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Hughes AD, Davey Smith G, Howe LD, Lawlor D, Jones S, Park CM, Chaturvedi N. Differences between brachial and aortic blood pressure in adolescence and their implications for diagnosis of hypertension. J Hypertens 2024:00004872-990000000-00454. [PMID: 38660719 DOI: 10.1097/hjh.0000000000003743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Blood pressure (BP) is the leading global cause of mortality, and its prevalence is increasing in children and adolescents. Aortic BP is lower than brachial BP in adults. We aimed to assess the extent of this difference and its impact on the diagnosis of hypertension among adolescents. METHODS We used data from 3850 participants from a UK cohort of births in the early 1990s in the Southwest of England, who attended their ∼17-year follow-up and had valid measures of brachial and aortic BP at that clinic [mean (SD) age 17.8 (0.4) years, 66% female individuals]. Data are presented as mean differences [95% prediction intervals] for both sexes. RESULTS Aortic systolic BP (SBP) was lower than brachial SBP [male, -22.3 (-31.2, -13.3) mmHg; female, -17.8 (-25.5, -10.0) mmHg]. Differences between aortic and brachial diastolic BP (DBP) were minimal. Based on brachial BP measurements, 101 male individuals (6%) and 22 female individuals (1%) were classified as hypertensive. In contrast, only nine male individuals (<1%) and 14 female individuals (<1%) met the criteria for hypertension based on aortic BP, and the predictive value of brachial BP for aortic hypertension was poor (positive-predictive value = 13.8%). Participants with aortic hypertension had a higher left ventricular mass index than those with brachial hypertension. CONCLUSION Brachial BP substantially overestimates aortic BP in adolescents because of marked aortic-to-brachial pulse pressure amplification. The use of brachial BP measurement may result in an overdiagnosis of hypertension during screening in adolescence.
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Affiliation(s)
- Alun D Hughes
- MRC Unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
| | - Siana Jones
- MRC Unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London
| | - Chloe M Park
- MRC Unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London
| | - Nish Chaturvedi
- MRC Unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London
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Cadman T, Elhakeem A, Vinther JL, Avraam D, Carrasco P, Calas L, Cardo M, Charles MA, Corpeleijn E, Crozier S, de Castro M, Estarlich M, Fernandes A, Fossatti S, Gruszfeld D, Gurlich K, Grote V, Haakma S, Harris JR, Heude B, Huang RC, Ibarluzea J, Inskip H, Jaddoe V, Koletzko B, Luque V, Manios Y, Moirano G, Moschonis G, Nader J, Nieuwenhuijsen M, Andersen AMN, McEachen R, de Moira AP, Popovic M, Roumeliotaki T, Salika T, Marina LS, Santos S, Serbert S, Tzorovili E, Vafeiadi M, Verduci E, Vrijheid M, Vrijkotte TGM, Welten M, Wright J, Yang TC, Zugna D, Lawlor D. Associations of Maternal Educational Level, Proximity to Greenspace During Pregnancy, and Gestational Diabetes With Body Mass Index From Infancy to Early Adulthood: A Proof-of-Concept Federated Analysis in 18 Birth Cohorts. Am J Epidemiol 2023:kwad206. [PMID: 37856700 DOI: 10.1093/aje/kwad206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/06/2023] [Indexed: 10/21/2023] Open
Abstract
International sharing of cohort data for research is important and challenging. We explored the feasibility of multi-cohort federated analyses by examining associations between three pregnancy exposures (maternal education, exposure to green vegetation and gestational diabetes) with offspring BMI from infancy to 17 years. We used data from 18 cohorts (n=206,180 mother-child pairs) from the EU Child Cohort Network and derived BMI at ages 0-1, 2-3, 4-7, 8-13 and 14-17 years. Associations were estimated using linear regression via one-stage IPD meta-analysis using DataSHIELD. Associations between lower maternal education and higher child BMI emerged from age 4 and increased with age (difference in BMI z-score comparing low with high education age 2-3 years = 0.03 [95% CI 0.00, 0.05], 4-7 years = 0.16 [95% CI 0.14, 0.17], 8-13 years = 0.24 [95% CI 0.22, 0.26]). Gestational diabetes was positively associated with BMI from 8 years (BMI z-score difference = 0.18 [CI 0.12, 0.25]) but not at younger ages; however associations attenuated towards the null when restricted to cohorts which measured GDM via universal screening. Exposure to green vegetation was weakly associated with higher BMI up to age one but not at older ages. Opportunities of cross-cohort federated analyses are discussed.
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Prioreschi A, Pearson R, Richter L, Bennin F, Theunissen H, Cantrell SJ, Maduna D, Lawlor D, Norris SA. Protocol for the PLAY Study: a randomised controlled trial of an intervention to improve infant development by encouraging maternal self-efficacy using behavioural feedback. BMJ Open 2023; 13:e064976. [PMID: 36882258 PMCID: PMC10008478 DOI: 10.1136/bmjopen-2022-064976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION The early infant caregiving environment is crucial in the formation of parent-child relationships, neurobehavioural development and thus child outcomes. This protocol describes the Play Love And You (PLAY) Study, a phase 1 trial of an intervention designed to promote infant development through encouraging maternal self-efficacy using behavioural feedback, and supportive interventions. METHODS AND ANALYSIS 210 mother-infant pairs will be recruited at delivery from community clinics in Soweto, South Africa, and individually randomised (1:1) into two groups. The trial will consist of a standard of care arm and an intervention arm. The intervention will start at birth and end at 12 months, and outcome assessments will be made when the infants are 0, 6 and 12 months of age. The intervention will be delivered by community health helpers using an app with resource material, telephone calls, in person visits and behavioural feedback with individualised support. Every 4 months, mothers in the intervention group will receive rapid feedback via the app and in person on their infant's movement behaviours and on their interaction styles with their infant. At recruitment, and again at 4 months, mothers will be screened for mental health risk and women who score in the high-risk category will receive an individual counselling session from a licensed psychologist, followed by referral and continued support as necessary. The primary outcome is efficacy of the intervention in improving maternal self-efficacy, and the secondary outcomes are infant development at 12 months, and feasibility and acceptability of each component of the intervention. ETHICS AND DISSEMINATION The PLAY Study has received ethical approval from the Human Research Ethics Committee of the University of the Witwatersrand (M220217). Participants will be provided with an information sheet and required to provide written consent prior to being enrolled. Study results will be shared via publication in peer-reviewed journals, conference presentation and media engagement. TRIAL REGISTRATION NUMBER This trial was registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za) on 10 February 2022 (identifier: PACTR202202747620052).
