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van Gelder MMHJ, Beekers P, van Rijt-Weetink YRJ, van Drongelen J, Roeleveld N, Smits LJM. Associations Between Late-Onset Preeclampsia and the Use of Calcium-Based Antacids and Proton Pump Inhibitors During Pregnancy: A Prospective Cohort Study. Clin Epidemiol 2022; 14:1229-1240. [PMID: 36325201 PMCID: PMC9621001 DOI: 10.2147/clep.s382303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/11/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Preeclampsia is a leading cause of maternal morbidity and mortality. Calcium-based antacids and proton pump inhibitors (PPIs) are commonly used during pregnancy to treat symptoms of gastroesophageal reflux disease. Both have been hypothesized to reduce the risk of preeclampsia. We determined associations of calcium-based antacid and PPI use during pregnancy with late-onset preeclampsia (≥34 weeks of gestation), taking into account dosage and timing of use. Patients and Methods We included 9058 pregnant women participating in the PRIDE Study (2012–2019) or The Dutch Pregnancy Drug Register (2014–2019), two prospective cohorts in The Netherlands. Data were collected through web-based questionnaires and obstetric records. We estimated risk ratios (RRs) for late-onset preeclampsia for any use and trajectories of calcium-based antacid and PPI use before gestational day 238, and hazard ratios (HRs) for time-varying exposures after gestational day 237. Results Late-onset preeclampsia was diagnosed in 2.6% of pregnancies. Any use of calcium-based antacids (RR 1.2 [95% CI 0.9–1.6]) or PPIs (RR 1.4 [95% CI 0.8–2.4]) before gestational day 238 was not associated with late-onset preeclampsia. Use of low-dose calcium-based antacids in gestational weeks 0–16 (<1 g/day; RR 1.8 [95% CI 1.1–2.9]) and any use of PPIs in gestational weeks 17–33 (RR 1.6 [95% CI 1.0–2.8]) seemed to increase risks of late-onset preeclampsia. We did not observe associations between late-onset preeclampsia and use of calcium-based antacids (HR 1.0 [95% CI 0.6–1.5]) and PPIs (HR 1.4 [95% CI 0.7–2.9]) after gestational day 237. Conclusion In this prospective cohort study, use of calcium-based antacids and PPIs during pregnancy was not found to reduce the risk of late-onset preeclampsia.
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Affiliation(s)
- Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands,Correspondence: Marleen MHJ van Gelder, Department for Health Evidence (HP 133), Radboud University Medical Center, P.O. Box 9101, Nijmegen, 6500 HB, the Netherlands, Tel +31 24 3615305, Fax +31 24 3613505, Email
| | - Pim Beekers
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands,National Health Care Institute, Diemen, the Netherlands
| | | | - Joris van Drongelen
- Department of Obstetrics & Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Luc J M Smits
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
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Associations between maternal awakening salivary cortisol levels in mid-pregnancy and adverse birth outcomes. Arch Gynecol Obstet 2022; 306:1989-1999. [PMID: 35320387 DOI: 10.1007/s00404-022-06513-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/06/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Elevated levels of maternal cortisol have been hypothesized as the intermediate process between symptoms of depression and psychosocial stress during pregnancy and adverse birth outcomes. Therefore, we examined associations between cortisol levels in the second trimester of pregnancy and risks of three common birth outcomes in a nested case-control study. METHODS This study was embedded in the PRIDE Study (n = 3,019), from which we selected all cases with preterm birth (n = 64), low birth weight (n = 49), and small-for-gestational age (SGA; n = 65), and 260 randomly selected controls, among the participants who provided a single awakening saliva sample in approximately gestational week 19 in 2012-2016. Multivariable linear and logistic regression was performed to assess the associations between continuous and categorized cortisol levels and the selected outcomes. RESULTS We did not observe any associations between maternal cortisol levels and preterm birth and low birth weight. However, high cortisol levels (≥ 90th percentile) seemed to be associated with SGA (adjusted odds ratio 2.1, 95% confidence interval 0.9-4.8), in particular among girls (adjusted odds ratio 3.7, 95% confidence interval 1.1-11.9, based on eight exposed cases) in an exploratory analysis. CONCLUSION The results of this study showed no suggestions of associations between maternal awakening cortisol levels in mid-pregnancy and adverse birth outcomes, except for an increased risk of SGA.
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Rothschild CW, Dublin S, Brown JS, Klasnja P, Herzig-Marx C, Reynolds JS, Wyner Z, Chambers C, Martin D. Use of a mobile app to capture supplemental health information during pregnancy: Implications for clinical research. Pharmacoepidemiol Drug Saf 2021; 31:37-45. [PMID: 34216500 DOI: 10.1002/pds.5320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/04/2021] [Accepted: 06/25/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Mobile applications ("apps") may be efficient tools for improving the quality of clinical research among pregnant women, but evidence is sparse. We assess the feasibility and generalizability of a mobile app for capturing supplemental data during pregnancy. METHODS In 2017, we conducted a pilot study of the FDA MyStudies mobile app within a pregnant population identified through Kaiser Permanente Washington (KPWA), an integrated healthcare delivery system. We ascertained health conditions, medications, and substance use through app-based questionnaires. In a post-hoc analysis, we utilized electronic health records (EHR) to summarize sociodemographic and health characteristics of pilot participants and, for comparison, a pregnant population identified using similar methods. RESULTS Six percent (64/1070) of contacted women enrolled in the pilot study. Nearly half (23/53) reported taking medication for headaches and one-fourth for constipation (13/53) and nausea (12/53) each. Few instances (2/92) of over-the-counter medication use were identified in electronic dispensing records. One-quarter to one-third of participants with depression and anxiety/panic, respectively, reported recently discontinuing medications for these conditions. Eighty-eight percent of pilot participants reported White race (95%CI: 81-95%), versus 67% of the comparison population (N = 2065). More pilot participants filled ≥1 prescription for antianxiety medication (22% [95%CI: 13-35%]) and antidepressants (19% [95%CI 10-31%]) pre-pregnancy than the comparison population (10 and 9%, respectively). CONCLUSIONS Mobile apps may be a feasible tool for capturing health data not routinely available in EHR. Pregnant women willing to use a mobile app for research may differ from the general pregnant population, but confirmation is needed.
