Prospective Birth Cohort Study Research Articles

Instability of revised Korean Developmental Screening Test classification in first year of life.

Early development is characterized by considerable variability. To investigate the stability of the revised Korean Developmental Screening Test (K-DST) classification of the development of healthy term 4-6 and 10-12 month-old infants. This study used data from the Korean Children's Environmental Health study, a nationwide prospective birth cohort study. Sixty-nine healthy term infants (26 boys, 43 girls) underwent two serial tests at 4-6 and 10-12 months of age between August 2017 and December 2019. We divided the entire group into three categories according to the revised K-DST cut-off points. At 4-5 months, more than 50% of infants were categorized into the ≥-1 standard deviations (SD) group. The lowest prevalence (52.7%) was observed in the gross motor domain. Seven infants (10.1%) scored below -2 SD in at least one domain. The prevalence of scores below -2 SD was 7.3% in the gross and fine motor domains. At 10-12 months, >70% were as categorized into the ≥-1 SD group except in the language domain. Six infants (9.5%) scored below -2 SD in at least one domain. The prevalence of scores below -2SD was 4.8%, 3.2%, 3.2% in the cognition, language, and gross motor domains, respectively. On serial follow-up for 4-12 months, a significant number of infants improved to the peer and high-level group (≥-1 SD), especially in the gross motor domain (33.3%). Among the seven infants who scored below -2 SD at 4-5 months, only two had -2 SD scores at 10-12 months. For infants presenting with suspected developmental delay on the revised K-DST 4-5 months questionnaire, especially in the gross motor domain, in the absence of any abnormal neurological findings or developmental red flags, close monitoring and repeated assessments should be performed.

Breastfeeding and Children's Cognitive Development up to the Age of 4 Years: The Japan Environment and Children's Study.

Objective: Breastfeeding, depending on its duration, has been suggested to benefit children's cognitive development. We aimed to examine this issue by using the Japan Environment and Children's Study, a nationwide prospective birth cohort study. Methods: We evaluated the relationship between feeding methods and cognitive development in 2- and 4-year-old children. We classified the children based on the following feeding method during the first 6 months postpartum: (1) exclusive breastfeeding group, solely breastfeeding; (2) partial breastfeeding group, solely breastfeeding for ≤5 months and combination of breastfeeding/formula for the rest of months; (3) formula-fed group, solely formula feeding for ≥4 months; and (4) others. Cognitive development was assessed by trained testers using the Kyoto Scale of Psychological Development 2001. Results: Data on 1,329 boys and 1,398 girls were analyzed. Multiple regression analysis was performed using the exclusive breastfeeding group as the reference. Boys of age 2 years in the formula-fed group had significantly lower developmental quotients (DQs) in the language-social developmental (L-S) area (partial regression coefficient [B]: -4.624, p = 0.01), whereas no significant difference was observed in those of age 4 years. Girls of age 2 and 4 years in the formula-fed group had significantly lower L-S area DQ (B: -3.637, p = 0.03 and B: -3.414, p = 0.03, respectively). In the partial breastfeeding group, no significant differences in the L-S area DQ were observed in 2- and 4-year-old boys and girls. Conclusions: Exclusive breastfeeding for the first 6 months postpartum may be more beneficial for verbal cognitive development in 4-year-old girls than solely formula feeding for ≥4 months. Furthermore, breastfeeding combined with formula for the first 6 months postpartum may not have a disadvantage on cognitive development in boys and girls of age ≥ 2 years, when compared with that observed with exclusive breastfeeding during the first 6 months postpartum.

Mycobacterium tuberculosis infection and tuberculosis disease in the first decade of life: a South African birth cohort study