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Affiliation(s)
- Alessandra Prioreschi
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Rebecca Pearson
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Academic Mental Health, Addiction and Suicide Research, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Linda Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Fiona Bennin
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Helene Theunissen
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Sarah J Cantrell
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Dumsile Maduna
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Deborah Lawlor
- Department of Social Medicine, MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
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Hayes B, Martin R, Lawlor D, Richmond R, Robinson T. Abstract P5-03-06: Effect of Sleep Traits on Subtype Specific Breast Cancer Survival: a Mendelian Randomization Analysis. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-03-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background There is increasing interest in the relationship between sleep traits and both quality of life and survival in breast cancer. Recent work has found that oestrogen receptor positive (ER+) tumour cells are more likely to spread, via the circulation, at night than in the morning, providing support for a potential role of sleep characteristics influencing metastasis and therefore survival from breast cancer. The aim of this study was to investigate causal effects of sleep traits on subtype-specific breast cancer survival. Methods Single-nucleotide polymorphisms (SNPs) identified from GWAS associated with sleep traits with were used as a genetic instruments for Chronotype (N=697,828), Insomnia (N=1,331,010), Sleep Duration (N=446,118), Napping (N=452,633), Daytime sleepiness(N=452,071) and Ease of Getting up (N=461,658). All instruments were identified in data from UK Biobank, except chronotype and insomnia, which were identified in meta-analyses of UK Biobank and 23andme. For all instruments female-specific effect estimates were used. For these SNPs, summary statistics of their association with breast cancer survival were obtained from GWAS meta-analyses of European women from the Breast Cancer Association Consortium (BCAC), (N=91,686, with 7531 breast cancer specific deaths over a median follow-up of 8.1 years). To estimate the causal effect of the sleep traits on breast cancer survival, we applied two-sample MR for both overall and subtype-specific breast cancer (Luminal A-like, Luminal B-like, Human Epidermal Growth Factor 2 (Her2) positive, Her2 negative and triple negative (TNBC)). Further stratification by tumour characteristics at diagnosis and treatment received was also used. Sensitivity analyses were used to assess the robustness of main analyses to MR assumptions. Results For every hour increase in sleep duration, we observed worsening 5-year breast cancer specific survival in patients with ER+ tumours who received endocrine therapy (HR: 2.55, 95% CI: 1.10, 5,82) and for all patients receiving aromatase inhibitors (HR: 9.57, 95% CI: 1.61, 57.10). Conversely, improved 5-year survival was observed in patients with ER- tumours who received chemotherapy (HR: 0.30, 95% CI: 0.10, 0.87) and all patients receiving taxanes (HR: 0.23, 95% CI: 0.05, 0.98). We also observed that an increase in daytime sleepiness improved 15-year survival in patients both overall (HR: 0.34, 95% CI: 0.14, 0.80) and with lymph node negative tumours at diagnosis (HR: 0.12, 95% CI: 0.02, 0.64). Detailed sensitivity analyses are ongoing. Conclusions The current study uses a causal approach to identify potential effects between sleep patterns and breast cancer survival and confirms the previously observed relationships with increased sleep duration and worse survival in ER+ breast cancer. The reasons for opposite effects seen in those with ER- and those receiving taxanes needs further mechanistic work. Although the improved survival in relation to increased daytime sleepiness appears to be in-keeping with previous findings, this may largely reflect shorter sleep duration. Further work accurately characterising sleep quality, rather than duration in those with breast cancer, examining the effects on quality of life and survival and establishing mechanisms are needed.
Citation Format: Bryony Hayes, Richard Martin, Deborah Lawlor, Rebecca Richmond, Tim Robinson. Effect of Sleep Traits on Subtype Specific Breast Cancer Survival: a Mendelian Randomization Analysis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-03-06.