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Affiliation(s)
- Claire W Rothschild
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sascha Dublin
- Department of Epidemiology, University of Washington, Seattle, Washington, USA.,Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Jeffrey S Brown
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Predrag Klasnja
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Chayim Herzig-Marx
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Juliane S Reynolds
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Zachary Wyner
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Christina Chambers
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - David Martin
- Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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Questionnaires and salivary cortisol to measure stress and depression in mid-pregnancy. PLoS One 2021; 16:e0250459. [PMID: 33891645 PMCID: PMC8064545 DOI: 10.1371/journal.pone.0250459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 04/06/2021] [Indexed: 11/19/2022] Open
Abstract
The hypothalamic-pituitary-adrenal axis, with cortisol as its final metabolite, has been proposed as a potential underlying biological mechanism for associations between depression and stress symptoms during pregnancy and adverse perinatal outcomes. In this study, we explored associations between salivary cortisol as a potential biomarker for stress and depressive symptoms and several self-completed psychological measurement scales among pregnant women. In total, 652 pregnant women participating in the PRegnancy and Infant DEvelopment (PRIDE) Study completed the Edinburgh Depression Scale (EDS), Patient Health Questionnaire-2 (PHQ-2), Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R), and Tilburg Pregnancy Distress Scale (TPDS) and collected a single awakening salivary cortisol sample around gestational week 17. Odds ratios, Spearman’s correlation coefficients (ρs) and Cohen’s Kappa coefficients (κ) were calculated to examine the associations between the EDS, PHQ-2, PRAQ-R, TPDS, and maternal cortisol levels. The overall correlation coefficient between the score on the EDS and the salivary cortisol level was 0.01 (p = 0.89) with κ = -0.01 (95% confidence interval [CI] -0.08–0.06). We did not observe agreement between the PHQ-2 and cortisol levels either (κ = 0.06 (95% CI -0.02–0.14)). The results for the PRAQ-R and TPDS were similar with overall correlations with maternal cortisol levels of ρs = 0.01 (p = 0.81) and ρs = 0.06 (p = 0.35) and agreements of κ = 0.02 (95% CI -0.06–0.09) and κ = -0.02 (95% CI -0.11–0.07), respectively. Maternal awakening salivary cortisol levels and measures of maternal psychological distress, anxiety, depressive symptoms, and pregnancy-related anxiety, assessed by self-completed questionnaires, did not seem to be related in mid-pregnancy.
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van Gelder MMHJ, Merkus PJFM, van Drongelen J, Swarts JW, van de Belt TH, Roeleveld N. The PRIDE Study: Evaluation of online methods of data collection. Paediatr Perinat Epidemiol 2020; 34:484-494. [PMID: 31868970 PMCID: PMC7496449 DOI: 10.1111/ppe.12618] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/04/2019] [Accepted: 10/09/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Large birth cohort studies are extremely valuable in assessing associations between early life exposures and long-term outcomes. Establishing new birth cohorts is challenging due to declining participation rates. Online methods of data collection may increase feasibility, but have not been evaluated thoroughly. OBJECTIVE The primary objective of the ongoing PRegnancy and Infant DEvelopment (PRIDE) Study is to identify exposures during pregnancy and in early life that may affect short-term or long-term health of mother and/or child. In this manuscript, we aimed to evaluate methods of recruitment and online data collection applied. POPULATION Dutch women aged ≥18 years in early pregnancy. DESIGN Prospective cohort study. METHODS Initially, only prenatal care providers recruited participants, but alternative recruitment methods were added as a result of disappointing participation rates, including collaboration with "Moeders voor Moeders" (organisation that visits women in early pregnancy) and Facebook advertisements. Data on demographic characteristics, obstetric history, maternal health, life style factors, occupational exposures, nutrition, pregnancy complications, and infant outcomes are primarily collected through Web-based questionnaires at multiple time points during and after pregnancy. Additional data collection components include paternal questionnaires, blood and saliva sampling, and linkage to medical records. PRELIMINARY RESULTS By September 2019, 9573 women were included in the PRIDE Study, of which 1.3% completed paper-based questionnaires. Mean age of the women analysed was 30.6 years, 71.1% had a high level of education, 57.2% were primiparae, and mean gestational age at enrolment was 9.9 (range 3, 37) weeks, with slight differences between recruitment methods. Pregnancy outcome was known for 89.8%. Retention rate at 6 months after the estimated date of delivery was estimated at 70%. Multiple validation studies conducted within the PRIDE Study indicated high data quality. CONCLUSION(S) Although challenging and time-consuming, online methods for recruitment and data collection may enable the establishment of new birth cohort studies.
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Affiliation(s)
- Marleen M. H. J. van Gelder
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands,Radboud REshape Innovation CenterRadboud University Medical CenterNijmegenThe Netherlands
| | - Peter J. F. M. Merkus
- Department of Paediatric PulmonologyRadboudumc Amalia Children's HospitalRadboud University Medical CenterNijmegenThe Netherlands
| | - Joris van Drongelen
- Department of Obstetrics and GynaecologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Jessie W. Swarts
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Tom H. van de Belt
- Radboud REshape Innovation CenterRadboud University Medical CenterNijmegenThe Netherlands,Radboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Nel Roeleveld
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
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Google AdWords and Facebook Ads for Recruitment of Pregnant Women into a Prospective Cohort Study With Long-Term Follow-Up. Matern Child Health J 2020; 23:1285-1291. [PMID: 31222599 PMCID: PMC6732125 DOI: 10.1007/s10995-019-02797-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives Several types of epidemiologic studies suffer from decreasing participation rates, resulting in potential selection bias and delay or termination of studies. We aimed to determine the feasibility of online methods for recruitment of pregnant women into a prospective cohort study. Methods In addition to traditional recruitment through prenatal care providers, we advertized participation in the PRegnancy and Infant DEvelopment (PRIDE) Study, an ongoing prospective cohort study with long-term follow-up in The Netherlands enrolling women in early pregnancy, through Google AdWords (30 days) and Facebook Ads (31 and 27 days) campaigns between September 2016 and January 2017. We calculated costs per eligible participant and compared demographics, health-related characteristics, and follow-up rates between participants recruited through online methods and prenatal care providers. Results During the study period, we recruited six women through AdWords (€54.28 per participant), 59 through Facebook (€10.17 per participant), and 327 through prenatal care providers (no valid cost estimate available). Facebook participants seemed to be younger (29.0 vs. 30.7 years), to have a higher body mass-index and/or low/intermediate education (27.0 vs. 24.0 kg/m2 and 41 vs. 25%, respectively), and to start prenatal care in secondary care more often (12 vs. 5%) than participants recruited through prenatal care providers. Item non-response and loss to follow-up rates were higher among women recruited online than among those recruited through prenatal care providers. Conclusion Google AdWords did not contribute substantially, but Facebook Ads may complement traditional recruitment methods of pregnant women into prospective cohort studies, despite challenges that may threaten internal validity.
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Meertens LJE, Scheepers HCJ, van Kuijk SMJ, Roeleveld N, Aardenburg R, van Dooren IMA, Langenveld J, Zwaan IM, Spaanderman MEA, van Gelder MMHJ, Smits LJM. External validation and clinical utility of prognostic prediction models for gestational diabetes mellitus: A prospective cohort study. Acta Obstet Gynecol Scand 2020; 99:891-900. [PMID: 31955406 PMCID: PMC7317858 DOI: 10.1111/aogs.13811] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 11/14/2019] [Accepted: 12/14/2019] [Indexed: 11/29/2022]
Abstract
Introduction We performed an independent validation study of all published first trimester prediction models, containing non‐invasive predictors, for the risk of gestational diabetes mellitus. Furthermore, the clinical potential of the best performing models was evaluated. Material and methods Systemically selected prediction models from the literature were validated in a Dutch prospective cohort using data from Expect Study I and PRIDE Study. The predictive performance of the models was evaluated by discrimination and calibration. Clinical utility was assessed using decision curve analysis. Screening performance measures were calculated at different risk thresholds for the best model and compared with current selective screening strategies. Results The validation cohort included 5260 women. Gestational diabetes mellitus was diagnosed in 127 women (2.4%). The discriminative performance of the 12 included models ranged from 68% to 75%. Nearly all models overestimated the risk. After recalibration, agreement between the observed outcomes and predicted probabilities improved for most models. Conclusions The best performing prediction models showed acceptable performance measures and may enable more personalized medicine‐based antenatal care for women at risk of developing gestational diabetes mellitus compared with current applied strategies.
