were similar to those for other outcome measures. Exposure to B2RA in utero could be a risk for childhood asthma.

Influence of antibiotic use in early childhood on asthma and allergic diseases at age 5

BackgroundIn the past few decades, the prevalence of allergic diseases has increased rapidly worldwide. At the same time, the overuse of antibiotics has been observed, especially in Japan. ObjectiveTo elucidate the association of early childhood antibiotic use with allergic diseases in later childhood at 5 years of age. MethodsRelevant data were extracted from the hospital-based birth cohort study, the Tokyo Children's Health, Illness and Development Study. To identify signs of asthma and allergic diseases in children, the International Study of Asthma and Allergies in Childhood questionnaire was used. Logistic regression models were applied to estimate the effect of antibiotic use on outcomes in later life. ResultsAntibiotic exposure in children within the first 2 years of life was associated with current asthma (adjusted odds ratio [aOR] 1.72, 95% confidence interval [CI] 1.10–2.70), current atopic dermatitis (aOR 1.40, 95% CI 1.01–1.94), and current allergic rhinitis (aOR 1.65, 95% CI 1. 05–2.58) at 5 years of age. Analysis of the associations by type of antibiotics showed that cephem was associated with current asthma (aOR 1.97, 95% CI 1.23–3.16) and current rhinitis (aOR 1.82, 95% CI 1.12–2.93), and macrolide was associated with current atopic dermatitis (aOR 1.58, 95% CI 1.07–2.33). ConclusionOur findings suggest that antibiotic use within the first 2 years of life was a risk factor for current asthma, current atopic dermatitis, and current allergic rhinitis in 5-year-old children.

Yogurt consumption in infancy is inversely associated with atopic dermatitis and food sensitization at 5 years of age: A hospital-based birth cohort study

BackgroundSeveral studies have suggested that habitual yogurt consumption is associated with favorable outcomes for health issues in children. However, the effects of yogurt consumption on allergic diseases and sensitization in children remain poorly understood. ObjectiveThis prospective birth cohort study aimed to investigate for associations between habitual yogurt consumption in infancy and development of allergic diseases/sensitization at 5 years of age. MethodsData were obtained from the Tokyo Children’s Health, Illness and Development (T-CHILD) study. A total of 1550 children were born to the recruited women. Consumption of yogurt by children during infancy was determined by using questionnaires completed at 12 months of age. Outcome data for children were collected from the questionnaires and medical check-ups completed at 5 years of age. Possible associations between habitual yogurt consumption in infancy and allergic diseases/sensitization were analyzed by multiple logistic regression analyses. ResultsWe analyzed the data for 1166 children whose parents responded at 5 years of age. Habitual yogurt consumption in infancy and atopic dermatitis at 5 years of age were significantly associated (UKWP criteria: aOR, 0.70; 95% CI, 0.51–0.97; P=0.03). Children with habitual yogurt consumption in infancy were less likely to be sensitized to food allergens (aOR, 0.53; 95% CI, 0.31–0.93; P=0.03), but no associations were seen in regard to any other allergens. ConclusionsOur study demonstrated that habitual consumption of yogurt in infancy has the potential to prevent development of atopic dermatitis and food sensitization, but not other allergic diseases, at 5 years of age.

Influence of early childhood antibiotics use on asthma and allergic diseases at the age of five years

Introduction: In these decades, we have been facing with rapid increase in prevalence of allergic diseases world-widely. At the same time, overuse of antibiotics have been pointed out especially in Japan. The aim of this study is to elucidate the association of early childhood antibiotics use with signs of asthma and allergic diseases in later childhood. Methods: Relevant data were extracted from a hospital based birth cohort study named as Tokyo-Children’s Health, Illness and Development Study (T-CHILD), of which questionnaire surveys were conducted during pregnancy and yearly after delivery. To identify signs of asthma and allergic diseases in the children, the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) was used. Logistic regression models were applied to estimate the effect of antibiotic use on outcomes in later life and adjustments were made for maternal history of allergy, maternal age at pregnancy, maternal smoking during pregnancy, mode of delivery, gestational age at delivery, daycare attendance, number of previous live births, bronchitis, and gender of child. Results: Antibiotics exposure of children under 3 years of age was associated with current asthma (adjusted odds ratio [aOR], 1.72; 95% confidence interval [CI], 1.10-2.69), current atopic dermatitis (aOR, 1.39; 95% CI, 1.001-1.92), and current rhinitis (aOR, 1.64; 95% CI, 1. 05-2.58) at their five years of age. Conclusions: Our findings suggest that antibiotics use under 3 years of age was a risk factor of asthma, atopic dermatitis and rhinitis in 5 years old children.