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Mires S, de Jesus SE, Bamber AR, Mumford A, Power B, Bradshaw C, Lawlor D, Gill H, Luyt K, Baquedano M, Overton T, Caputo M, Skerritt C. Surgical-PEARL protocol: a multicentre prospective cohort study exploring aetiology, management and outcomes for patients with congenital anomalies potentially requiring surgical intervention. BMJ Open 2022; 12:e066480. [PMID: 36600324 PMCID: PMC9743368 DOI: 10.1136/bmjopen-2022-066480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Congenital anomalies affect over 2% of pregnancies. Surgical advances have reduced mortality and improved survival for patients with congenital anomalies potentially requiring surgical (CAPRS) intervention. However, our understanding of aetiology, diagnostic methods, optimal management, outcomes and prognostication is limited. Existing birth cohorts have low numbers of individual heterogenous CAPRS. The Surgical Paediatric congEnital Anomalies Registry with Long term follow-up (Surgical-PEARL) study aims to establish a multicentre prospective fetal, child and biological parent cohort of CAPRS. METHODS AND ANALYSIS From 2022 to 2027, Surgical-PEARL aims to recruit 2500 patients with CAPRS alongside their biological mothers and fathers from up to 15 UK centres. Recruitment will be antenatal or postnatal dependent on diagnosis timing and presentation to a recruitment site. Routine clinical data including antenatal scans and records, neonatal intensive care unit (NICU) records, diagnostic and surgical data and hospital episode statistics will be collected. A detailed biobank of samples will include: parents' blood and urine samples; amniotic fluid if available; children's blood and urine samples on admission to NICU, perioperatively or if the child has care withdrawn or is transferred for extracorporeal membrane oxygenation; stool samples; and surplus surgical tissue. Parents will complete questionnaires including sociodemographic and health data. Follow-up outcome and questionnaire data will be collected for 5 years. Once established we will explore the potential of comparing findings in Surgical-PEARL to general population cohorts born in the same years and centres. ETHICS AND DISSEMINATION Ethical and health research authority approvals have been granted (IRAS Project ID: 302251; REC reference number 22/SS/0004). Surgical-PEARL is adopted onto the National Institute for Health Research Clinical Research Network portfolio. Findings will be disseminated widely through peer-reviewed publication, conference presentations and through patient organisations and newsletters. TRIAL REGISTRATION NUMBER ISRCTN12557586.
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Affiliation(s)
- Stuart Mires
- Translational Health Sciences, University of Bristol, Bristol, UK
- Women and Children's Health, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Andrew R Bamber
- Translational Health Sciences, University of Bristol, Bristol, UK
- Pathology, North Bristol NHS Foundation Trust, Bristol, UK
| | - Andrew Mumford
- Translational Health Sciences, University of Bristol, Bristol, UK
- Haematology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Catherine Bradshaw
- Women and Children's Health, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit, Department of Social Medicine, University of Bristol, Bristol, UK
| | - Hannah Gill
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
- Anaesthesia, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Karen Luyt
- Translational Health Sciences, University of Bristol, Bristol, UK
- Women and Children's Health, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Mai Baquedano
- Translational Health Sciences, University of Bristol, Bristol, UK
| | - Tim Overton
- Women and Children's Health, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Massimo Caputo
- Translational Health Sciences, University of Bristol, Bristol, UK
- Bristol Heart Institute, University of Bristol, Bristol, UK
| | - Clare Skerritt
- Women and Children's Health, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Wagener M, van Heemst D, Kooijman S, Willems van Dijk K, Redline S, Tan X, Lawlor D, Rutter M, Noordam R. Dissecting insomnia from sleep duration in relation to coronary artery disease: evidence from multivariable-adjusted and factorial Mendelian Randomization analyses. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Torres Toda M, Avraam D, James Cadman T, Fossati S, de Castro M, Dedele A, Donovan G, Elhakeem A, Estarlich M, Fernandes A, Gonçalves R, Grazuleviciene R, Harris JR, Harskamp-van Ginkel MW, Heude B, Ibarluzea J, Iñiguez C, Wv Jaddoe V, Lawlor D, Lertxundi A, Lepeule J, McEachan R, Moirano G, Lt Nader J, Nybo Andersen AM, Pedersen M, Pizzi C, Roumeliotaki T, Santos S, Sunyer J, Yang T, Vafeiadi M, Gm Vrijkotte T, Nieuwenhuijsen M, Vrijheid M, Foraster M, Dadvand P. Exposure to natural environments during pregnancy and birth outcomes in 11 European birth cohorts. Environ Int 2022; 170:107648. [PMID: 36436464 DOI: 10.1016/j.envint.2022.107648] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/25/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
Research suggests that maternal exposure to natural environments (i.e., green and blue spaces) promotes healthy fetal growth. However, the available evidence is heterogeneous across regions, with very few studies on the effects of blue spaces. This study evaluated associations between maternal exposure to natural environments and birth outcomes in 11 birth cohorts across nine European countries. This study, part of the LifeCycle project, was based on a total sample size of 69,683 newborns with harmonised data. For each participant, we calculated seven indicators of residential exposure to natural environments: surrounding greenspace in 100m, 300m, and 500m using Normalised Difference Vegetation Index (NDVI) buffers, distance to the nearest green space, accessibility to green space, distance to the nearest blue space, and accessibility to blue space. Measures of birth weight and small for gestational age (SGA) were extracted from hospital records. We used pooled linear and logistic regression models to estimate associations between exposure to the natural environment and birth outcomes, controlling for the relevant covariates. We evaluated the potential effect modification by socioeconomic status (SES) and region of Europe and the influence of ambient air pollution on the associations. In the pooled analyses, residential surrounding greenspace in 100m, 300m, and 500m buffer was associated with increased birth weight and lower odds for SGA. Higher residential distance to green space was associated with lower birth weight and higher odds for SGA. We observed close to null associations for accessibility to green space and exposure to blue space. We found stronger estimated magnitudes for those participants with lower educational levels, from more deprived areas, and living in the northern European region. Our associations did not change notably after adjustment for air pollution. These findings may support implementing policies to promote natural environments in our cities, starting in more deprived areas.