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Affiliation(s)
- Linda J E Meertens
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Hubertina C J Scheepers
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robert Aardenburg
- Department of Obstetrics and Gynecology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Ivo M A van Dooren
- Department of Obstetrics and Gynecology, Sint Jans Gasthuis Weert, Weert, The Netherlands
| | - Josje Langenveld
- Department of Obstetrics and Gynecology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Iris M Zwaan
- Department of Obstetrics and Gynecology, Laurentius Hospital, Roermond, The Netherlands
| | - Marc E A Spaanderman
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luc J M Smits
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Abstract
Information on the safety of medication use during pregnancy and breastfeeding is scarce, yet use of medication among pregnant and breastfeeding women is widespread. The pREGnant, the Dutch Pregnancy Drug Register, was set up to obtain insight into medication use among pregnant and breastfeeding women and potential effects on maternal and fetal/infant health. The systematically documented, good quality data on medication use during pregnancy and lactation in pREGnant will be used in signal detection, epidemiologic studies and counseling of healthcare providers and patients. The register has a prospective cohort design. The population is derived from pregnant women throughout the Netherlands. Data collection started in April 2014 and enrollment of women is continuous and is characterized by a relative high proportion of women born in the Netherlands with a high education compared with the general Dutch pregnant population. Data on current pregnancy, obstetric history, maternal lifestyle, health and medication use, delivery, and infant health are collected through web-based questionnaires completed by the participating women (three times during pregnancy and three times during the infant’s first year of life). If permission is given, the self-reported data can be complemented with information retrieved from Perined, the perinatal registry of the Netherlands, and from obstetric and medical records, and/or pharmacy records. Here, we provide detailed information on the design of the pREGnant, the Dutch Pregnancy Drug Register, as well as descriptive information on characteristics of the participants so far. Currently, steps are being taken to implement the register on a large scale in the Netherlands.
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van Gelder MMHJ, de Jong LAA, Te Winkel B, Olyslager EJH, Vorstenbosch S, van Puijenbroek EP, Verbeek ALM, Roeleveld N. Assessment of medication use during pregnancy by Web-based questionnaires, pharmacy records and serum screening. Reprod Toxicol 2019; 84:93-97. [PMID: 30615926 DOI: 10.1016/j.reprotox.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/28/2018] [Accepted: 01/03/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To compare assessment of early pregnancy medication exposure using three methods of data collection. METHODS Serum samples were obtained from 752 women participating in the PRegnancy and Infant DEvelopment (PRIDE) Study before gestational week 17. For 52 women using medication at the date of blood sampling according to Web-based questionnaires or pharmacy records, we analysed serum samples using untargeted liquid chromatography time-of-flight spectrometry. RESULTS Medication was detected in 18 serum samples (35%). Medications taken orally for chronic conditions reported in the questionnaire were detected in serum and vice versa. Pharmacy records did not identify additional exposed women, but missed exposure in 5 women mainly due to unavailability. We observed substantial discordance between the three methods for inhaled medication, dermatological preparations, and medications for short-term use, which went often undetected in serum. CONCLUSIONS It remains challenging to assess medication use in large-scale studies as no 'gold standard' is currently available.
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Affiliation(s)
- Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands; Radboud REshape Innovation Center, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
| | - Lutea A A de Jong
- Department of Pharmacy, Gelre Hospitals, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands.
| | - Bernke Te Winkel
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, the Netherlands.
| | - Erik J H Olyslager
- Department of Pharmacy, Gelre Hospitals, P.O. Box 9014, 7300 DS, Apeldoorn, the Netherlands.
| | - Saskia Vorstenbosch
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, the Netherlands.
| | - Eugène P van Puijenbroek
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, the Netherlands; PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - André L M Verbeek
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
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10
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van de Loo KFE, Vlenterie R, Nikkels SJ, Merkus PJFM, Roukema J, Verhaak CM, Roeleveld N, van Gelder MMHJ. Depression and anxiety during pregnancy: The influence of maternal characteristics. Birth 2018. [PMID: 29517137 DOI: 10.1111/birt.12343] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression and anxiety during pregnancy are associated with adverse health outcomes for both mother and child. This study aims to investigate the occurrence of symptoms of depression and anxiety in early and late pregnancy, the longitudinal changes from early to late pregnancy, and factors associated with symptoms of depression and anxiety in pregnant women in the Netherlands. METHODS We studied 2897 women participating in the PRegnancy and Infant DEvelopment (PRIDE) Study. To assess symptoms of depression and anxiety, web-based questionnaires including the Hospital Anxiety and Depression Scale (HADS) and multiple questions on maternal characteristics were completed in early and late pregnancy. Cross-sectional and longitudinal multivariable linear regression analyses were conducted. RESULTS The depressive symptoms in our population increased, with a prevalence of probable depression from 5.4% in early pregnancy to 10.0% in late pregnancy (P < .001), whereas the anxiety symptoms decreased, with a prevalence of probable anxiety from 17.9% to 14.2% (P < .001). Characteristics associated with depressive or anxiety symptoms included low level of education, multiparity, a history of depression, severe nausea, extreme fatigue, lack of physical exercise, and negative life events. Being non-Dutch, not living with a partner, and having an unplanned pregnancy or a long time to pregnancy were associated with the depressive and/or anxiety symptoms in early pregnancy only. DISCUSSION Symptoms of depression and anxiety are common in both early and late pregnancy. Screening for risk factors in early pregnancy is important, since prenatal depression and anxiety may be related to adverse maternal and child health outcomes.
