Mother-child Cohort In Crete Research Articles

Maternal sleep disturbances during late pregnancy and child neuropsychological and behavioral development in early childhood.

The present study aims to explore the association of maternal sleep disturbances during late pregnancy on child neuropsychological and behavioral development in preschool years. The study included 638 mother-child pairs from the prospective Rhea mother-child cohort in Crete, Greece. Information on antenatal sleep disturbances was collected through a computer-assisted interview. Children's neuropsychological and behavioral development was assessed using the McCarthy Scales of Children's Abilities (MSCA), the Attention-Deficit Hyperactivity Disorder Test (ADHDT), and the Strengths and Difficulties Questionnaire (SDQ). Multivariate analysis showed that maternal sleep duration less than 8h was associated with reduced scores in the general cognitive scale (β = -2.28, 95% CI -4.54, -0.02, R2 = 0.417) and memory span (β = -3.24, 95% CI -5.72, -0.77, R2 = 0.304), while mild-severe daytime sleepiness was associated with reduced scores in the memory scale (β = -5.42, 95% CI -10.47, -0.37, R2 = 0.304), memory span (β = -5.44, 95% CI -10.68, -0.21, R2 = 0.304), nd functions of posterior cortex (β = -5.55, 95% CI -10.40, -0.70, R2 = 0.393) of MSCA. Snoring in late pregnancy was related to higher child hyperactivity scores in SDQ (β = 1.05, 95% CI 0.16, 1.95, R2 = 0.160). An interaction between child sex and maternal sleep duration in response to ADHD symptoms was also found (p for interaction < 0.05). Stratified analysis revealed increased hyperactivity, inattention, and ADHD total scores for girls of mothers with sleep duration less than 8h. Maternal sleep disturbances during pregnancy may be associated with impaired child neuropsychological and behavioral development during the preschool years. Early detection and intervention is necessary to reduce sleep disturbances habits in pregnancy and improve child neurodevelopment.

Association between high levels of inflammatory markers and cognitive outcomes at 4 years of age: The Rhea mother-child cohort study, Crete, Greece

There is growing evidence associating inflammatory markers in complex, higher order neurological functions, such as cognition and memory. We examined whether high levels of various inflammatory markers are associated with cognitive outcomes at 4 years of age in a mother-child cohort in Crete, Greece (Rhea study). We included 642 children in this cross-sectional study. Levels of several inflammatory markers (IFN-γ, IL-1β, IL-6, IL-8, IL-17α, IL-10, MIP-1α, TNF-α and the ratios of IL-6 to IL-10 and TNF-α to IL-10) were determined in child serum via immunoassay. Neurodevelopment at 4 years was assessed by means of the McCarthy Scales of Children’s Abilities. Multivariate linear regression analyses were used to estimate the associations between the exposures and outcomes of interest after adjustment for various confounders. Our results indicate that children with high TNF-α concentrations (≥90th percentile) in serum demonstrated decreased scores in memory (adjusted β = −4.0; 95% CI: −7.7, −0.2), working memory (adjusted β = −4.0; 95% CI: −8.0, −0.1) as well as in memory span scale (adjusted β = −4.0; 95% CI: −7.9, −0.1). We also found that children with high IFN-γ serum levels showed lower scores in memory span scale (adjusted β = −3.4; 95% CI: −7.3, −0.4). Children with elevated TNF-α/IL-10 ratio demonstrated decreased quantitative (adjusted β = −4.3; 95% CI: −8.2, −0.4), motor (adjusted β = −3.5; 95% CI: −7.5, −0.5), executive function (adjusted β = −4.8; 95% CI: −8.5, −1.1), general cognitive (adjusted β = −3.6; 95% CI: −7.3, −0.1), memory (adjusted β = −3.8; 95% CI: −7.6, −0), working memory (adjusted β = −3.5; 95% CI: −7.5, −0.5) and memory span scores (adjusted β = −5.3; 95% CI: −9.1, −1.4) The findings suggest that high levels of TNF-α may contribute to reduced memory performance at preschool age.

Cohort Profile: The Mother-Child Cohort in Crete, Greece (Rhea Study).

Cohort Profile: The Mother-Child Cohort in Crete, Greece (Rhea Study).