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Affiliation(s)
- Maria Torres Toda
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain.
| | - Demetris Avraam
- Population Health Sciences Institute, Newcastle University, Newcastle, UK; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Timothy James Cadman
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
| | - Serena Fossati
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain.
| | - Montserrat de Castro
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain.
| | - Audrius Dedele
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, 53361 Akademija, Lithuania.
| | - Geoffrey Donovan
- Center for Public Health Research, Massey University-Wellington Campus, PO Box 756, Wellington 6140, New Zealand; USDA Forest Service, PNW Research Station, 620 SW Main, Suite 502, Portland, OR 97205, USA.
| | - Ahmed Elhakeem
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Science, Bristol Medical School, University of Bristol, UK.
| | - Marisa Estarlich
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain; Nursing School, Universitat de València, C/Menendez y Pelayo, s/n, 46010, Valencia, Spain.
| | - Amanda Fernandes
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
| | - Romy Gonçalves
- The Generation R Study Group (NA-2915), Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
| | - Regina Grazuleviciene
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, 53361 Akademija, Lithuania.
| | - Jennifer R Harris
- Center for Fertility and Health, The Nowegian Institute of Public Health, Oslo, Norway.
| | - Margreet W Harskamp-van Ginkel
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, Netherlands.
| | - Barbara Heude
- Université de Paris Cité, Inserm, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Jesús Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastian, Spain; Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain.
| | - Carmen Iñiguez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain; Department of Statistics and Operational Research, Universitat de València, Dr. Moliner, 50 46100, Valencia, Spain.
| | - Vincent Wv Jaddoe
- The Generation R Study Group (NA-2915), Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - Deborah Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Science, Bristol Medical School, University of Bristol, UK.
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), 48940, Leioa, Spain.
| | - Johanna Lepeule
- Université Grenoble Alpes, Institut Albert Bonniot, équipe d'épidémiologie environnementale appliquée à la reproduction et la santé respiratoire, F-38000 Grenoble, France; Inserm, Institut Albert Bonniot, équipe d'épidémiologie environnementale appliquée à la reproduction et la santé respiratoire, F-38000 Grenoble, France.
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
| | - Giovenale Moirano
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy.
| | - Johanna Lt Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway.
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Marie Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Costanza Pizzi
- Department of Medical Sciences, University of Turin, CPO-Piemonte, Turin, Italy.
| | - Theano Roumeliotaki
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Social Medicine, School of Medicine, University of Crete, Greece.
| | - Susana Santos
- The Generation R Study Group (NA-2915), Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Erasmus Medical Center, University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Portugal.
| | - Jordi Sunyer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain.
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
| | - Marina Vafeiadi
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Social Medicine, School of Medicine, University of Crete, Greece.
| | - Tanja Gm Vrijkotte
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, Netherlands.
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain.
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain.
| | - Maria Foraster
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain.
| | - Payam Dadvand
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain.
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Hayes B, Vabistsevits M, Robinson T, Martin R, Lawlor D, Richmond R. Orienting causal relationships between sleep and adiposity traits using Mendelian randomisation. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Madley-Dowd P, Dardani C, Wootton RE, Dack K, Palmer T, Thurston R, Havdahl A, Golding J, Lawlor D, Rai D. Maternal vitamin D during pregnancy and offspring autism and autism-associated traits: a prospective cohort study. Mol Autism 2022; 13:44. [PMID: 36371219 PMCID: PMC9652971 DOI: 10.1186/s13229-022-00523-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/02/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There has been a growing interest in the association between maternal levels of vitamin D during pregnancy and offspring autism. However, whether any associations reflect causal effects is still inconclusive. METHODS We used data from a UK-based pregnancy cohort study (Avon Longitudinal Study of Parents and Children) comprising 7689 births between 1991 and 1992 with maternal blood vitamin D levels recorded during pregnancy and at least one recorded outcome measure, including autism diagnosis and autism-associated traits. The association between each outcome with seasonal and gestational age-adjusted maternal serum 25-hydroxyvitamin D during pregnancy was estimated using confounder-adjusted regression models. Multiple imputation was used to account for missing data, and restricted cubic splines were used to investigate nonlinear associations. Mendelian randomization was used to strengthen causal inference. RESULTS No strong evidence of an association between maternal serum 25-hydroxyvitamin D during pregnancy and any offspring autism-associated outcome was found using multivariable regression analysis (autism diagnosis: adjusted OR = 0.98, 95% CI = 0.90-1.06), including with multiple imputation (autism diagnosis: adjusted OR = 0.99, 95% CI = 0.93-1.06), and no evidence of a causal effect was suggested by Mendelian randomization (autism diagnosis: causal OR = 1.08, 95% CI = 0.46-2.55). Some evidence of increased odds of autism-associated traits at lower levels of maternal serum 25-hydroxyvitamin D was found using spline analysis. LIMITATIONS Our study was potentially limited by low power, particularly for diagnosed autism cases as an outcome. The cohort may not have captured the extreme lows of the distribution of serum 25-hydroxyvitamin D, and our analyses may have been biased by residual confounding and missing data. CONCLUSIONS The present study found no strong evidence of a causal link between maternal vitamin D levels in pregnancy and offspring diagnosis or traits of autism.
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Affiliation(s)
- Paul Madley-Dowd
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
| | - Christina Dardani
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Kyle Dack
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tom Palmer
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Jean Golding
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Avon and Wiltshire Partnership, NHS Mental Health Trust, Bristol, UK
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10
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Purayastha M, Roberts S, Gardiner J, Brison D, Nelson S, Lawlor D, Sutcliffe A. A national cohort of children born after assisted conception in the UK (1992-2009). Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.1806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
ObjectiveTo establish a cohort of children consisting of those born after assisted reproductive technology (ART) in the UK between 1992 and 2009, their naturally conceived siblings (NCS) and matched naturally conceived population controls (NCP) and linking this to postnatal health records up to 2015.