Paediatric tuberculosis leads to more than 200 000 deaths annually. We aimed to investigate the incidence of Mycobacterium tuberculosis infection and tuberculosis disease in the first decade of life in the Drakenstein Child Health Study (DCHS), a South African cohort in a community with high tuberculosis and HIV incidence. In this prospective birth cohort study, we enrolled pregnant women aged 18 years or older who were between 20 and 28 weeks' of gestation in a peri-urban setting outside of Cape Town, South Africa. We followed up their children for tuberculosis until age 10 years. To measure M tuberculosis infection tuberculin skin tests were administered to children at age 6 months, 12 months, and then annually in children with a negative test, and at the time of a lower respiratory tract infection. Tuberculin skin test conversion was defined by an induration reaction of 10 mm or more. To measure tuberculosis disease, active surveillance was done throughout follow-up. Each episode of presumed tuberculosis disease was investigated using sputum induction, tested with Xpert MTB/RIF and liquid culture for M tuberculosis. Survival analyses were performed and multivariable Cox regression was used to measure factors associated with M tuberculosis infection or disease. Between March 5, 2012, and March 31, 2015, 1137 women and their 1143 children (248 [21·7%] of 1143 children were HIV-exposed, two [0·2%] children with HIV) were included in the analysis. Children were followed up for 8870 person-years (median follow-up 9·1 years [IQR 8·2-10·2]). The annual risk of tuberculin conversion during follow-up was 6·6 infections per 100 person-years (95% CI 5·8-7·3) but ranged from 4-9 infections per 100 person-years over the follow-up period. 98 children developed tuberculosis (1105 cases per 100 000 person-years; 95% CI 906-1347). The cumulative hazard of tuberculin conversion was 36% (95% CI 32-41) at age 8 years and the cumulative hazard of tuberculosis disease was 10% (8-12) at age 10 years. Preventive treatment was associated with a reduction in tuberculosis disease among children who had tuberculin conversion (adjusted hazard ratio 0·23 [95% CI 0·12-0·47]). Most cases of tuberculosis disease (78 [79%; 95% CI 69-86] of 98 children) occurred among children who had tuberculin skin test conversion but were not administered preventive treatment. In this prospective South African birth cohort, M tuberculosis transmission was consistently high throughout the first decade of life leading to approximately 10% of children developing tuberculosis disease. A multipronged approach to decrease paediatric tuberculosis is needed that combines preventive treatment for children at risk, reducing community M tuberculosis transmission, and active case finding. Bill & Melinda Gates Foundation, Medical Research Council South Africa, and National Research Foundation South Africa.

Association between infant sleep and neurodevelopment in a prospective birth cohort study

ObjectivesTo investigate the association of infant sleep and sleep trajectories through the first year of life with infant neurodevelopment. MethodsThis study was conducted with 3251 infants in China. Sleep parameters were evaluated by the Brief Infant Sleep Questionnaire at 42days, 6months, and 1year of age. Neurodevelopment was evaluated at 1year of age using the Bayley Scales of Infant and Toddler Development, Third Edition. The latent variable growth curve model was used to evaluate the developmental trajectories of infant sleep, including total sleep duration trajectories, night awakening trajectories and sleep onset latency trajectories. Poisson regression was applied to assess the association between sleep parameters and sleep trajectories and infant neurodevelopment. ResultsInfants with frequent night awakenings at 6months had a higher risk of nonoptimal gross motor development. Additionally, infants with prolonged sleep onset latency at 1year had an increased risk of nonoptimal fine and gross motor development. A consistent frequent night-awakening trajectory increased the risk of nonoptimal gross motor development (adjusted relative risk, 1.52; 95% confidence interval, 1.09 to 2.10). Furthermore, an increasing trajectory in sleep onset latency was associated with an increased risk of nonoptimal fine (adjusted relative risk, 2.70; 95% confidence interval, 1.12 to 6.51) and gross motor development (adjusted relative risk, 2.76; 95% confidence interval, 1.70 to 4.48). However, no significant association was observed between total sleep duration, or its trajectory, and infant neurodevelopment. ConclusionsSleep problems or specific sleep trajectories during the initial year of life may increase risk of compromised neurodevelopment.

Typologies of Residential Mobility in Childhood and Associations with Sociodemographic Characteristics: a Prospective Birth Cohort Study in Aotearoa New Zealand

AbstractDespite documented associations between childhood area-level socioeconomic status (SES), residential mobility and health, studies in this domain rarely use lifecourse study designs. This study examined temporal patterns of four residential mobility typologies based on area-level SES exposure from birth to 16 years. We devised four main residential mobility typologies: advantaged stayers (remaining in high SES areas), disadvantaged stayers (remaining in low SES areas), advantaged or upward movers (moving between high SES areas or transitioning from low to high SES areas), and disadvantaged or downward movers (moving between low SES areas or transitioning from high to low SES areas). Secondly, the research examined selected sociodemographic characteristics associated with the residential mobility typologies and whether these associations varied by age. Data from the Christchurch Health and Development (CHDS) prospective birth cohort study were used to obtain individual (i.e., gender, ethnic) and family sociodemographic (i.e., family SES) characteristics, and home addresses from birth to 16 years. Geocoded home addresses were linked to area-level SES. Two-level multinomial logistic regression models examined associations between sociodemographic characteristics and residential mobility typologies and their variations by age. Disadvantaged stayers constituted over one-fifth of the cohort during most of childhood. Children with Māori ethnicity, younger mothers, family instability, and childhood adversity are more vulnerable to frequent moves coupled with exposure to low area-level SES. Our study paves the way for the exploration of childhood environmental exposures and later-life health within a spatial lifecourse epidemiology framework.