Timing of eczema onset and risk of food allergy at 3 years of age: A hospital-based prospective birth cohort study

BackgroundAlthough recent studies suggest that eczema in early childhood is important in the development of food allergy, the importance of the timing of eczema onset has not been fully clarified. ObjectiveThis study aim to identify an association between the timing of eczema onset and development of food allergy in a prospective birth cohort study. MethodsData were obtained from the Tokyo Children’s Health, Illness and Development (T-CHILD) study, which is a hospital-based birth cohort study currently in progress in Japan. A total of 1550 children were born to the recruited women. Outcome data for children were collected from questionnaires completed at 6 months, 1 and 3 years of age. Association between the timing of eczema onset and development of food allergy was estimated by logistic regression analyses. All analysis were performed using SPSS software with a two-sided 5% significance level. ResultsEczema in the first year of life was a significant risk factor in multivariate analysis (aOR 3.90, 95% CI 2.34–6.52, p<0.001). In each age (by month) stratum, infants with onset of eczema within the first 1–2 months after birth had the highest risk of food allergy at 3 years of age (aOR 6.61, 95% CI 3.27–13.34, p<0.001). ConclusionInfants with early eczema onset (especially within the first 1–4 months after birth) were found to have an increased risk of developing food allergy at 3 years of age. Our findings may contribute to a better understanding of the timing of eczema onset as a potentially modifiable risk factor and to defining those who may need to be on guard for food allergy.

The Association of Prenatal Exposure to Perfluorinated Chemicals with Glucocorticoid and Androgenic Hormones in Cord Blood Samples: The Hokkaido Study.

Background:Perfluorinated chemicals (PFCs) disrupt cholesterol homeostasis. All steroid hormones are derived from cholesterol, and steroid hormones such as glucocorticoids and androgenic hormones mediate several vital physiologic functions. However, the in utero effects of PFCs exposure on the homeostasis of these steroid hormones are not well understood in humans.Objectives:We examined the relationship between prenatal exposure to perfluorooctane sulfonate (PFOS)/perfluorooctanoate (PFOA) and cord blood levels of glucocorticoid and androgenic hormones.Methods:We conducted a hospital-based birth cohort study between July 2002 and October 2005 in Sapporo, Japan (n = 514). In total, 185 mother–infant pairs were included in the present study. Prenatal PFOS and PFOA levels in maternal serum samples were measured using liquid chromatography–tandem mass spectrometry (LC-MS-MS). Cord blood levels of glucocorticoid (cortisol and cortisone) and androgenic hormones [dehydroepiandrosterone (DHEA) and androstenedione] were also measured in the same way.Results:We found a dose–response relationship of prenatal PFOS, but not PFOA, exposure with glucocorticoid levels after adjusting for potential confounders. Cortisol and cortisone concentrations were –23.98-ng/mL (95% CI: –0.47.12, –11.99; p for trend = 0.006) and –63.21-ng/mL (95% CI: –132.56, –26.72; p for trend < 0.001) lower, respectively, in infants with prenatal PFOS exposure in the fourth quartile compared with those in the first quartile. The highest quartile of prenatal PFOS exposure was positively associated with a 1.33-ng/mL higher DHEA level compared with the lowest quartile (95% CI: 0.17, 1.82; p for trend = 0.017), whereas PFOA showed a negative association with DHEA levels (quartile 4 vs. quartile 1: –1.23 ng/mL, 95% CI: –1.72, –0.25; p for trend = 0.004). We observed no significant association between PFCs and androstenedione levels.Conclusions:Our results indicate that prenatal exposure to PFCs is significantly associated with glucocorticoid and DHEA levels in cord blood.Citation:Goudarzi H, Araki A, Itoh S, Sasaki S, Miyashita C, Mitsui T, Nakazawa H, Nonomura K, Kishi R. 2017. The association of prenatal exposure to perfluorinated chemicals with glucocorticoid and androgenic hormones in cord blood samples: the Hokkaido Study. Environ Health Perspect 125:111–118; http://dx.doi.org/10.1289/EHP142

Preconceptional exposure to oral contraceptive pills and the risk of wheeze, asthma and rhinitis in children