MethodsDeterministic record linkage between the Human Fertilization & Embryology Authority (HFEA) register and Office for National Statistics (ONS) birth registration datasets was carried out to identify a cohort of children born after ART between 1992 and 2009, their NCS, and matched NCP controls (HFEA-ONS linkage). This cohort was linked to the UK Hospital Episode Statistics database to allow monitoring of the child’s post-natal health outcomes up to 2015 (HFEA-ONS-HES linkage). Birthweight and health outcomes were compared between groups and by treatment type.
ResultsThe HFEA-ONS linkage consisted of 75348 children born after non-donor ART carried out in the UK between 1st April 1992 and 31st July 2009, 14763 NCS and 164823 matched NCP controls. Of these, 63877 ART, 11343 NCS, and 127544 matched NCP controls were linked to hospital admissions and outpatient data (HFEA-ONS-HES sub-cohort). The study had 1.6-million-person years of follow-up (mean: 12.9 years; range 0-19 years). Children born after fresh embryo transfers were lighter and those born after frozen embryo transfers were heavier than the NCP controls. The within-sibling analyses were directionally consistent with the NCP analyses, but attenuated for the fresh vs NC and increased for the frozen vs NC analyses. ART singletons had increased risk of hospital admission as well as higher admission rates compared to NCP but not NCS.
ConclusionBespoke record linkage was carried out to generate a new child cohort for use in exploring the relationship between conception via ART and short- and long-term health outcomes in offspring. Identification of NCS as well as matched NCP controls allows exploration of the association of ART with adverse offspring outcomes while accounting for parental factors related to sub-fertility which may confound these associations.
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11
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Joshi R, Wannamethee G, Engmann J, Gaunt T, Lawlor D, Price J, Tillin T, Chaturvedi N, Kivimaki M, Hughes A, Wong A, Hingorani A, Schmidt A. Association of triglyceride and cholesterol content in fourteen lipoprotein subfractions with coronary heart disease: A mendelian randomisation analysis. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Pickett KE, Ajebon M, Hou B, Kelly B, Bird PK, Dickerson J, Shire K, McIvor C, Mon-Williams M, Small N, McEachan R, Wright J, Lawlor D. Vulnerabilities in child well-being among primary school children: a cross-sectional study in Bradford, UK. BMJ Open 2022; 12:e049416. [PMID: 35772827 PMCID: PMC9247690 DOI: 10.1136/bmjopen-2021-049416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the prevalence of factors related to well-being among primary school children in a deprived multiethnic community in the UK. DESIGN AND PARTICIPANTS Cross-sectional survey of 15 641 children aged 7-10 years in Born in Bradford's Primary School Years study: whole-classroom samples in 89 Bradford primary schools between 2016 and 2019. MAIN OUTCOME MEASURES Prevalence estimates by ethnicity (%, 95% CI) of single and multiple vulnerabilities in child well-being within and across four domains (Home, Family, Relationships; Material Resources; Friends and School; Subjective Well-being). RESULTS Only 10% of children had no vulnerabilities in any domain of well-being; 10% had one or more vulnerabilities in all four domains. The highest prevalence estimates were for being bullied some or all of the time (52.7%, 95% CI: 51.9% to 53.4%), keeping worries to oneself (31.2%, 95% CI: 30.5% to 31.9%), having no park near home (30.8%, 95% CI: 30.1% to 31.5%) and worrying all the time about how much money their family has (26.3%, 95% CI: 25.6% to 27%). Boys were consistently significantly more likely than girls to report all of the vulnerabilities in the Home, Family and Family Relationships domain, and the majority of indicators in the other domains, and in all domains except Friends and School, boys were significantly more likely to have at least one vulnerability. Girls were significantly more likely to report not having many friends (16.7%, 95% CI: 15.9% to 17.6% vs 12.5%, 95% CI: 11.8% to 13.2%), being bullied some or all of the time (55.8%, 95% CI: 54.7% to 56.9% vs 49.7%, 95% CI: 48.6% to 50.8%) and feeling left out all the time (12.1%, 95% CI: 11.4% to 12.8%) versus (10.3%, 95% CI: 9.7% to 11.0%). Variations in vulnerabilities by ethnicity were complex, with children in black, Asian and minority ethnic groups sometimes reporting more vulnerabilities and sometimes fewer than white British children. For example, compared with children of Pakistani heritage, white British children were more likely to say that their family never gets along well (6.3%, 95% CI: 5.6% to 7.1% vs 4.1%, 95% CI: 3.6% to 4.6%) and to have no access to the internet at home (22.3%, 95% CI: 21% to 23.6% vs 18%, 95% CI: 17% to 18.9%). Children with Pakistani heritage were more likely than white British children to say they had no park near their home where they can play with friends (32.7%, 95% CI: 31.6% to 33.9% vs 29.9%, 95% CI: 28.6% to 31.3%), to report not having three meals a day (17.9%, 95% CI: 16.9% to 18.8% vs 11.9%, 95% CI: 10.9% to 12.9%) and to worry all the time about how much money their families have (29.3%, 95% CI: 28.2% to 30.3%) vs (21.6%, 95% CI: 20.4% to 22.9%). Gypsy/Irish Traveller children were less likely than white British children to say they were bullied some or all of the time (42.2%, 95% CI: 35.4% to 49.4% vs 53.8%, 95% CI: 52.3% to 55.3%), but more likely to say they were mean to others all the time (9.9%, 95% CI: 6.3% to 15.2% vs 4%, 95% CI: 3.5% to 4.7%) and can never work out what to do when things are hard (15.2%, 95% CI: 10.6% to 21.2% vs 9%, 95% CI: 8.2% to 9.9%). We considered six vulnerabilities to be of particular concern during the COVID-19 pandemic and associated national and local lockdowns: family never gets along well together; no garden where child can play; no nearby park where they can play; not having three meals a day; no internet at home; worried about money all the time. Pre-pandemic, 37.4% (95% CI: 36.6% to 38.3%) of Bradford children had one of these vulnerabilities and a further 29.6% (95% CI: 28.9% to 30.4%) had more than one. CONCLUSIONS Although most primary school children aged 7-10 in our study had good levels of well-being on most indicators across multiple domains, fewer than 10% had no vulnerabilities at all, a worrying 10% had at least one vulnerability in all the four domains we studied and two-thirds had vulnerabilities of particular concern during the COVID-19 lockdowns.