Factors predicting a decrease in suicidality among young people (0-28 years old)

Abstract Background Suicide, self-harm and suicidal thoughts (i.e., suicidality) are important public health concerns. Most youth that experience suicidality find a way to overcome these affronts. Preventative public health measures require an understanding of factors that can help youth overcome their suicidality. Methods Data come from a Dutch prospective birth-cohort study that surveyed youth from age 11 to 28 (measurements 2-3 years apart). We determined the proportion of youth that experienced suicidality across seven waves and focused on changes in suicidality, and factors associated with changes in suicidality using linear discriminant analysis. We examined a mix of individual, family, peer and socio-cultural factors in line with an ecological framework, e.g. the Interpersonal Theory of Suicide. Results Between 4-8% of youth experienced suicidal thoughts and between 2-5% experienced self-harm across time points. Most youth (89%-94% across time points) did not experience changes in suicidality, while between 3-6% experienced a decline of suicidal thoughts and between 2-4% a decline in self-harm across time points. Discriminant analyses could correctly identify ≈90% of subgroup per case (decline, increase, stable suicidality). But, the model was not very accurate in predicting which youth belonged to the declining suicidality subgroup. Functions with best predictive ability indicated the importance of interpersonal factors; belonging to peers, parents, classmates, teachers and religion. Also, overall happiness and positive changes in romantic relationships and family had predictive value. Conclusions It remains difficult to distinguish youth who experience a decrease in suicidality. Interpersonal factors may play a role in changes in suicidality, but we need to identify new factors related to declines in suicidality. Future prospective birth-cohort study should consider including factors that may be better predictors of decreases in suicidality and mental health in general. Key messages • Factors that contribute to decreases in suicidality will enrich suicide prevention strategies, which have until thusfar mostly been informed by a risk perspective. • Interpersonal factors might play an important role in changes in suicidality among youth, which indicates we need an ecological perspective on suicidality rather than an individual perspective.

Changes in social relationships from 26 to 34 years of age in adults born very preterm.

Very preterm and/or very low birthweight (VP/VLBW; <32 weeks' gestation and/or <1500 g birthweight) individuals rated their partner and peer relationships lower than term-born individuals in emerging adulthood, but their quality of relationships with parents has been rarely investigated. Moreover, it is unclear whether previously reported differences in social relationship characteristics persist or lessen from emerging to established adulthood. To investigate changes in social relationship characteristics in VP/VLBW adults compared to term-born adults from 26 to 34 years and whether the association between VP/VLBW and social relationship characteristics varies according to sex. In this prospective whole-population birth cohort study in South Bavaria, Germany, social relationship characteristics with parents, partners and peers, and overall social relationships across these domains were evaluated with a Life Course Interview at 26 and 34 years. Interview items related to these domains were extracted and scored as 0 (optimal) and 1 (non-optimal). Each score was summed into domain-specific composite scores and standardised according to the total sample. Participants included 262 VP/VLBW (52.7% males) and 230 term-born individuals (47.0% males). VP/VLBW adults had lower overall social relationship scores than term-born adults (β = -.61, 95% CI -0.85, -0.37). Specifically, partner (β = -.50, 95% CI-0.74, -0.27) and peer relationship scores (β = -.55, 95% CI-0.78, -0.32) were lower than those of term-born adults, but scores did not differ for parent relationships. On average, partner (β = .25, 95% CI 0.14, 0.35) and peer relationship scores increased (β = .16, 95% CI 0.03, 0.29), while parent relationship scores decreased (β = -.64, 95% CI-0.79, -0.49) from 26 to 34 years. These changes were similar for VP/VLBW and term-born individuals. Patterns of change for the improved partner and peer but worsening parental social relationship scores were common across VP/VLBW and term-born adults, but differences between the two groups persisted from 26 to 34 years.