Effect of parental obesity and gestational diabetes on child neuropsychological and behavioral development at 4 years of age: the Rhea mother–child cohort, Crete, Greece

Studies have suggested an association between maternal obesity pre-pregnancy and gestational diabetes (GDM) with impaired offspring neurodevelopment, but it is not clear if these associations are explained by shared familiar characteristics. We aimed to assess the associations of maternal and paternal obesity, maternal glucose intolerance in early pregnancy and GDM, with offspring neurodevelopment at 4years of age. We included 772 mother-child pairs from the "Rhea" Mother-Child cohort in Crete, Greece. Data on maternal/paternal body mass index (BMI) and maternal fasting serum samples for glucose and insulin measurements were collected at 12weeks of gestation. GDM screening was performed at 24-28weeks. Neurodevelopment at 4years was assessed using the McCarthy Scales of Children's Abilities. Behavioral difficulties were assessed by Strengths and Difficulties Questionnaire and Attention Deficit Hyperactivity Disorder Test. Multivariate linear regression analyses showed that maternal obesity was associated with a significant score reduction in general cognitive ability (β-coeff -4.03, 95% CI: -7.08, -0.97), perceptual performance (β-coeff -4.60, 95% CI: -7.74, -1.47), quantitative ability (β-coeff -4.43, 95% CI: -7.68, -1.18), and executive functions (β-coeff -4.92, 95% CI: -8.06, -1.78) at 4years of age, after adjustment for several confounders and paternal BMI. Maternal obesity was also associated with increased behavioral difficulties (β-coeff 1.22, 95% CI: 0.09, 2.34) and ADHD symptoms (β-coeff 4.28, 95% CI: 1.20, 7.36) at preschool age. Paternal obesity maternal glucose intolerance in early pregnancy and GDM was not associated with child neurodevelopment. These findings suggest that maternal obesity may impair optimal child neurodevelopment at preschool age independently of family shared characteristics.

Pregnancy, perinatal and postpartum complications as determinants of postpartum depression: the Rhea mother-child cohort in Crete, Greece.

Few epidemiological studies evaluated associations between perinatal complications and maternal mood at the early postpartum period and the findings are inconsistent. We aimed at investigating a wide range of complications during pregnancy, at delivery, and at the early postpartum period as determinants of postpartum depression (PPD) at 8 weeks postpartum. A total of 1037 women who enrolled in the Rhea mother-child cohort in Crete, Greece participated in the present study. Information on pregnancy, perinatal and postpartum complications was obtained from clinical records or by questionnaires. Postpartum depressive symptoms were assessed at 8 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear and logistic regression models were fit to estimate the association between pregnancy, perinatal and postpartum complications and maternal depressive symptoms, adjusting also for potential confounders. The prevalence of women with probable depression (EPDS score ≥ 13) was 13.6% at 8 weeks postpartum. Gestational hypertension and/or preeclampsia (β coefficient 1.86, 95% CI: 0.32, 3.41) and breastfeeding difficulties (β coefficient 0.77, 95% CI: 0.02, 1.53) were significantly associated with higher PPD symptoms. Sleep patterns during pregnancy, such as sleep deprivation (OR = 3.57, 95% CI: 1.91, 6.67) and snoring (OR = 1.81, 95% CI: 1.11, 2.93), and breastfeeding duration less than 2 months (OR = 1.77, 95% CI: 1.19, 2.64) were significantly associated with increase in the odds for PPD. Some other complications, such as unplanned pregnancy and hospitalisation during pregnancy were also associated with EPDS score, but these associations were explained by socio-demographic characteristics of the mother. We found that several pregnancy, perinatal and postpartum complications may have an adverse effect on maternal mood at the early postpartum period. These findings have considerable implications for developing effective prevention and early psychoeducational intervention strategies for women at risk of developing PPD.

Leptin, acylcarnitine metabolites and development of adiposity in the Rhea mother-child cohort in Crete, Greece.