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Affiliation(s)
| | | | - Bo Hou
- Bradford Institute for Health Research, Bradford, UK
| | - Brian Kelly
- Bradford Institute for Health Research, Bradford, UK
| | | | | | - Katy Shire
- Bradford Institute for Health Research, Bradford, UK
| | - Claire McIvor
- Bradford Institute for Health Research, Bradford, UK
| | | | - Neil Small
- Health Studies, University of Bradford, Bradford, UK
| | | | - John Wright
- Bradford Institute for Health Research, Bradford, UK
| | - Deborah Lawlor
- Bristol Medical School, University of Bristol, Bristol, UK
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13
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Guerlich K, Cadman T, Charles MA, Fernandez-Barres S, Guxens M, Heude B, Inskip H, Julvez J, Lawlor D, Salika T, Koletzko B, Grote V, Plancoulaine S. 0490 Longitudinal associations between sleep and behavior and cognition in preschoolers from five European birth-cohorts. Sleep 2022. [DOI: 10.1093/sleep/zsac079.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
There has been little focus on sleep and its relation to behavior and cognition in preschool-aged children. We aimed to investigate the association between sleep duration in early preschoolers (» 3.5 years of age) and later behavioral and cognitive outcomes (» 5 years of age) in European children.
Methods
We used harmonized data from five cohorts from the EU Child Cohort Network, established by the LifeCycle Project (n=16.444 children): ALSPAC and SWS from UK, EDEN and ELFE from France and INMA from Spain. Within all cohorts, total sleep duration per day and behavioral and cognitive information were reported by parents. Internalizing and externalizing behaviors were measured with the Strengths and Difficulties Questionnaire and treated as percentile scores. Verbal and non-verbal intelligence were assessed by the Wechsler Preschool and Primary Scale of Intelligence or with the McCarthy Scales of Children’s Abilities depending on the cohort and treated as standardized scores. All scores were cohort specific. Associations between sleep duration during early preschool age and later behavior and/or cognition were estimated using linear regression and pooled with two-stage individual participant data meta-analysis adjusted for child, maternal and household information. Analyses were done in DataSHIELD.
Results
Global mean sleep duration was 11h54 ± 1h00 per day at mean age 3.5 years but differed by country, with children from France showing longer sleep duration than children from the UK or Spain. In multivariate meta-analysis, 1 hour of additional sleep duration per day at mean age 3.5 years was associated with reduced internalizing and externalizing behavior percentile scores at mean age 5.1 years (internalizing behavior: badjusted= -1.05, 95%-CI [-1.93, -0.18], I2: 30.3%; externalizing behavior: badjusted= -2.12, 95%-CI [-2.78, -1.47], I2: 0.0%). No association was observed between sleep duration and subsequent verbal or non-verbal intelligence
Conclusion
Longer sleep duration in early preschool age (» 3.5 years of age) was associated with subsequent lower internalizing and externalizing behavior scores (» 5 years of age), but not with verbal or non-verbal intelligence. Adequate sleep duration at an early age is important for children’s later mental health.
Support (If Any)
KG was granted a LifeCycle fellowship.
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Affiliation(s)
- Kathrin Guerlich
- LMU University Hospital Munich, Division of Metabolic and Nutritional Medicine, Department of Pediatrics, Dr. von Hauner Children’s Hospital
| | - Tim Cadman
- University of Copenhagen, Department of Public Health, Faculty of Health and Medical Sciences
| | | | | | | | | | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton
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14
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Ronkainen J, Heiskala A, Vehmeijer FO, Lowry E, Caramaschi D, Estrada Gutierrez G, Heiss JA, Hummel N, Keikkala E, Kvist T, Kupsco A, Melton PE, Pesce G, Soomro MH, Vives-Usano M, Baiz N, Binder E, Czamara D, Guxens M, Mustaniemi S, London SJ, Rauschert S, Vääräsmäki M, Vrijheid M, Ziegler AG, Annesi-Maesano I, Bustamante M, Huang RC, Hummel S, Just AC, Kajantie E, Lahti J, Lawlor D, Räikkönen K, Järvelin MR, Felix JF, Sebert S. Maternal haemoglobin levels in pregnancy and child DNA methylation: a study in the pregnancy and childhood epigenetics consortium. Epigenetics 2022; 17:19-31. [PMID: 33331245 PMCID: PMC8813068 DOI: 10.1080/15592294.2020.1864171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/26/2020] [Accepted: 12/08/2020] [Indexed: 01/05/2023] Open
Abstract
Altered maternal haemoglobin levels during pregnancy are associated with pre-clinical and clinical conditions affecting the fetus. Evidence from animal models suggests that these associations may be partially explained by differential DNA methylation in the newborn with possible long-term consequences. To test this in humans, we meta-analyzed the epigenome-wide associations of maternal haemoglobin levels during pregnancy with offspring DNA methylation in 3,967 newborn cord blood and 1,534 children and 1,962 adolescent whole-blood samples derived from 10 cohorts. DNA methylation was measured using Illumina Infinium Methylation 450K or MethylationEPIC arrays covering 450,000 and 850,000 methylation sites, respectively. There was no statistical support for the association of maternal haemoglobin levels with offspring DNA methylation either at individual methylation sites or clustered in regions. For most participants, maternal haemoglobin levels were within the normal range in the current study, whereas adverse perinatal outcomes often arise at the extremes. Thus, this study does not rule out the possibility that associations with offspring DNA methylation might be seen in studies with more extreme maternal haemoglobin levels.