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Affiliation(s)
- Kim F E van de Loo
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Richelle Vlenterie
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Sylke J Nikkels
- Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Peter J F M Merkus
- Department of Paediatric Pulmonology, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Jolt Roukema
- Department of Paediatric Pulmonology, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Chris M Verhaak
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.,Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud university medical center, Nijmegen, The Netherlands
| | - Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.,Radboud REshape Innovation Center, Radboud university medical center, Nijmegen, The Netherlands
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Kim KN, Lim YH, Shin CH, Lee YA, Kim BN, Kim JI, Hwang IG, Hwang MS, Suh JH, Hong YC. Cohort Profile: The Environment and Development of Children (EDC) study: a prospective children’s cohort. Int J Epidemiol 2018; 47:1049-1050f. [DOI: 10.1093/ije/dyy070] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 01/21/2023] Open
Affiliation(s)
- Kyoung-Nam Kim
- Institute of Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University Medical Research Centre, Seoul, Republic of Korea
- Environmental Health Centre
| | - Choong Ho Shin
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Ah Lee
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Johanna Inhyang Kim
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - In Gyun Hwang
- Food Safety Risk Assessment Division, National Institute of Food and Drug Safety Evaluation, Cheongwon, Republic of Korea
| | - Myung Sil Hwang
- Food Safety Risk Assessment Division, National Institute of Food and Drug Safety Evaluation, Cheongwon, Republic of Korea
| | - Jin-Hyang Suh
- Food Safety Risk Assessment Division, National Institute of Food and Drug Safety Evaluation, Cheongwon, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Centre, Seoul, Republic of Korea
- Environmental Health Centre
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van Gelder MM, Engelen LJ, Sondag T, van de Belt TH. Utilizing Consumer Technology (Apple's ResearchKit) for Medical Studies by Patients and Researchers: Proof of Concept of the Novel Platform REach. J Particip Med 2018; 10:e6. [PMID: 33052112 PMCID: PMC7434096 DOI: 10.2196/jopm.9335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 07/13/2017] [Accepted: 02/12/2018] [Indexed: 01/27/2023] Open
Abstract
Medical research suffers from declining response rates, hampering the quest for answers to clinically relevant research questions. Furthermore, objective data on a number of important study variables, such as physical activity, sleep, and nutrition, are difficult to collect with the traditional methods of data collection. Reassuringly, current technological developments could overcome these limitations. In addition, they may enable research being established by patients themselves provided that they have access to a user-friendly platform. Using the features of Apple's ResearchKit, an informed consent procedure, questionnaire, linkage with HealthKit data, and “active tasks” may be administered through a publicly available app. However, ResearchKit requires programming skills, which many patients and researchers lack. Therefore, we developed a platform (REach) with drag and drop functionalities producing a ready-to-use code that can be embedded in existing or new apps. Participants in the pilot study were very satisfied with data collection through REach and measurement error was minimal. In the era of declining participation rates in observational studies and patient involvement, new methods of data collection, such as REach, are essential to ensure that clinically relevant research questions are validly answered. Due to linkage with HealthKit and active tasks, objective health data that are impossible to collect with the traditional methods of data collection can easily be collected.
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Affiliation(s)
- Marleen Mhj van Gelder
- Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands.,Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lucien Jlpg Engelen
- Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands
| | - Thijs Sondag
- Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands.,Process Improvement & Health Care Innovations, Radboud University Medical Center, Nijmegen, Netherlands
| | - Tom H van de Belt
- Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, Netherlands
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13
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van Gelder MMHJ, Vorstenbosch S, te Winkel B, van Puijenbroek EP, Roeleveld N. Using Web-Based Questionnaires to Assess Medication Use During Pregnancy: A Validation Study in 2 Prospectively Enrolled Cohorts. Am J Epidemiol 2018; 187:326-336. [PMID: 29401360 DOI: 10.1093/aje/kwx239] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/02/2017] [Indexed: 01/27/2023] Open
Abstract
Medication use is often underreported in paper-based questionnaires or interviews. Web-based questionnaires may improve recall of medication use, but data on their validity are currently lacking. Participants in the Pregnancy and Infant Development (PRIDE) Study (2014-2016; n = 557) and the Pregnancy Drug Registry (pREGnant) (2015-2016; n = 169) completed a 6-week paper-based medication diary during gestational weeks 19-24 or 26-31. In week 34, they completed a Web-based questionnaire with questions on medication names, time period and frequency of use, and quantity taken. To assess the degree of underreporting, we calculated the questionnaire's sensitivity using the medication diary as the reference standard. Sensitivity was high for many medication groups, including antiepileptic medication (sensitivity (Sn) = 0.96, 95% confidence interval (CI): 0.89, 1.00), antacids (Sn = 0.89, 95% CI: 0.86, 0.93), and iron preparations (Sn = 0.81, 95% CI: 0.64, 0.98). However, medications for short-term use were underreported more frequently, with sensitivities of 0.54 (95% CI: 0.35, 0.72) for antihistamines, 0.63 (95% CI: 0.57, 0.69) for analgesic and antipyretic agents, and 0.57 (95% CI: 0.51, 0.64) for acetaminophen. Shortening the period of time between exposure and questionnaire administration increased sensitivity substantially. In conclusion, underreporting in Web-based questionnaires is limited for many medication groups. In prospective studies, underreporting of medications for short-term use may be reduced by decreasing the interval between consecutive questionnaires.
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Affiliation(s)
- Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Saskia Vorstenbosch
- Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch, the Netherlands
| | - Bernke te Winkel
- Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch, the Netherlands
| | - Eugène P van Puijenbroek
- Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch, the Netherlands
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Pediatrics, Radboudumc Amalia Children’s Hospital, Radboud University Medical Center, Nijmegen, the Netherlands
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14
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Vlenterie R, van Ras HWP, Roeleveld N, Pop-Purceleanu M, van Gelder MMHJ. Epidemiological evaluation of the Patient Health Questionnaire-2 in a pregnant population. J Psychosom Res 2017; 101:96-103. [PMID: 28867428 DOI: 10.1016/j.jpsychores.2017.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 07/08/2017] [Accepted: 08/03/2017] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The Patient Health Questionnaire-2 (PHQ-2) is a commonly used 2-item screening tool for depressive symptoms among pregnant women in primary care settings. However, its validity has not been assessed for large-scale epidemiological studies. Therefore, the aim of this study was to provide an epidemiological evaluation of the PHQ-2 among pregnant women. METHOD A total of 3033 pregnant women participating in the PRegnancy and Infant DEvelopment Study completed the PHQ-2 as well as the Hospital Anxiety Depression Scale-Depression (HADS-D) or the Edinburgh Depression Scale (EDS) three times throughout pregnancy. The validity of the PHQ-2 was assessed with the HADS-D/EDS as reference standard. RESULTS Sensitivity and specificity of the PHQ-2 were 69-84% and 79-84%, respectively. The positive predictive values (range 19-26%) were substantially lower than the negative predictive values (96-99%). CONCLUSION Despite the relatively high number of false-positive screens, initial screening for depression by two questions only may enhance routine evaluation of depressive symptoms among pregnant women.