Adherence to plant-based diet during pregnancy and risk of gestational diabetes: a prospective birth cohort study

BackgroundStudies have shown that plant-based foods have a protective effect against gestational diabetes (GDM). We examined the association between plant-based dietary patterns and the risk of GDM in a sample of Iranian adults.MethodsWe enrolled 635 pregnant women for the present study. Dietary intakes were evaluated by using a 90-item food frequency questionnaire during the first trimester of pregnancy. Three plant-based including plant-based (PDI), unhealthy (uPDI) and healthy (hPDI) were calculated. Cox proportional hazard model were fitted to estimate hazard ratio (HR) and 95% confidence interval (CI) of GDM across categories of the plan-based dietary indices, while controlling for age, educational level, physical activity, family income, prepregnancy body mass index, gestational weight gain, and total energy intake.ResultsA total of 635 mothers were included, of whom 79 participants were diagnosed with GDM. Those in the third tertile of the PDI (HR: 0.55, 95% CI: 0.30, 0.98) and hPDI (HR: 0.43, 95% CI: 0.24, 0.78) had a lower risk of developing GDM during their current pregnancy as compared to the first tertile. There was no association between uPDI and risk of GDM.ConclusionsWe found that higher adherence to a plant-based diet during early pregnancy may be associated with a lower GDM risk among Iranian women. Confirmation of this finding is necessary in larger cohort studies, taking into account other pregnancy outcomes such as birth weight.

The fetal origins of metabolic health: exploring the association between newborn biological age and metabolism hormones in childhood

BackgroundTelomere length (TL), mitochondrial DNA copy number (mtDNAcn), and DNA methylation age (DNAmAge) are common aging biomarkers. However, research on the associations between these three markers at birth and subsequent metabolic status was limited. This study aimed to evaluate the association between TL, mtDNAcn, and DNAmAge in newborns and the variation in metabolic hormones of children at 3 years old.MethodsThis research involved 895 mother–child pairs from a birth cohort in China, with TL and mtDNAcn measured using quantitative real-time PCR, DNA methylation (DNAm) assessed using Infinium MethylationEPIC Beadchip, and DNAm age (DNAmAge) determined using Horvath’s epigenetic clock. Insulin and leptin levels were measured via electrochemiluminescence assay. Multivariable adjusted linear regression and restricted cubic spline (RCS) analysis were utilized to examine the association between aging markers and metabolic hormones.ResultsThe linear regression analysis indicated the percentage change of metabolism hormones for per doubling of aging biomarkers alterations and found significant associations between DNAmAge and insulin levels (adjusted percent change (95% CI), − 13.22 (− 23.21 to − 1.94)), TL and leptin levels (adjusted percent change (95% CI), 15.32 (1.32 to 31.24)), and mtDNAcn and leptin levels (adjusted percent change (95% CI), − 14.13 (− 21.59 to − 5.95)). The RCS analysis revealed significant non-linear associations between TL (Ln transformed) and insulin (Ln transformed) (P = 0.024 for nonlinearity), as well as DNAmAge (Ln transformed) and leptin (Ln transformed) (P = 0.043 for nonlinearity). Specifically, for TL and insulin, a positive association was observed when TL (Ln transformed) was less than − 0.05, which transitioned to an inverse association when TL (Ln transformed) was greater than − 0.05. Regarding DNAmAge and leptin, there was a sharp decline when DNAmAge (Ln transformed) was less than − 1.35, followed by a plateau between − 1.35 and − 0.67 and then a further decline when DNAmAge (Ln transformed) was greater than − 0.67.ConclusionsIn this prospective birth cohort study, variation in metabolic hormones of children at 3 years old was associated with TL, mtDNAcn, and DNAmAge at birth. These findings suggested that TL, mtDNAcn, and DNAmAge might play a role in the biological programming of metabolic health from birth.