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Affiliation(s)
- Justiina Ronkainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Anni Heiskala
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Florianne O.L. Vehmeijer
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Estelle Lowry
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- School of Natural and Built Environment, Queen’s University Belfast, Belfast, Northern Ireland
| | - Doretta Caramaschi
- Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, Population Health Science, University of Bristol, Bristol, UK
| | | | - Jonathan A. Heiss
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nadine Hummel
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Elina Keikkala
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Tuomas Kvist
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA
| | - Allison Kupsco
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Phillip E. Melton
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Bentley, Australia
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Australia
| | - Giancarlo Pesce
- Sorbonne Université, Institut Pierre Louis D’épidémiologie Et De Santé Publique (IPLESP), Paris, France
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Institut National De La Santé Et De La Recherche Médicale (INSERM) UMR-S 1136, Institut Pierre Louis D’épidémiologie Et De Santé Publique (IPLESP), Team EPAR, Paris, France
| | - Munawar H. Soomro
- Sorbonne Université, Institut Pierre Louis D’épidémiologie Et De Santé Publique (IPLESP), Paris, France
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Institut National De La Santé Et De La Recherche Médicale (INSERM) UMR-S 1136, Institut Pierre Louis D’épidémiologie Et De Santé Publique (IPLESP), Team EPAR, Paris, France
| | - Marta Vives-Usano
- Centre for Genomic Regulation (CRG), the Barcelona Institute of Science and Technology, Barcelona, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Nour Baiz
- Sorbonne Université, Institut Pierre Louis D’épidémiologie Et De Santé Publique (IPLESP), Paris, France
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Institut National De La Santé Et De La Recherche Médicale (INSERM) UMR-S 1136, Institut Pierre Louis D’épidémiologie Et De Santé Publique (IPLESP), Team EPAR, Paris, France
| | - Elisabeth Binder
- Department of Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Mònica Guxens
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Sanna Mustaniemi
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Stephanie J. London
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, WashingtonDC, USA
| | | | - Marja Vääräsmäki
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
| | - Martine Vrijheid
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Anette-G. Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
- Forschergruppe Diabetes, Technical University Munich, Klinikum Rechts Der Isar, Munich-Neuherberg, Germany
- Forschergruppe Diabetes e.V., Helmholtz Zentrum München, Munich-Neuherberg, Germany
| | - Isabella Annesi-Maesano
- Sorbonne Université, Institut Pierre Louis D’épidémiologie Et De Santé Publique (IPLESP), Paris, France
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Institut National De La Santé Et De La Recherche Médicale (INSERM) UMR-S 1136, Institut Pierre Louis D’épidémiologie Et De Santé Publique (IPLESP), Team EPAR, Paris, France
| | - Mariona Bustamante
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Rae-Chi Huang
- Telethon Kids Institute, University of Western Australia, Australia
| | - Sandra Hummel
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
- Forschergruppe Diabetes, Technical University Munich, Klinikum Rechts Der Isar, Munich-Neuherberg, Germany
- Forschergruppe Diabetes e.V., Helmholtz Zentrum München, Munich-Neuherberg, Germany
| | - Allan C. Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eero Kajantie
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- Turku Institute for Advanced Studies, University of Turku, Turku, Finland
| | - Deborah Lawlor
- Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, Population Health Science, University of Bristol, Bristol, UK
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Janine F. Felix
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Department for Genomics of Common Diseases, School of Medicine, Imperial College London, LondonUK
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15
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Fernández-Sanlés A, Carter A, Millard L, Smith D, Griffith G, Clayton G, Hughes R, Morris T, Lawlor D, Tilling K, Borges MC. 1484Selection bias in COVID-19 research: Prospective analyses of two UK cohort studies. Int J Epidemiol 2021. [PMCID: PMC8499831 DOI: 10.1093/ije/dyab168.442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Non-random sampling could bias estimates of association in observational studies but the extent to which this occurs in studies of SARS-CoV-2 infection/COVID-19 severity is not well established. Methods Using ALSPAC and UK Biobank we investigated pre-pandemic predictors of selection (i.e. having data on SARS-CoV-2 infection and COVID-19 severity from self-report and/or health record linkage). We conducted empirical analyses and simulations to explore the potential presence, direction and magnitude of bias due to selection when estimating the association of BMI with SARS-CoV-2 infection and COVID-19 severity. Results A broad range of characteristics related to selection in both cohorts, sometimes in opposite directions. We found bias in all simulated scenarios, mostly of small magnitude. Both the direction and magnitude of bias was influenced by the presence of an effect of BMI on SARS-CoV-2 infection and COVID-19 severity and the control group definition used (e.g. assuming no effect of BMI on SARS-CoV-2 infection our main simulation showed bias equivalent to an estimated odds ratio of 0.99 when using non-infected controls but 1.16 when using controls combining non-infected and non-assessed). Conclusions Despite small amounts of bias in most scenarios, a control group definition including those non-assessed (e.g. non-tested) can induce more bias. In large samples such as UK Biobank the statistical power means incorrect conclusions could be made. Key messages Observational studies estimating associations of factors with SARS-CoV-2 or COVID-19 may be biased due to non-random selection into the analytic sample.