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Affiliation(s)
- Richelle Vlenterie
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Hilde W P van Ras
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Department of Pediatrics, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Monica Pop-Purceleanu
- Department of Psychiatry, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Radboud REshape Innovation Center, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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15
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Park CH, Winglee M, Kwan J, Andrews L, Hudak ML. Comparison of Recruitment Strategy Outcomes in the National Children's Study. Pediatrics 2017; 140:peds.2016-2822. [PMID: 28724571 PMCID: PMC5527671 DOI: 10.1542/peds.2016-2822] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In 2000, the US Congress authorized the National Institutes of Health to conduct a prospective national longitudinal study of environmental influences on children's health and development from birth through 21 years. Several recruitment methodologies were piloted to determine the optimal strategy for a main National Children's Study. METHODS After an initial pilot recruitment that used a household enumeration strategy performed poorly, the National Children's Study Vanguard Study developed and evaluated the feasibility, acceptability, and cost of 4 alternate strategies to recruit a large prospective national probability sample of pregnant women and their newborn children. We compare household-based recruitment, provider-based recruitment, direct outreach, and provider-based sampling (PBS) strategies with respect to overall recruitment success, efficiency, cost, and fulfillment of scientific requirements. RESULTS Although all 5 strategies achieved similar enrollment rates (63%-81%) among eligible women, PBS achieved the highest recruitment success as measured by the ratio of observed-to-expected newborn enrollees per year of 0.99, exceeding those of the other strategies (range: 0.35-0.48). Because PBS could reach the enrollment target through sampling of high volume obstetric provider offices and birth hospitals, it achieved the lowest ratio of women screened to women enrolled and was also the least costly strategy. With the exception of direct outreach, all strategies enrolled a cohort of women whose demographics were similar to county natality data. CONCLUSIONS PBS demonstrated the optimal combination of recruitment success, efficiency, cost, and population representativeness and serves as a model for the assembly of future prospective probability-based birth cohorts.
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Affiliation(s)
| | | | - Jennifer Kwan
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Linda Andrews
- Social & Scientific Systems Inc, Silver Spring, Maryland; and
| | - Mark L. Hudak
- Department of Pediatrics, University of Florida College of Medicine – Jacksonville, Jacksonville, Florida
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16
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van Gelder MMHJ, Vorstenbosch S, Derks L, Te Winkel B, van Puijenbroek EP, Roeleveld N. Web-based questionnaires to assess perinatal outcome proved to be valid. J Clin Epidemiol 2017; 90:136-143. [PMID: 28728921 DOI: 10.1016/j.jclinepi.2017.07.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/31/2017] [Accepted: 07/12/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective of this study was to validate a Web-based questionnaire completed by the mother to assess perinatal outcome used in a prospective cohort study. STUDY DESIGN AND SETTING For 882 women with an estimated date of delivery between February 2012 and February 2015 who participated in the PRegnancy and Infant DEvelopment (PRIDE) Study, we compared data on pregnancy outcome, including mode of delivery, plurality, gestational age, birth weight and length, head circumference, birth defects, and infant sex, from Web-based questionnaires administered to the mothers 2 months after delivery with data from obstetric records. For continuous variables, we calculated intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs), whereas sensitivity and specificity were determined for categorical variables. RESULTS We observed only very small differences between the two methods of data collection for gestational age (ICC, 0.91; 95% CI, 0.90-0.92), birth weight (ICC, 0.96; 95% CI, 0.95-0.96), birth length (ICC, 0.90; 95% CI, 0.87-0.92), and head circumference (ICC, 0.88; 95% CI, 0.80-0.93). Agreement between the Web-based questionnaire and obstetric records was high as well, with sensitivity ranging between 0.86 (termination of pregnancy) and 1.00 (four outcomes) and specificity between 0.96 (term birth) and 1.00 (nine outcomes). CONCLUSION Our study provides evidence that Web-based questionnaires could be considered as a valid complementary or alternative method of data collection.
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Affiliation(s)
- Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands; Radboud REshape Innovation Center, Radboud University Medical Center, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands.
| | - Saskia Vorstenbosch
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 's-Hertogenbosch 5237 MH, The Netherlands
| | - Lineke Derks
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands
| | - Bernke Te Winkel
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 's-Hertogenbosch 5237 MH, The Netherlands
| | - Eugène P van Puijenbroek
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 's-Hertogenbosch 5237 MH, The Netherlands; PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands; Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands
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17
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Andrade SE, Bérard A, Nordeng HME, Wood ME, van Gelder MMHJ, Toh S. Administrative Claims Data Versus Augmented Pregnancy Data for the Study of Pharmaceutical Treatments in Pregnancy. CURR EPIDEMIOL REP 2017; 4:106-116. [PMID: 29399433 PMCID: PMC5780544 DOI: 10.1007/s40471-017-0104-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Purpose of Review Administrative claims databases, which collect reimbursement-related information generated from healthcare encounters, are increasingly used to evaluate medication safety in pregnancy. We reviewed the strengths and limitations of claims-only databases and how other data sources may be used to improve the accuracy and completeness of information critical for studying medication safety in pregnancy. Recent Findings Research on medication safety in pregnancy requires information on pregnancy episodes, mother-infant linkage, medication exposure, gestational age, maternal and birth outcomes, confounding factors, and (in some studies) long-term follow-up data. Claims data reliably identifies live births and possibly other pregnancies. It allows mother-infant linkage and has prospectively collected prescription medication information. Its diagnosis and procedure information allows estimation of gestational age. It captures maternal medical conditions but generally has incomplete data on reproductive and lifestyle factors. It has information on certain, typically short-term maternal and infant outcomes that may require chart review confirmation. Other data sources including electronic health records and birth registries can augment claims data or be analyzed alone. Interviews, surveys, or biological samples provide additional information. Nationwide and regional birth and pregnancy registries, such as those in several European and North American countries, generally contain more complete information essential for pregnancy research compared to claims-only databases. Summary Claims data offers several advantages in medication safety in pregnancy research. Its limitations can be partially addressed by linking it with other data sources or supplementing with primary data collection. Rigorous assessment of data quality and completeness is recommended regardless of data sources.
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Affiliation(s)
- Susan E Andrade
- 1Meyers Primary Care Institute, Fallon Community Health Plan, Reliant Medical Group, University of Massachusetts Medical School, 425 North Lake Avenue, Worcester, MA 01605 USA
| | - Anick Bérard
- 2Faculty of Pharmacy, and CHU Ste-Justine Research Center, University of Montreal, 3175 Côte-Ste-Catherine, Montreal, QC H3T 1C5 Canada
| | - Hedvig M E Nordeng
- 3Pharmacoepidemiology and Drug Safety Research Group, School of Pharmacy, PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, P.O. Box 1068, Blindern, 0316 Oslo, Norway.,4Department of Child Health, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, 0403 Oslo, Norway
| | - Mollie E Wood
- 3Pharmacoepidemiology and Drug Safety Research Group, School of Pharmacy, PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, P.O. Box 1068, Blindern, 0316 Oslo, Norway
| | - Marleen M H J van Gelder
- 5Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.,6Radboud REshape Innovation Center, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Sengwee Toh
- 7Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215 USA
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18
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Vlenterie R, Roeleveld N, van Gelder MMHJ. Single awakening salivary measurements provide reliable estimates of morning cortisol levels in pregnant women. Psychoneuroendocrinology 2016; 74:295-301. [PMID: 27701043 DOI: 10.1016/j.psyneuen.2016.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/31/2016] [Accepted: 09/15/2016] [Indexed: 11/28/2022]
Abstract
Mood disorders during pregnancy have been associated with adverse effects on maternal as well as fetal health. Since mood, anxiety, and stress disorders are related with elevated cortisol levels, salivary cortisol may be a useful biomarker. Although multiple samples are generally recommended, a single measurement of awakening salivary cortisol could be a simpler and more cost-effective method to determine whether women have elevated morning cortisol levels during a specific period of pregnancy. Therefore, the aim of this validation study among 177 women in the PRIDE Study was to examine whether one awakening salivary cortisol measurement will suffice to classify pregnant women as having normal or elevated cortisol levels compared to awakening salivary cortisol measurements on three consecutive working days. We calculated intraclass correlation coefficients (ICC) and Cohen's kappa statistics (κ) overall as well as in sub-analyses within strata based on maternal age, level of education, net household income, pre-pregnancy BMI, parity, complications during pregnancy, caffeine consumption, gestational week of sampling, and awakening time. The mean cortisol concentrations were 8.98ng/ml (SD 5.32) for day one, 8.62ng/ml (SD 4.55) for day two, and 8.39ng/ml (SD 4.58) for day three. The overall ICC was 0.86 (95% CI 0.82-0.89) while the κ was 0.75 (95% CI 0.64-0.86). For the ICCs calculated within sub-analyses, a maximum difference of 0.11 was observed between the strata. For the κ statistics, most strata did not differ more than 0.12, except for pre-pregnancy BMI, severe nausea, and extreme fatigue with differences up to 0.22. In conclusion, one awakening salivary cortisol measurement is as reliable for the classification of pregnant women into normal and elevated morning cortisol levels as salivary cortisol measurements on three consecutive working days.