Relationship between sleep quality during pregnancy and postpartum anxiety: a prospective birth cohort study

The present study aimed to determine the relationship between sleep quality during pregnancy and postpartum anxiety.A total of 237 pregnant women participated in this birth cohort study, using the sequential sampling method. The data collection tools included a demographic information form, Pittsburgh Sleep Quality Inventory, and Spielberger State-Trait Anxiety Inventory. The PSQI was completed by the participants at 28 and 40 weeks of gestation, and the STAI was completed in two stages, that is, once in the third trimester and once at eight weeks postpartum.The mean global PSQI score of the participants was 8.11 (SD=5.41) in this study. Overall, 138 (58.2%) women had poor sleep quality. The mean score for overt anxiety was 36.58 (SD=9.37), and the mean score for latent anxiety was 37.56 (SD=9.44). There was a significant positive correlation between the total score of sleep quality during pregnancy and the scores of overt anxieties (r=0.314, P&lt;0.001) and latent anxiety (r=0.344, P&lt;0.001) after delivery.The results of the present study indicated a significant relationship between sleep quality during pregnancy and postpartum anxiety. Therefore, it is recommended to evaluate the quality of sleep of pregnant women and design appropriate interventions during pregnancy to reduce postpartum anxiety. Keywords: Sleep; pregnant woman; postpartum period.

Associations of inflammation related prenatal adversities with neurodevelopment of offspring in one year: a longitudinal prospective birth cohort study

BackgroundThe recent Maternal Immune Activation (MIA) theory suggests maternal systemic inflammation may serve as a mediator in associations between prenatal maternal adversities and neurodevelopmental diseases in offspring. Given the co-exposure to multiple adversities may be experienced by pregnant person, it is unclear whether a quantitative index can be developed to characterize the inflammation related exposure level, and whether this index is associated with neurodevelopmental delays in offspring.MethodsBased on Jiangsu Birth Cohort (JBC), a total of 3051 infants were included in the analysis. Inflammation related Prenatal Adversity Index (IPAI) was constructed using maternal data. Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, third edition, screening test in one year. Multivariate linear regression and Poisson regression model were performed to analyze the associations between IPAI and neurodevelopment in offspring.ResultsCompared with “low IPAI” group, offspring with “high IPAI” have lower scores of cognition, receptive communication, expressive communication, and fine motor. The adjusted β were − 0.23 (95%CI: -0.42, -0.04), -0.47 (95%CI: -0.66, -0.28), -0.30 (95%CI: -0.49, -0.11), and − 0.20 (95%CI: -0.33, -0.06). Additionally, the elevated risk for noncompetent development of cognition and receptive communication among “high IPAI” group was observed. The relative risk [RR] and 95% confidence interval [CI] were 1.35 (1.01, 1.69) and 1.37 (1.09, 1.72).ConclusionsOur results revealed a significant association between higher IPAI and lower scores across cognition, receptive communication, expressive communication, and fine motor domains, and an increased risk of noncompetent development in the cognition and receptive communication domains.

Maternal exercise during pregnancy is associated with reduced risk of asthma in the child: A prospective birth cohort study.

The means of primary prevention of asthma are limited. Maternal physical activity during pregnancy promotes fetal lung development and the newborn's lung function; thus, it could lower asthma risk and aid in asthma prevention. The objective of this study is to determine whether maternal physical activity during pregnancy is associated with asthma development in the child. The study population included 963 mother-infant pairs from the prospective Kuopio Birth Cohort study. Data on maternal physical activity during pregnancy, confounding factors, and children's asthma at 5 to 7 years of age were obtained from the Kuopio University Hospital birth registry and questionnaires. Maternal physical activity during pregnancy, when practiced three or more times per week, was associated with a reduced risk of asthma in the child, with an adjusted odds ratio of 0.54 (95% confidence interval 0.33-0.89; p= 0.02). The association was stable across a comprehensive set of adjustments, including length of gestation, mode of delivery, and maternal health indicators (e.g., asthma, smoking, pre-pregnancy body mass index and weight gain during pregnancy, infections, medication, healthy diet, stress), as well as various family environment variables. Maternal physical activity during pregnancy may be associated with marked protection of asthma in childhood and should be studied further as an applicable measure for asthma prevention. The study has been financially supported by grants from the Academy of Finland (no. 349427), the Emil Aaltonen Foundation, the Finnish Cultural Foundation, the Yrjö Jahnsson Foundation, the Juho Vainio Foundation (no. 202200461), the Kuopio Area Respiratory Foundation, and the Ida Montini Foundation.

Epigenetic Clock at Birth and Childhood Blood Pressure Trajectory: A Prospective Birth Cohort Study.