SummaryObjectiveThis study aims to investigate relations of serum leptin at age 4 with development of adiposity and linear growth during 3 years of follow‐up among 75 Greek children and to identify serum metabolites associated with leptin at age 4 and to characterize their associations with adiposity gain and linear growth.MethodsLinear regression models that accounted for maternal age, education and gestational weight gain and child's age and sex were used to examine associations of leptin and leptin‐associated metabolites measured at age 4 with indicators of adiposity and linear growth at age 7.ResultsEach 1‐unit increment in natural log‐(ln)‐transformed leptin corresponded with 0.33 (95% CI: 0.10, 0.55) units greater body mass index‐for‐age z‐score gain during follow‐up. Likewise, higher levels of the leptin‐associated metabolites methylmalonyl‐carnitine and glutaconyl‐carnitine corresponded with 0.14 (95% CI: 0.01, 0.27) and 0.07 (95% CI: −0.01, 0.16) units higher body mass index‐for‐age z‐score gain, respectively. These relationships did not differ by sex or baseline weight status and were independent of linear growth.ConclusionsThese findings suggest that leptin, methylmalonyl‐carnitine and possibly glutaconyl‐carnitine are associated with weight gain during early childhood. Future studies are warranted to confirm these findings in other populations.

Prenatal exposure to persistent organic pollutants in association with offspring neuropsychological development at 4 years of age: The Rhea mother-child cohort, Crete, Greece

BackgroundPersistent Organic Pollutants (POPs) are highly-resistant compounds to environmental degradation and due to fat solubility they bioaccumulate through the food chain. As they cross the placenta, in utero exposure to POPs could disrupt child neurodevelopment as they are considered to be neurotoxic. AimsWe examined whether in utero exposure to levels of different POPs is associated with offspring cognitive and behavioral outcomes at 4years of age in a mother-child cohort in Crete, Greece (Rhea study). MethodsWe included 689 mother-child pairs. Concentrations of several polychlorinated biphenyls (PCBs) and other organochlorine compounds (dichlorodiphenyl dichloroethene [DDE], hexachlorobenzene [HCB]) were determined in maternal serum collected in the first trimester of pregnancy by triple quadrupole mass spectrometry. Neurodevelopment at 4years was assessed by means of the McCarthy Scales of Children's Abilities. Behavioral difficulties were assessed by Strengths and Difficulties Questionnaire and Attention Deficit Hyperactivity Disorder Test. Linear regression analyses were used to estimate the associations between the exposures and outcomes of interest after adjustment for potential confounders. ResultsChildren with “high” HCB concentrations (≥90th percentile) in maternal serum, demonstrated decreased scores in perceptual performance (adjusted β=−6.07; 95% CI: −10.17, −1.97), general cognitive (adjusted β=−4.97; 95% CI: −8.99, −0.96), executive function (adjusted β=−6.24; 95% CI: −10.36, −2.11) and working memory (adjusted β=−4.71; 95% CI: −9.05, −0.36) scales at 4years of age. High exposure to PCBs (≥90th percentile) during pregnancy was associated with a 4.62 points reduction in working memory score at 4years of age (95% CI: −9.10, −0.14). Prenatal exposure to DDE, HCB and PCBs was not associated with child behavioral difficulties. ConclusionsThe findings suggest that prenatal exposure to HCB and PCBs may contribute to reduced cognitive development at preschool age. Our results raise the possibility that exposure to HCB may play a more important role in child cognition than previously considered.

Is there an association between eating behaviour and attention-deficit/hyperactivity disorder symptoms in preschool children?

There is some evidence that aberrant eating behaviours and obesity co-occur with attention-deficit/hyperactivity disorder (ADHD) symptoms. The present study is the first that aims to investigate the association between eating behaviours and ADHD symptoms in early childhood in a population-based cohort. We included 471 preschool children from the Rhea mother-child cohort in Crete, Greece. Parents completed the Children's Eating Behaviour Questionnaire to assess children's eating behaviour and the 36-item ADHD test (ADHDT) to evaluate ADHD symptoms at 4years of age. Multivariable linear regression models were used to examine the association of eating behaviours with ADHD symptoms. Regarding children's food approach eating behaviours, we observed a positive association between food responsiveness and total ADHD index, as well as impulsivity, inattention and hyperactivity subscale, separately. Similarly, there was a significant positive association between emotional overeating and ADHD symptoms. With regard to children's food avoidant behaviours, food fussiness was found to be significantly associated with the impulsivity subscale. A dose-response association between the food approach behaviours and ADHD symptoms was also observed. Children on the medium and highest tertile of the food responsiveness subscale had increased scores on the ADHD total scale, as compared to those on the lowest tertile. As regards emotional overeating, children in the highest tertile of the scale had higher scores on ADHD total and hyperactivity. Our findings provide evidence that food approach eating behaviours such as food responsiveness and emotional overeating are associated with the increased ADHD symptoms in preschool children. Future studies to better understand this overlap will enhance potential interventions.