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Affiliation(s)
- Richelle Vlenterie
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Department of Pediatrics, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands; Radboud REshape Innovation Center, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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19
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van Gelder MMHJ, Geuijen PM, de Vries JHM, Roeleveld N. Effects of estimated completion time and unconditional gift certificates on questionnaire response. J Epidemiol Community Health 2016; 71:520. [PMID: 27836918 DOI: 10.1136/jech-2016-208555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 10/26/2016] [Indexed: 11/04/2022]
Affiliation(s)
- Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Pauline M Geuijen
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeanne H M de Vries
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Paediatrics, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
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20
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Schock H, Zeleniuch-Jacquotte A, Lundin E, Grankvist K, Lakso HÅ, Idahl A, Lehtinen M, Surcel HM, Fortner RT. Hormone concentrations throughout uncomplicated pregnancies: a longitudinal study. BMC Pregnancy Childbirth 2016; 16:146. [PMID: 27377060 PMCID: PMC4932669 DOI: 10.1186/s12884-016-0937-5] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/24/2016] [Indexed: 12/03/2022] Open
Abstract
Background Evidence suggests that the hormonal milieu of pregnancy is an important determinant of subsequent cancer and other chronic diseases in both the mother and the offspring. Many of the existing maternity and birth cohorts include specimens drawn only once during pregnancy. How well a single blood specimen collected during a pregnancy characterizes exposure to these hormones throughout gestation, and also in subsequent pregnancies, is not well understood. Methods We used serial serum samples from 71 pregnant women (25 primiparous, 25 multiparous, and 21 with two consecutive pregnancies) with natural, complication-free pregnancies and a healthy offspring at term who participated in a population-based screening trial for congenital infections in Finland between January 1st, 1988 and June 30, 1989 and provided a blood sample in each trimester. Results Hormone levels were more strongly correlated between consecutive trimesters of a pregnancy than between the 1st and 3rd trimester (e.g., estradiol, rT1 vs. T2 = 0.51 and rT2 vs. T3 = 0.60, p < 0.01; rT1 vs. T3 = 0.32, p < 0.05). Concentrations of sRANKL remained stable throughout gestation, whereas estradiol, estrone, progesterone, testosterone, prolactin, and osteoprotegerin increased throughout pregnancy. First trimester hormone concentrations explained less of the variation in the third trimester on their own than second trimester hormone levels (e.g. estradiol R2T1
= 16 % and R2T2 = 42 %). Addition of maternal (e.g., smoking) and/or child characteristics (e.g., sex) improved the accuracy of the 3rd trimester estimates for some of the hormones. Conclusions One hormone measurement in early pregnancy, in conjunction with maternal and fetal characteristics, permits estimation of 3rd trimester hormone concentrations. Therefore, single hormone measurements available from maternity cohorts are suitable to quantify hormone exposure during pregnancy. To our knowledge, we provide the first data on correlations between hormone concentrations both across trimesters of a single pregnancy, as well as between two subsequent pregnancies. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0937-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg, 69120, Germany. .,Department of Medical Biosciences, Umeå University, Umeå, Sweden.
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health, New York University School of Medicine, New York, USA.,New York University Cancer Institute, New York University School of Medicine, New York, USA
| | - Eva Lundin
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Kjell Grankvist
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Hans-Åke Lakso
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Matti Lehtinen
- School of Public Health, University of Tampere, Tampere, Finland
| | - Heljä-Marja Surcel
- Unit of Sexual and Reproductive Health, National Institute for Health and Welfare, Oulu, Finland
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg, 69120, Germany
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21
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van Rooij IALM, van der Zanden LFM, Bongers EMHF, Renkema KY, Wijers CHW, Thonissen M, Dokter EMJ, Marcelis CLM, de Blaauw I, Wijnen MHWA, Hoogerbrugge PM, Bokkerink JPM, Schreuder MF, Koster-Kamphuis L, Cornelissen EAM, Kapusta L, van Heijst AFJ, Liem KD, de Gier RPE, Kuijpers-Jagtman AM, Admiraal RJC, Bergé SJ, van der Biezen JJ, Verdonck A, Vander Poorten V, Hens G, Roosenboom J, Lilien MR, de Jong TP, Broens P, Wijnen R, Brooks A, Franke B, Brunner HG, Carels CEL, Knoers NVAM, Feitz WFJ, Roeleveld N. AGORA, a data- and biobank for birth defects and childhood cancer. ACTA ACUST UNITED AC 2016; 106:675-84. [PMID: 27150573 DOI: 10.1002/bdra.23512] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Research regarding the etiology of birth defects and childhood cancer is essential to develop preventive measures, but often requires large study populations. Therefore, we established the AGORA data- and biobank in the Netherlands. In this study, we describe its rationale, design, and ongoing data collection. METHODS Children diagnosed with and/or treated for a structural birth defect or childhood cancer and their parents are invited to participate in the AGORA data- and biobank. Controls are recruited through random sampling from municipal registries. The parents receive questionnaires about demographics, family and pregnancy history, health status, prescribed medication, lifestyle, and occupational exposures before and during the index pregnancy. In addition, blood or saliva is collected from children and parents, while medical records are reviewed for diagnostic information. RESULTS So far, we have collected data from over 6,860 families (3,747 birth defects, 905 childhood cancers, and 2,208 controls). The types of birth defects vary widely and comprise malformations of the digestive, respiratory, and urogenital tracts as well as facial, cardiovascular, kidney, skeletal, and central nervous system anomalies. The most frequently occurring childhood cancer types are acute lymphatic leukemia, Hodgkin and non-Hodgkin lymphoma, Wilms' tumor, and brain and spinal cord tumors. Our genetic and/or epidemiologic studies have been focused on hypospadias, anorectal malformations, congenital anomalies of the kidney and urinary tract (CAKUT), and orofacial clefts. CONCLUSION The large AGORA data- and biobank offers great opportunities for investigating genetic and nongenetic risk factors for disorders in children and is open to collaborative initiatives. Birth Defects Research (Part A) 106:675-684, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Iris A L M van Rooij
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Loes F M van der Zanden
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Ernie M H F Bongers
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands
| | - Kirsten Y Renkema