The impact of methylation gestational age (GAmAge; a biomarker of fetal maturity) at birth on childhood blood pressure (BP) trajectories is unknown. This cohort study included 500 boys and 440 girls with data on cord blood DNA methylation and BP at 3 to 15 years of age. Systolic BP (SBP) and diastolic BP percentiles were calculated based on clinical guidelines. Time-series K-means clustering identified 4 distinct SBP and diastolic BP percentile trajectories: high-steady, high-decrease, normal-increase, and normal-steady. GAmAge was estimated using an existing pediatric epigenetic clock. Extrinsic age acceleration was calculated as residuals of associations between GAmAge and chronological gestational age. Intrinsic age acceleration was calculated using the same method adjusting for cord blood cell compositions. Extrinsic age acceleration and intrinsic age acceleration were inversely associated with repeated measures of BP percentiles. Significant inverse associations were observed between extrinsic age acceleration and SBP percentiles in boys (β=-2.02; P=0.02) but not in girls (β=-0.49; P=0.58). Both extrinsic age acceleration and intrinsic age acceleration were inversely associated with SBP percentiles in girls born preterm (<37 weeks; βEAA=-2.95; βIAA=-3.00; P<0.05). Compared with the normal-steady SBP trajectory, significant inverse associations were observed between intrinsic age acceleration and high-steady, high-decrease, and normal-increase SBP trajectories in boys (odds ratio, 0.73-0.81; P<0.03), and significant positive associations were observed for high-decrease and normal-increase SBP trajectories in girls (odds ratio, 1.26-1.38; P<0.01). Significant sex differences were observed (Psex-interaction<2×10-16). GAmAge acceleration at birth was inversely associated with child BP, and such association was more pronounced in boys than in girls. Our findings may shed new light on the developmental origins of high BP and sex differences in cardiovascular risk.

Perinatal risk factors and neurocognitive outcomes in children and adolescents with sickle cell disease.

The literature on cognitive and academic outcomes for children with sickle cell disease (SCD) who experience perinatal risk factors is limited. We aimed to evaluate if low birthweight (LBW), gestational age, and history of neonatal intensive care unit (NICU) admission were associated with neurocognitive functioning, grade retention, or receipt of early intervention or formal educational support in children with SCD. This prospective birth cohort study included 336 participants, ages 8-18, with SCD, who received cognitive testing as part of standard of care and whose caregivers completed behavioral rating scales. Multivariable generalized linear regression models were used to examine associations between perinatal risks and outcome variables, after adjusting for demographic and medical covariates. The prevalence of NICU admission and LBW were 12.03% and 13.50%, respectively. Lower birthweight, earlier gestational age, and NICU admission were associated with worse working memory performance and receipt of early intervention services. Lower birthweight and NICU admission were also associated with slower processing speed. History of NICU admission was associated with caregiver ratings of hyperactivity and emotional dysregulation. The effects of perinatal risk factors on neurocognitive, academic, or educational outcomes were not dependent on SCD genotype. History of LBW or NICU admission was associated with worse cognitive outcomes and increased use of early intervention services among children with SCD. Early identification of perinatal risk factors will help identify children who will benefit from formal developmental or neuropsychological evaluations to manage the comorbidity of SCD and perinatal risks and facilitate increased intervention.

Early-Life Risk Factors for Carotid Intima-Media Thickness and Carotid Stiffness in Adolescence