Exposure of Preschool-Age Greek Children (RHEA Cohort) to Bisphenol A, Parabens, Phthalates, and Organophosphates.

Phthalate esters (PEs), bisphenol A (BPA), and parabens (PBs), which are used in numerous consumer products, are known for their endocrine disrupting properties. Organophosphate chemicals (OPs), which form the basis of the majority of pesticides, are known for their neurotoxic activity in humans. All of these chemicals are associated with health problems to which children are more susceptible. Once they enter the human body, PEs, BPA, PBs, and OPs are metabolized and/or conjugated and finally excreted via urine. Hence, human exposure to these substances is examined through a determination of the urinary concentrations of their metabolites. This study assessed the exposure of Greek preschool-age children to PEs, BPA, PBs, and OPs by investigating the urinary levels of seven PEs metabolites, six PBs, BPA, and six dialkyl phosphate metabolites in five-hundred samples collected from 4-year-old children, subjects of the "RHEA" mother-child cohort in Crete, Greece. Daily intake of endocrine disruptors, calculated for 4 year old children, was lower than the corresponding daily intake for 2.5 year old children, which were determined in an earlier study of the same cohort. In some cases the daily intake levels exceeded the U.S. Environmental Protection Agency Tolerable Daily Intake (TDI) values and the EFSA Reference Doses (RfD) (e.g., for di-2-ethyl-hexyl phthalate, 3.6% and 1% of the children exceeded RfD and TDi, respectively). Exposure was linked to three main sources: PEs-BPA to plastic, PBs-diethyl phthalate to personal hygiene products, and OPs to food.

Prenatal Second-Hand Smoke Exposure Measured with Urine Cotinine May Reduce Gross Motor Development at 18 Months of Age

Objective To evaluate the association of second-hand smoke exposure of pregnant mothers using urine cotinine with the neurodevelopment of their children at 18 months of age in the mother-child cohort in Crete (Rhea Study). Study design Selected participants were Greek mothers with singleton pregnancies, had never smoked, and had available urine cotinine measurements in pregnancy, and their children for whom a neurodevelopmental assessment was completed. We performed face-to-face interviews twice during pregnancy and postnatally, and assessed children's neurodevelopment at 18 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition. We used linear regression and generalized additive models. Results Of 599 mothers, 175 (29%) met the inclusion criteria. Maternal urine cotinine levels were low (mean: 10.3 ng/mL, SD: 11.7 ng/mL). Reported passive smoking from different sources was strongly associated with urine cotinine levels. A negative association was observed between cotinine levels in pregnancy and child's gross motor function (beta = −3.22 per 10 ng/mL, 95% CI −5.09 to −1.34) after adjusting for factors potentially associated with neurodevelopment; results were similar in both sexes. A negative association was also observed for cognitive and receptive communication scales but the effect was small and not statistically significant. Conclusions Maternal exposure during pregnancy to second-hand smoke measured through urine cotinine was associated with a decrease in gross motor function among 18-month-old children, even at low levels of exposure.

Early life determinants of dietary patterns in preschool children: Rhea mother-child cohort, Crete, Greece.

The determination of dietary patterns in children examines the effects of the overall diet at early ages, instead of looking at individual foods or energy providing nutrients. The present analysis aims to identify the dietary patterns of preschool children and to examine their associations with multiple socio-economic and lifestyle characteristics. Dietary data were collected for 1081 children participating in the Rhea mother-child cohort in Crete, Greece. Diet was assessed using a validated food frequency questionnaire, and dietary patterns were identified with principal component analysis. Multivariable linear regression models were used to examine factors associated with each dietary pattern. Three dietary patterns were identified explaining 45.8% of the total diet variation. The 'Mediterranean' pattern was based on pulses, olive oil, vegetables, fish and fruits; the 'Snacky' pattern included potatoes and other starchy roots, salty snacks, sugar products and eggs; the 'Western' pattern contained cereals, cheese, added lipids, beverages and meat. Preschool attendance and increased time spent with the mother (⩾2 h/day) were positively associated with the 'Mediterranean' pattern, whereas watching TV was inversely associated with this pattern. Lower parental education, maternal age and earlier introduction to solid foods were positively associated with the 'Snacky' pattern. Higher scores on the 'Western' type diet were associated with exposure to passive smoking and watching TV. No variation in energy providing nutrient intake was observed across tertiles of the identified dietary patterns. The results from this analysis indicate the important role of socio-demographic factors on children's dietary preferences in early age.