BackgroundThe prevalence of maternal oral contraceptive pills (OCP) use and that of childhood asthma are high in western countries. The aim of this study is to examine the association of OCP use with childhood wheeze and allergic diseases in Japan. MethodsRelevant data were extracted from a hospital based birth cohort study named as Tokyo-Children's Health, Illness and Development Study (T-CHILD) of which questionnaire conducted during pregnancy included maternal history and duration of OCP use. To identify wheeze and allergic diseases in the children, the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) was used. Logistic regression models were applied to estimate those association and adjustments were made for maternal history of allergy, maternal education level, maternal age at pregnancy, maternal BMI, maternal smoking during pregnancy, mode of delivery, gestational age at delivery, daycare attendance, number of previous live births, and gender of child. ResultsOCP use was associated with ever wheeze (adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 1.10–2.40), current wheeze (aOR, 1.59; 95% CI, 1.01–2.50), ever asthma (aOR, 1.65; 95% CI, 1.02–2.65), and ever rhinitis (aOR, 1.90; 95% CI, 1.30–2.80). Compared with no prior OCP use, using OCP for more than three months statistically increased the odds of ever wheeze (P = 0.012), current wheeze (P = 0.035), and ever rhinitis (P = 0.002). ConclusionsOur findings suggest that maternal OCP use has a role in the development of wheeze, asthma and rhinitis in children. Extended use of OCP is likely to increase the risk of wheeze and rhinitis.

Maternal socioeconomic status and the risk of asthma among offspring.

BackgroundTo evaluate the association between maternal socioeconomic status (SES) during pregnancy and asthma among offspring.MethodsA retrospective observational hospital-based birth cohort study in a university-based Obstetrics and Gynecology department in Finland. A total of 40 118 women with singleton live births between 1989 and 2007 were linked with data from the register for asthma medication for their offspring (n = 2518). Pregnancy and maternal SES factors were recorded during pregnancy and labor. SES was categorized thus: upper white-collar workers (highest SES), lower white-collar workers, blue-collar workers, others (lowest SES) and cases with missing information. Logistic regression analysis was used to determine the association between maternal SES and childhood asthma.ResultsWe found no convincing evidence of a direct association between maternal SES and childhood asthma. Parental smoking was the clearest factor affecting asthma among children of lower white-collar workers. Differences in pregnancy and delivery characteristics were observed between the SES groups.ConclusionsMaternal socioeconomic status had no significant direct impact on the prevalence of asthma in this Finnish birth cohort. Finnish public health services appeared to offer equal quality services independently of SES.Trial registrationThe study is registered in Kuopio University Hospital register (TUTKI): ID5302448.

Association of cord blood levels of lead, arsenic, and zinc with neurodevelopmental indicators in newborns: A birth cohort study in Chitwan Valley, Nepal

In this study, we aimed to investigate the association between in utero toxic (lead [Pb] and arsenic [As]) and essential element (zinc [Zn]) levels and neurodevelopmental indicators after birth in Chitwan Valley, Nepal. We conducted a hospital-based birth cohort study with 100 pregnant women in Chitwan, Nepal. We measured Pb, As, and Zn concentrations in cord blood. We assessed 100 infants at 1 day after birth, using the Brazelton neonatal behavioral assessment scale, third edition (NBAS III). Multivariate regression was performed to adjust for mother's age, parity, educational level, and body mass index (BMI); family income; and newborn's birth weight, gestational age, and age in hours at the time of NBAS III assessment. Among the 7 clusters of NBAS III, the motor cluster score was inversely associated with the cord blood levels of Pb (coefficient=−2.15, at 95% confidence interval [CI]=−4.27 to −0.03). The cord blood levels of As were inversely associated with the state regulation cluster score (coefficient=−6.71, at 95% CI=−12.17 to −1.24). The cord blood levels of Zn were not associated with NBAS III scores. The cord blood levels of Pb and As, but not Zn, showed significant inverse association with the neurodevelopment of newborns. These results suggest that high levels of Pb or As exposure during the prenatal period may induce retardation during in utero neurodevelopment.

Maternal fecundity and asthma among offspring—is the risk programmed preconceptionally? Retrospective observational study

To evaluate the association between maternal fecundity factors and time to pregnancy and risk of asthma in offspring. Retrospective observational hospital-based birth cohort study. A university-based obstetrics and gynecology department. A total of 40,914 women, who delivered between 1989 and 2007, were linked with the register for asthma reimbursement (n = 2,577) for their offspring. Fecundity factors were recorded during pregnancy. Logistic regression analyses were used. None. Asthma among offspring. The risk of asthma was significantly increased if the mother had any infertility problems (adjusted odds ratio [adjusted OR] 1.39, 95% confidence interval [CI] 1.19-1.63), medical infertility treatment (aOR 1.43, 95% CI 1.13-1.80), or any infertility treatment (aOR 1.50, 95% CI 1.26-1.79). The risk of asthma among offspring was also higher among mothers who had more than two miscarriages (aOR 1.25, 95% CI 1.04-1.51) and time to pregnancy over 3 months (aOR 1.25, 95% CI 1.07-1.45). These findings suggest that maternal subfertility exposes offspring to an increased risk of asthma. The study is registered in Kuopio University Hospital register (TUTKI): ID5302448.