ImportanceAtherogenesis starts during childhood, making childhood and adolescence an important window of opportunity to prevent atherosclerotic cardiovascular disease later in life.ObjectiveTo identify early-life risk factors for preclinical atherosclerosis in adolescence.Design, Setting, and ParticipantsThis cohort study is part of the ongoing Wheezing Illness Study in Leidsche Rijn (WHISTLER) prospective birth cohort study, which includes 3005 healthy newborns born between December 2001 and December 2012 in the Leidsche Rijn area of Utrecht, the Netherlands. Eligible participants included those from the WHISTLER cohort who visited the clinic between March 2019 and October 2020 for adolescent follow-up. This study’s analyses were performed in January 2024.ExposuresEarly-life growth was assessed at birth to 6 months, 5 years, and 12 to 16 years. Abdominal ultrasonography determined abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) depth. Blood pressure (BP) percentiles and body mass index (BMI) z scores were used.Main Outcomes and MeasuresCarotid ultrasonography was performed at age 12 to 16 years to assess carotid intima-media thickness (cIMT) and the distensibility coefficient (DC), established measures of preclinical atherosclerosis. Multivariable linear regression models were used to identify early-life risk factors for cIMT and DC in adolescence.ResultsIn total, 232 adolescents (median [IQR] age, 14.9 [13.7-15.8] years; 121 female [52.2%]) were included. More postnatal weight gain (B = 12.34; 95% CI, 2.39 to 22.39), higher systolic BP at 5 years (B = 0.52; 95% CI, 0.02 to 1.01), more VAT at 5 years (B = 3.48; 95% CI, 1.55 to 5.40), and a larger change in VAT between 5 and 12 to 16 years (B = 3.13; 95% CI, 1.87 to 4.39) were associated with a higher cIMT in adolescence. A higher BMI (B = −2.70, 95% CI,−4.59 to −0.80) and VAT at 5 years (B = −0.56; 95% CI, −0.87 to −0.25), as well as a larger change in BMI between 5 and 12 to 16 years (B = −3.63; 95% CI, −5.66 to −1.60) were associated with a higher carotid stiffness in adolescence. On the contrary, a larger change in SAT between 5 and 12 to 16 years (B = 0.37; 95% CI, 0.16 to 0.58) was associated with a higher carotid DC in adolescence.Conclusions and RelevanceIn this cohort study of 232 participants, early-life growth parameters, and particularly abdominal VAT development, were associated with a higher cIMT and carotid stiffness in adolescence. These findings suggest that assessment of adipose tissue development during childhood can aid characterization of lifetime risk trajectories and tailoring of cardiovascular prevention and risk management strategies.

Association of nighttime sleep duration at 1.5 years with height at 3 years: The Japan Environment and Children's Study.

Adequate nighttime sleep duration has been considered beneficial for linear growth in children; however, there is limited and conflicting evidence regarding the association between sleep duration and subsequent linear growth. To investigate the association between sleep duration at 1.5 years and height at 3 years of age. The Japan Environment and Children's Study is a nationwide prospective birth cohort study. Data from 52,140 term singleton births born at an appropriate-for-gestational age without background disorders that could potentially affect linear growth in the analyses were included. Nighttime and total sleep durations were calculated based on a self-administered questionnaire completed by caregivers. Tall stature was defined as height at or above the 75th percentile among participants. After adjustment for height at 1.5 years, sex, monthly age, mother's height, presence of siblings at 1.5 years, environmental tobacco smoke at 1.5 years, daily TV/DVD screen time at 2 years, attendance at nursery at 2 years, household annual income at birth, and parents' educational status, multivariate odds ratio (95% confidence interval) for tall stature at 3 years were 1.09 (1.01-1.17), 1.09 (1.01-1.17), and 1.25 (1.14-1.37) for 9.5 or 10, 10.5 or 11, and ≥ 11.5 h of nighttime sleep duration at 1.5 years, respectively, compared with those with ≤ 9 h sleep (p for trend <0.0001). Total sleep duration was not associated with tall stature. This study underscores the importance of nighttime sleep duration, not total sleep duration, in the linear growth of very young children.

A clinical protocol for a German birth cohort study of the Maturation of Immunity Against respiratory viral Infections (MIAI).

Respiratory viral infections (RVIs) are a major global contributor to morbidity and mortality. The susceptibility and outcome of RVIs are strongly age-dependent and show considerable inter-population differences, pointing to genetically and/or environmentally driven developmental variability. The factors determining the age-dependency and shaping the age-related changes of human anti-RVI immunity after birth are still elusive. We are conducting a prospective birth cohort study aiming at identifying endogenous and environmental factors associated with the susceptibility to RVIs and their impact on cellular and humoral immune responses against the influenza A virus (IAV), respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The MIAI birth cohort enrolls healthy, full-term neonates born at the University Hospital Würzburg, Germany, with follow-up at four defined time-points during the first year of life. At each study visit, clinical metadata including diet, lifestyle, sociodemographic information, and physical examinations, are collected along with extensive biomaterial sampling. Biomaterials are used to generate comprehensive, integrated multi-omics datasets including transcriptomic, epigenomic, proteomic, metabolomic and microbiomic methods. The results are expected to capture a holistic picture of the variability of immune trajectories with a focus on cellular and humoral key players involved in the defense of RVIs and the impact of host and environmental factors thereon. Thereby, MIAI aims at providing insights that allow unraveling molecular mechanisms that can be targeted to promote the development of competent anti-RVI immunity in early life and prevent severe RVIs. https://drks.de/search/de/trial/, identifier DRKS00034278.

Prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances and childhood bone mineral density: A prospective birth cohort study

Background and aimPerfluoroalkyl and polyfluoroalkyl substances (PFAS) have demonstrated potential toxicity in skeletal development. However, the relationship between prenatal PFAS exposure and offspring bone health remains unclear in epidemiological studies. Therefore, we aim to investigate whether prenatal exposure to PFAS is associated with bone mineral density (BMD) in offspring. MethodThis study population included 182 mother-child pairs in the Shanghai Obesity and Allergy Cohort, enrolled during 2012–2013. 10 PFAS were measured by liquid chromatography-mass spectrometry (LC-MS) in cord plasma. The child's spinal BMD was measured using a dual-energy X-ray absorptiometry (DXA) scanner at the age of 8. Multivariable linear regression models were used to estimate the associations between individual PFAS concentrations (as a continuous variable or categorized into quartiles) and child BMD. Bayesian kernel machine regression (BKMR) was employed to explore the joint effects of PFAS mixtures on BMD. ResultsAmong the 10 PFAS, 8 of them had a detection rate >90% and were included in the subsequent analysis. We observed no significant associations between individual PFAS (as a continuous variable) and spinal BMD in 8-year-old children using the multivariable linear regression model. When treated as quartile categories, the second and fourth quartiles of perfluorobutane sulfonate (PFBS) was associated with higher BMD in the first lumbar vertebra, compared with the lowest quartile. BKMR analysis revealed no association between the PFAS mixture and child BMD. ConclusionWe observed no associations of prenatal PFAS exposure with child BMD at 8 years of age. Given the inconsistent epidemiological evidence, further research is needed to confirm these findings from other studies or elucidate the potentially toxic effects of PFAS on bone.

Association between mode of delivery and early neurodevelopment: A prospective birth cohort study.

This study suggested that the adverse impact of CD on child neurodevelopment stems from the procedure itself rather than CD-related medical conditions. It is important to minimize the use of CD when there is no medical necessity. • Caesarean delivery (CD) may influence child neurodevelopment and other long-term outcomes. • In China, approximately one-quarter of CD are performed due to maternal request without medical indications. • The negative impact of CD on the neurodevelopmental outcomes of children may be primarily attributed to the procedure itself, as opposed to related medical conditions. • In the absence of medical indications, unnecessary CD may have adverse impacts on children's neurodevelopment.

A prospective birth cohort study on the association between gestational blood pressure and neurodevelopment in 2-year-old children

Objective: To investigate the association between gestational blood pressure and neurodevelopment in 2-year-old children. Methods: Based on the"Wuhan Healthy Baby Birth Cohort", 3 754 mother-infant pairs were enrolled in this study. Based on multiple blood pressure measurements during pregnancy, the mean, cumulative, and variability of blood pressure throughout the entire pregnancy and each trimester were calculated. Blood pressure variability was evaluated using standard deviation (SD), coefficient of variability (CV), and variability independent of mean (VIM). Follow-up testing of neurodevelopment in infants and young children at the age of two was conducted to obtain the Mental Development Index (MDI) and the Psychomotor Development Index (PDI). The multivariate linear regression and generalized estimation equation were used to analyze the association between gestational blood pressure data and neurodevelopmental index. Results: The age of 3 754 pregnant women was (29.1±3.6) years, with a pre-pregnancy BMI of (20.9±2.7) kg/m² and a gestational age of (39.3±1.2) weeks. The birth weight of 3 754 children was (3 330.9±397.7) grams, and the birth length was (50.3±1.6) centimeters. The results of the multivariate linear regression analysis showed that after adjusting for relevant confounding factors, the mean blood pressure, cumulative blood pressure, standard deviation of blood pressure, coefficient of variation of blood pressure, independent blood pressure variability of systolic blood pressure, diastolic blood pressure, and pulse pressure throughout pregnancy were negatively associated with the MDI and PDI scores of 2-year-old children. The analysis results of the generalized estimation equation showed that after adjusting for relevant confounding factors, the average systolic blood pressure in the first, second, and third trimesters was negatively associated with MDI/PDI. The negative association between cumulative blood pressure and MDI/PDI was only found in the first trimester. The negative association between blood pressure variation during pregnancy and MDI/PDI was mainly concentrated in the second and third trimesters. Conclusion: There is a negative association between gestational blood pressure and the neurodevelopmental index of 2-year-old children.