Prenatal Second-Hand Smoke Exposure Measured with Urine Cotinine May Reduce Gross Motor Development at 18 Months of Age

To evaluate the association of second-hand smoke exposure of pregnant mothers using urine cotinine with the neurodevelopment of their children at 18 months of age in the mother-child cohort in Crete (Rhea Study). Selected participants were Greek mothers with singleton pregnancies, had never smoked, and had available urine cotinine measurements in pregnancy, and their children for whom a neurodevelopmental assessment was completed. We performed face-to-face interviews twice during pregnancy and postnatally, and assessed children's neurodevelopment at 18 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition. We used linear regression and generalized additive models. Of 599 mothers, 175 (29%) met the inclusion criteria. Maternal urine cotinine levels were low (mean: 10.3 ng/mL, SD: 11.7 ng/mL). Reported passive smoking from different sources was strongly associated with urine cotinine levels. A negative association was observed between cotinine levels in pregnancy and child's gross motor function (beta = -3.22 per 10 ng/mL, 95% CI -5.09 to -1.34) after adjusting for factors potentially associated with neurodevelopment; results were similar in both sexes. A negative association was also observed for cognitive and receptive communication scales but the effect was small and not statistically significant. Maternal exposure during pregnancy to second-hand smoke measured through urine cotinine was associated with a decrease in gross motor function among 18-month-old children, even at low levels of exposure.

Prenatal Exposure to Persistent Organic Pollutants and Risk of Obesity in the Offspring: RHEA Mother-Child Cohort in Crete, Greece

Background: The environmental obesogen hypothesis suggests that prenatal or early life exposure to certain endocrine disrupting chemicals such as persistent organic pollutants (POPs) may cause permanent physiological changes predisposing to later increased fat mass and obesity. Aims: We examined whether in utero exposure to low levels of different POPs is associated with postnatal growth and obesity rates in preschool children in the RHEA mother-child cohort in Crete, Greece. Methods: We included 700 mothers and their children from the Rhea study. Concentrations of several polychlorinated biphenyls (PCBs) and other organochlorine compounds (dichlorodiphenyl dichloroethene [DDE], and hexachlorobenzene [HCB]) were determined in 1st trimester maternal serum by triple quadrupole mass spectrometry. Rapid growth at the first 6 months of life was defined as a weight gain Z score &gt;0.67. Age- and sex-specific Z scores for body mass index (BMI) were calculated at 4 years. Abdominal obesity was defined as waist circumference =90th percentile of national reference curves. Multiple linear and log Poisson regression models were used to examine the associations between exposures and continuous and binary outcomes respectively. Results: 36% of the children were rapid growers at 6 months and 21% were overweight/obese at 4 years. Geometric mean HCB, DDE and PCBs serum concentrations in pregnant women were 89, 2036 and 319 pg/ml respectively. Prenatal HCB exposure was associated with both increased risk of rapid growth at the first 6 months of life (RR= 1.97 [95% CI: 1.01 to 3.85] and overweight/obesity at 4 years (RR= 1.13 [95% CI: 0.98 to 1.30]. Prenatal DDE exposure was associated with increased risk of abdominal obesity at 4 years of age (RR= 2.09 [95% CI: 1.04 to 4.21]. Prenatal exposure to PCBs was not related to any of the examined outcomes. Conclusions: Prenatal exposure to even low levels of DDE and HCB may increase the risk of rapid postnatal growth and obesity in childhood.

Effect of Environmental Exposures and Diet on Genotoxicity in Newborns and Pregnant Mothers in Crete (RHEA Mother-Child Cohort)