- Department of Genetics, University Medical Center Utrecht, The Netherlands
| | - Charlotte H W Wijers
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Michelle Thonissen
- Department of Orthodontics and Craniofacial Biology, Radboud university medical center, Nijmegen, The Netherlands
| | - Elisabeth M J Dokter
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.,Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | - Carlo L M Marcelis
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands
| | - Ivo de Blaauw
- Department of Surgery, Pediatric Surgery, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands.,Department of Pediatric Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marc H W A Wijnen
- Department of Surgery, Pediatric Surgery, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Peter M Hoogerbrugge
- Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Jos P M Bokkerink
- Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Michiel F Schreuder
- Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Linda Koster-Kamphuis
- Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | | | - Livia Kapusta
- Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Arno F J van Heijst
- Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Kian D Liem
- Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Robert P E de Gier
- Department of Urology, Pediatric Urology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics and Craniofacial Biology, Radboud university medical center, Nijmegen, The Netherlands
| | - Ronald J C Admiraal
- Department of Otorhinolaryngology, Radboud university medical center, Nijmegen, The Netherlands
| | - Stefaan J Bergé
- Department of Oral and Maxillofacial surgery, Radboud university medical center, Nijmegen, The Netherlands
| | - Jan Jaap van der Biezen
- Department of Plastic Surgery and Hand Surgery, Medical Centre Leeuwarden, Leeuwarden, the Netherlands
| | - An Verdonck
- Department of Oral Health Sciences-Orthodontics and Leuven Cleft Lip and Palate Team, KU Leuven, University Hospitals KU Leuven, Belgium
| | - Vincent Vander Poorten
- Department of Otorhinolaryngology, Head and Neck Surgery and Leuven Cleft Lip and Palate Team, University Hospitals KU Leuven, Belgium
| | - Greet Hens
- Department of Otorhinolaryngology, Head and Neck Surgery and Leuven Cleft Lip and Palate Team, University Hospitals KU Leuven, Belgium
| | - Jasmien Roosenboom
- Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Belgium
| | - Marc R Lilien
- Department of Pediatric Nephrology, Wilhelmina Children's Hospital, University Medical Center Utrecht, The Netherlands
| | - Tom P de Jong
- Department of Pediatric Urology, Wilhelmina Children's Hospital, University Medical Center Utrecht, The Netherland.,Department of Pediatric Urology, Emma Children's Hospital, Academic Medical Center Amsterdam, The Netherlands
| | - Paul Broens
- Department of Surgery, Division of Pediatric Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Rene Wijnen
- Department of Pediatric Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Alice Brooks
- Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands.,Department of Psychiatry, Radboud university medical center, Nijmegen, The Netherlands
| | - Han G Brunner
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands
| | - Carine E L Carels
- Department of Orthodontics and Craniofacial Biology, Radboud university medical center, Nijmegen, The Netherlands.,Department of Oral Health Sciences-Orthodontics and Leuven Cleft Lip and Palate Team, KU Leuven, University Hospitals KU Leuven, Belgium
| | - Nine V A M Knoers
- Department of Genetics, University Medical Center Utrecht, The Netherlands
| | - Wout F J Feitz
- Department of Urology, Pediatric Urology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.,Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
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22
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Depressive symptoms among Dutch pregnant women after the crash of flight MH17: the PRIDE Study. Ann Epidemiol 2016; 26:155-156. [PMID: 26733082 DOI: 10.1016/j.annepidem.2015.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 11/16/2015] [Indexed: 11/23/2022]
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23
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Stanford JB, Brenner R, Fetterer D, Palmer L, Schoendorf KC. Impact of preconception enrollment on birth enrollment and timing of exposure assessment in the initial vanguard cohort of the U.S. National Children's Study. BMC Med Res Methodol 2015; 15:75. [PMID: 26399430 PMCID: PMC4581516 DOI: 10.1186/s12874-015-0067-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 09/10/2015] [Indexed: 11/27/2022] Open
Abstract
Background The initial vanguard cohort of the U.S. National Children’s Study was a pregnancy and birth cohort study that sought to enroll some women prior to pregnancy, and to assess exposures early in pregnancy. Methods During the recruitment phase (2009–2010), geographically based sampling was used to recruit women early in pregnancy and women not currently pregnant, not using contraception and heterosexually active. We assessed the following outcomes for women enrolled preconception and early in pregnancy: yield of births; demographic characteristics of births for different enrollment groups; time to pregnancy for preconception women; and the timing of study visits for exposure assessment. Results 1399 women were recruited into the initial vanguard cohort: 429 preconception (198 trying for pregnancy, and 231 not trying) and 970 already pregnant. There were 1135 pregnancies (81 % of women) and 922 newborns enrolled (81 % of pregnancies) through September 2012. Preconception women represented 30.6 % of women enrolled, and contributed 14.5 % of births. Among women who gave birth, and who had enrolled preconception trying for pregnancy, 67.3 % were white non-Hispanic, compared to 50.0 % of preconception women not trying for pregnancy, and 61.5 % of pregnant women. Women enrolled preconception who were trying for pregnancy had higher cumulative probability of pregnancy at one year compared to women not trying (adjusted 86 % versus 56 %). Of 165 women enrolled preconception who became pregnant, 19 % had a study visit within 30 days of conception. By 10.5 weeks after conception, 75 % of women enrolled preconception had completed a pregnancy study visit; for women enrolled pregnant, the 75 % threshold was reached at 28.4 weeks. Conclusions There were demographic differences in births from women enrolled preconception trying for pregnancy, preconception not trying for pregnancy, or during pregnancy. Time to pregnancy was shorter for women actively trying for pregnancy. Most women enrolled preconception did not have exposure assessment within 30 days of conception, but they did have exposure assessment much earlier during pregnancy than women who enrolled during pregnancy.
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Affiliation(s)
- Joseph B Stanford
- Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Salt Lake City, UT, 84108, USA. .,Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
| | - Ruth Brenner
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
| | | | - Leslie Palmer
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
| | - Kenneth C Schoendorf
- Greenspring Pediatric Associates, Sinai Hospital of Baltimore, Baltimore, MD, USA.