Effect of Environmental Exposures and Diet on Genotoxicity in Newborns and Pregnant Mothers in Crete (RHEA Mother-Child Cohort)Abstract Number:2109 Cristina O'Callaghan-Gordo*, Eleni Fthenou, Marie Pedersen, Leda Chatzi, Ana Espinosa, Marina Vafeiadi, Euripides Stephanou, Hannu Kiviranta, Marie Vahter, Rob Beelen, Mark Nieuwenhuijsen, Jos Kleinjans, Micheline Kirsch-Volders, and Manolis Kogevinas Cristina O'Callaghan-Gordo* Centre for Research in Environmental Epidemiology (CREAL), Spain, E-mail Address: [email protected] Search for more papers by this author , Eleni Fthenou Faculty of Medicine, University of Crete (UoC), Greece, E-mail Address: [email protected] Search for more papers by this author , Marie Pedersen Centre for Research in Environmental Epidemiology (CREAL), Spain, E-mail Address: [email protected] Search for more papers by this author , Leda Chatzi Faculty of Medicine, University of Crete (UoC), Greece, E-mail Address: [email protected] Search for more papers by this author , Ana Espinosa Centre for Research in Environmental Epidemiology (CREAL), Spain, E-mail Address: [email protected] Search for more papers by this author , Marina Vafeiadi Faculty of Medicine, University of Crete (UoC), Greece, E-mail Address: [email protected] Search for more papers by this author , Euripides Stephanou School of Sciences and Engineering, University of Crete (UoC), Greece, E-mail Address: [email protected] Search for more papers by this author , Hannu Kiviranta Department of Environmental Health, National Institute for Health and Welfare, Finland, E-mail Address: [email protected] Search for more papers by this author , Marie Vahter Department of Environmental Medicine, Karolinska Institute, Sweden, E-mail Address: [email protected] Search for more papers by this author , Rob Beelen Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Netherlands, E-mail Address: [email protected] Search for more papers by this author , Mark Nieuwenhuijsen Centre for Research in Environmental Epidemiology (CREAL), Spain, E-mail Address: [email protected] Search for more papers by this author , Jos Kleinjans Department of Toxicogenomics, Maastricht University, Netherlands, E-mail Address: [email protected] Search for more papers by this author , Micheline Kirsch-Volders Laboratory of Cell Genetics, Faculty of Science and Bio-engineering, Vrije Universitei Brussel, Belgium, E-mail Address: [email protected] Search for more papers by this author , and Manolis Kogevinas Centre for Research in Environmental Epidemiology (CREAL), Spain, E-mail Address: [email protected] Search for more papers by this author AbstractBackground: Incidence of childhood cancer has increased in recent decades. The causes of childhood cancer are poorly understood. High micronuclei (MN) frequency has been associated in adults with future cancer risk. Aim: We examined MN frequency, a biomarker of early genetic effects, in cord and mother’s blood in relation to environmental exposures and diet during pregnancy in the RHEA mother-child cohort in Crete, Greece (part of the European NewGeneris study).Methods: The cytokinesis-block micronucleus assay was used to assess MN frequencies in bi- and mono-nucleated T-lymphocytes in 223 newborns and 214 mothers in 2007-08. Persistent organic pollutants, metals (Cd, Pb) and cotinine were measured in mothers and adducts of genotoxic compounds were available from newborns. The ESCAPE methods were used for modeling outdoor air pollution at home addresses in 2010. Associations between exposures and MN frequency were examined using negative binomial regression.Results: Exposure to air pollutants during whole pregnancy was not associated with increased MN frequency in newborns. In mothers increased risk of MN frequency in bi-nucleated cells was found for PM2.5 (adjusted IRR per 5µg/m3 =1.6, 95%CI=1.1-2.5). Increased MN frequency in newborns and mothers was associated with season of birth with highest risk in summer (newborns: adjusted IRR =2.1 95%CI=1.6-2.8; mothers: adjusted IRR=1.5, 95%CI=1.1-2.0). Increased MN frequency in bi-nucleated cells was observed among large birth weight (>4000g) newborns (adjusted IRR =1.3, 95%CI=1.0-1.8). There were no consistent patterns in MN frequency and other environmental contaminants or active/passive smoking. Some associations were found between meat, vegetables, fruit and iron supplements intake during pregnancy and MN frequency in bi- and mono-nucleated cells in newborns and mothers.Conclusions: We found few and not fully consistent patterns of genotoxicity risks in newborns associated with environmental and dietary exposures.

Social capital, tolerance of diversity and adherence to Mediterranean diet: the Rhea Mother-Child Cohort in Crete, Greece.

To estimate the associations of individual maternal social capital and social capital dimensions (Participation in the Community, Feelings of Safety, Value of Life and Social Agency, Tolerance of Diversity) with adherence to the Mediterranean diet during pregnancy. This is a cross-sectional analysis of data from a prospective mother-child cohort (Rhea Study). Participants completed a social capital questionnaire and an FFQ in mid-pregnancy. Mediterranean diet adherence was evaluated through an a priori score ranging from 0 to 8 (minimal-maximal adherence). Maternal social capital scores were categorized into three groups: the upper 10 % was the high social capital group, the middle 80 % was the medium and the lowest 10 % was the low social capital group. Multivariable log-binomial and linear regression models adjusted for confounders were performed. Heraklion, Crete, Greece. A total of 377 women with singleton pregnancies. High maternal Total Social Capital was associated with an increase of almost 1 point in Mediterranean diet score (highest v. lowest group: β coefficient=0·95, 95 % CI 0·23, 1·68), after adjustment for confounders. Similar dose-response effects were noted for the scale Tolerance of Diversity (highest v. lowest group: adjusted β coefficient=1·08, 95 % CI 0·39, 1·77). Individual social capital and tolerance of diversity are associated with adherence to the Mediterranean diet in pregnancy. Women with higher social capital may exhibit a higher sense of obligation to themselves and to others that may lead to proactive nutrition-related activities. Less tolerant women may not provide the opportunity to new healthier, but unfamiliar, nutritional recommendations to become part of their regular diet.

Exposure to organochlorine compounds during pregnancy and birth outcomes in the mother-child cohort in Crete, Greece (Rhea study).

Exposure to organochlorine compounds during pregnancy and birth outcomes in the mother-child cohort in Crete, Greece (Rhea study).

Smoking and caesarean deliveries: major negative predictors for breastfeeding in the mother-child cohort in Crete, Greece (Rhea study).

Although benefits of breastfeeding have been widely promoted and accepted, exclusive breastfeeding for the first 6 months of life is far from the norm in many countries. In a prospective mother-child cohort study in Crete, Greece ('Rhea' study), we assessed the frequency of breastfeeding and its socio-demographic predictors. Information on breastfeeding was available for a period of 18 months post-partum for a cohort of 1181 mothers and their 1208 infants. The frequency of exclusive and predominant breastfeeding in the first month post-partum was 17.8% and 3.4%, respectively, with almost three-quarters of women (73.6%) ceasing any breastfeeding after 4 months post-partum. Women were less likely to initiate breastfeeding if they had a caesarean delivery (CD), whereas they were more likely to initiate breastfeeding if they had a higher education or gave birth to a private clinic. Among women breastfeeding, those who had a CD, were ex-smokers or smokers during pregnancy had a statistically significant shorter duration of breastfeeding, whereas higher education and being on leave from work were associated with a longer duration of breastfeeding. Study findings suggest suboptimal levels of exclusive and any breastfeeding and difficulty maintaining longer breastfeeding duration. CD and smoking are common in Greece and are strong negative predictors for breastfeeding initiation and/or duration, necessitating targeting women at risk early in the prenatal period so as to have a meaningful increase of breastfeeding practices in future cohorts of mothers.

The effect of high doses of folic acid and iron supplementation in early-to-mid pregnancy on prematurity and fetal growth retardation: the mother–child cohort study in Crete, Greece (Rhea study)

We examined whether high doses of folic acid and iron supplementation in early-to-mid pregnancy affect the risk of preterm birth, low birth weight, and small for gestational age neonates, in the mother-child cohort in Crete, Greece (Rhea study). We included 1,279 women with singleton pregnancies with complete data on supplements use in early-to-mid pregnancy and birth outcomes. Anthropometric measurements at birth were obtained from medical records. Red blood cell folate concentrations in cord blood were measured in a subsample of the study population (n = 58). Sixty-six percent of the study participants reported high doses of supplemental folic acid use (5 mg/day), while 21 % reported excessive doses of folic acid use (>5 mg/day) in early-to-mid pregnancy. Daily intake of 5-mg supplemental folic acid was associated with a 31 % decrease in the risk of preterm birth (RR, 0.69; 95 % CI, 0.44, 0.99), 60 % decrease in the risk of delivering a low birth weight neonate (RR, 0.40; 95 % CI, 0.21, 0.76), and 66 % decrease in the risk of delivering a small for gestational age (SGA) neonate (RR, 0.34; 95 % CI, 0.16, 0.73). Daily doses of iron supplementation more than 100 mg were associated with a twofold increased risk for SGA neonates (RR, 2.14; 95 % CI, 0.99, 5.97). These findings suggest that high daily doses of supplementary folic acid in early-to-mid pregnancy may be protective for preterm birth, low birth weight, and small for gestational age neonates, while high daily doses of supplementary iron may be harmful for fetal growth.