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24
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van Gelder MMHJ, Schouten NPE, Merkus PJFM, Verhaak CM, Roeleveld N, Roukema J. Using Web-Based Questionnaires and Obstetric Records to Assess General Health Characteristics Among Pregnant Women: A Validation Study. J Med Internet Res 2015; 17:e149. [PMID: 26081990 PMCID: PMC4526940 DOI: 10.2196/jmir.3847] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 04/02/2015] [Accepted: 04/18/2015] [Indexed: 11/21/2022] Open
Abstract
Background Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history are scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this parameter in large populations. Objective The aim of this study was to assess the validity of a Web-based questionnaire on chronic medical conditions, allergies, and blood pressure readings against obstetric records and data from general practitioners. Methods Self-reported questionnaire data were compared with obstetric records for 519 pregnant women participating in the Dutch PRegnancy and Infant DEvelopment (PRIDE) Study from July 2011 through November 2012. These women completed Web-based questionnaires around their first prenatal care visit and in gestational weeks 17 and 34. We calculated kappa statistics (κ) and the observed proportions of positive and negative agreement between the baseline questionnaire and obstetric records for chronic conditions and allergies. In case of inconsistencies between these 2 data sources, medical records from the woman’s general practitioner were consulted as the reference standard. For systolic and diastolic blood pressure, intraclass correlation coefficients (ICCs) were calculated for multiple data points. Results Agreement between the baseline questionnaire and the obstetric record was substantial (κ=.61) for any chronic condition and moderate for any allergy (κ=.51). For specific conditions, we found high observed proportions of negative agreement (range 0.88-1.00) and on average moderate observed proportions of positive agreement with a wide range (range 0.19-0.90). Using the reference standard, the sensitivity of the Web-based questionnaire for chronic conditions and allergies was comparable to or even better than the sensitivity of the obstetric records, in particular for migraine (0.90 vs 0.40, P=.02), asthma (0.86 vs 0.61, P=.04), inhalation allergies (0.92 vs 0.74, P=.003), hay fever (0.90 vs 0.64, P=.001), and allergies to animals (0.89 vs 0.53, P=.01). However, some overreporting of allergies was observed in the questionnaire and for some nonsomatic conditions sensitivity of both measurement instruments was low. The ICCs for blood pressure readings ranged between 0.72 and 0.92 with very small mean differences between the 2 methods of data collection. Conclusions Web-based questionnaires can be used to validly collect data on many chronic disorders, allergies, and blood pressure readings among pregnant women.
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Affiliation(s)
- Marleen M H J van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, Netherlands.
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25
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Barrett ES, Sathyanarayana S, Janssen S, Redmon JB, Nguyen RHN, Kobrosly R, Swan SH. Environmental health attitudes and behaviors: findings from a large pregnancy cohort study. Eur J Obstet Gynecol Reprod Biol 2014; 176:119-25. [PMID: 24647207 DOI: 10.1016/j.ejogrb.2014.02.029] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 02/11/2014] [Accepted: 02/15/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Environmental chemicals are widely found in food and personal care products and may have adverse effects on fetal development. Our aim was to examine women's attitudes about these chemicals and ask whether they try to limit their exposure during pregnancy. STUDY DESIGN A multi-center cohort of women in the first trimester of pregnancy completed questionnaires including items on attitudes and behaviors related to environmental chemicals. Multivariable logistic regression models were used to examine: (1) whether sociodemographic variables predict environmental health attitudes and behaviors; and (2) whether women's attitudes about environmental chemicals affect their lifestyle behaviors, particularly diet and personal care product use. RESULTS Of the 894 subjects, approximately 60% strongly agreed that environmental chemicals are dangerous and 25% strongly felt they were impossible to avoid. Adjusting for covariates, educated women were more likely to believe that environmental chemicals are dangerous (OR 1.74, 95% CI 1.13, 2.66), and that belief, in turn, was associated with a number of healthy behaviors including choosing organic foods, foods in safe plastics, and chemical-free personal care products, and limiting fast food intake. Younger women were more likely to believe that environmental chemicals are impossible to avoid (OR 1.04, 95% CI 1.00, 1.08). CONCLUSIONS Women's attitudes about environmental chemicals may impact their choices during pregnancy. Overcoming a lack of concern about environmental chemicals, particularly among certain sociodemographic groups, is important for the success of clinical or public health prevention measures.
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Affiliation(s)
- Emily S Barrett
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, United States.
| | - Sheela Sathyanarayana
- Department of Pediatrics, Seattle Children's Research Institute, University of Washington, Seattle, WA 98101, United States.
| | - Sarah Janssen
- Department of Urology, University of California-San Francisco School of Medicine, San Francisco, CA 94014, United States.
| | - J Bruce Redmon
- Division of Endocrinology & Diabetes, University of Minnesota Medical School, Minneapolis, MN 55455, United States.
| | - Ruby H N Nguyen
- Department of Epidemiology, University of Minnesota, Minneapolis, MN 55454, United States.
| | - Roni Kobrosly
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
| | - Shanna H Swan
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
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Larsen PS, Kamper-Jørgensen M, Adamson A, Barros H, Bonde JP, Brescianini S, Brophy S, Casas M, Charles MA, Devereux G, Eggesbø M, Fantini MP, Frey U, Gehring U, Grazuleviciene R, Henriksen TB, Hertz-Picciotto I, Heude B, Hryhorczuk DO, Inskip H, Jaddoe VWV, Lawlor DA, Ludvigsson J, Kelleher C, Kiess W, Koletzko B, Kuehni CE, Kull I, Kyhl HB, Magnus P, Momas I, Murray D, Pekkanen J, Polanska K, Porta D, Poulsen G, Richiardi L, Roeleveld N, Skovgaard AM, Sram RJ, Strandberg-Larsen K, Thijs C, Van Eijsden M, Wright J, Vrijheid M, Andersen AMN. Pregnancy and birth cohort resources in europe: a large opportunity for aetiological child health research. Paediatr Perinat Epidemiol 2013; 27:393-414. [PMID: 23772942 DOI: 10.1111/ppe.12060] [Citation(s) in RCA: 199] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND During the past 25 years, many pregnancy and birth cohorts have been established. Each cohort provides unique opportunities for examining associations of early-life exposures with child development and health. However, to fully exploit the large amount of available resources and to facilitate cross-cohort collaboration, it is necessary to have accessible information on each cohort and its individual characteristics. The aim of this work was to provide an overview of European pregnancy and birth cohorts registered in a freely accessible database located at http://www.birthcohorts.net. METHODS European pregnancy and birth cohorts initiated in 1980 or later with at least 300 mother-child pairs enrolled during pregnancy or at birth, and with postnatal data, were eligible for inclusion. Eligible cohorts were invited to provide information on the data and biological samples collected, as well as the timing of data collection. RESULTS In total, 70 cohorts were identified. Of these, 56 fulfilled the inclusion criteria encompassing a total of more than 500,000 live-born European children. The cohorts represented 19 countries with the majority of cohorts located in Northern and Western Europe. Some cohorts were general with multiple aims, whilst others focused on specific health or exposure-related research questions. CONCLUSION This work demonstrates a great potential for cross-cohort collaboration addressing important aspects of child health. The web site, http://www.birthcohorts.net, proved to be a useful tool for accessing information on European pregnancy and birth cohorts and their characteristics.
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Affiliation(s)
- Pernille Stemann Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen.
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