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Affiliation(s)
- Alba Fernández-Sanlés
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- These authors contributed equally
| | - Alice Carter
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- These authors contributed equally
| | - Louise Millard
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- These authors contributed equally
| | - Dan Smith
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Gareth Griffith
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Gemma Clayton
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rachel Hughes
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tim Morris
- MRC Clinical Trials Unit at UCL, London, United Kingdom
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kate Tilling
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Maria Carolina Borges
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Zhao J, Freathy R, Evans D, Warrington N, Langenberg C, Stewart I, Lotta L, Pietzner M, Borges MC, Lawlor D. 586Effects of maternal circulating amino acids on offspring birthweight: a Mendelian randomisation analysis. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
It is suggested amino acids are critical for fetal growth, but analyses assessing causality are lacking. Mendelian randomisation (MR) can be used to examine causal effects under instrumental variable (IV) assumptions.
Methods
We conducted a two-sample MR study utilizing summary data from genome-wide association studies (GWAS) of amino acids (sample 1, n = 86,507) and of offspring birthweight (sample 2, combined UK Biobank and Early Growth Genetics Consortium, n = 406,063). Seventy-five independent single nucleotide polymorphisms (SNPs) robustly associated with 18 amino acids (p < 4.9 × 10-10) were used as genetic instruments. Wald ratio and inverse variance weighted methods were used in MR main analysis. Sensitivity analyses were performed to explore IV assumption violations. To explore whether there was consistency between SNP-amino acid associations in pregnancy and in the GWAS, the latter were compared to associations in the Born in Bradford cohort.
Results
There was evidence of positive causal effects of maternal alanine (51.9 g birthweight increase per SD increase in amino acid level, 95% CI: 24.2, 79.5), glutamine (51.3 g, 95% CI: 33.5, 69.0), glycine (10.4 g, 95% CI: 1.3, 19.6) and serine (27.1 g, 95% CI: 11.2, 43.0) on birthweight and inverse causal effects of maternal isoleucine (-109.7 g, 95% CI: -194.6, -24.9) and histidine (-41.1 g, 95% CI: -78.5, -3.7) on birthweight. Sensitivity analyses to explore reverse causality and bias due to horizontal pleiotropy supported our findings.
Conclusions
Some maternal circulating amino acids have causal effects on birthweight.
Key messages
MR can be extended to probe effects of maternal nutrition on offspring development.
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Affiliation(s)
- Jian Zhao
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - Rachel Freathy
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - David Evans
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Nicole Warrington
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom
| | - Isobel Stewart
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Luca Lotta
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Maik Pietzner
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Maria Carolina Borges
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
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17
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Millard L, Tilling K, Gaunt T, Carslake D, Lawlor D. 221Association of physical activity bout length and changing intensity with mortality in UK Biobank. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Spending more time active (and less time sedentary) is associated with many health benefits but it is unclear whether these associations differ depending on whether time spent sedentary or in moderate-vigorous physical activity (MVPA) is accumulated in long or short bouts. We used a novel analytical approach to examine whether length of sedentary and MVPA bouts associates with all-cause mortality.
Methods
We used data on 79,507 participants from UK Biobank. We derived the total time participants spent in activity categories (sleep, sedentary, light activity and MVPA) and in sedentary and MVPA bouts of short (1-15 minutes), medium (16-40 minutes) and long (41+ minutes) duration, on average per day. We used Cox proportion hazards regression to estimate the association of spending 10 minutes more average daily time in one activity or bout length category, coupled with spending 10 minutes less time in another, with all-cause mortality.
Results
Those spending more time in MVPA had lower mortality risk, irrespective of whether this replaced time spent sleeping, sedentary or in light activity. We found little evidence to suggest that mortality risk differed depending on the length of sedentary or MVPA bouts.
Conclusions
We uniquely show that higher total MVPA improves health irrespective of whether it is obtained from several short bouts or fewer longer bouts, supporting recent policy changes in some countries.
Key messages
Our results suggest that time spent in MVPA associates with lower mortality risk irrespective of whether it is obtained from several short bouts or fewer longer bouts.
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Affiliation(s)
- Louise Millard
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kate Tilling
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tom Gaunt
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - David Carslake
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- Population health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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18
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Goulding N, Bos M, Heemst DV, Noordam R, Lawlor D. 454Relationships between sleep traits and metabolic profiles: evidence from multivariable regression and Mendelian randomization analyses. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sleep traits are associated with cardiometabolic disease. The aim of this study was to explore the causal effect of sleep traits (duration and insomnia) on multiple metabolic traits.
Methods
We used age, sex and BMI adjusted multivariable regression (N = 17,370) and two-sample summary statistic Mendelian randomization (MR) to examine effects of sleep duration and insomnia symptoms on ∼150 NMR metabolites. Multivariable analyses were conducted on data from nine European cohorts and meta-analysed. MR analyses utilised summary statistics from published genome-wide association studies (GWAS) of self-reported sleep traits (sample 1; N = 446,118 to 1,331,010) and from GWAS on NMR serum metabolites (sample 2; N = 38,618). We used inverse-variance weighted (IVW) for the main MR analyses and weighed median (WM) and MR-Egger to explore bias due to pleiotropy.
Results
MR IVW and multivariable analyses both suggest a positive effect of insomnia symptoms on glycoprotein acetyls (MR: 0.06 s.d. increase in mean concentration comparing any symptoms to none; p = 5.9e-4) and between total sleep duration and creatinine (MR: 0.16 s.d. increase per additional hour; p = 0.03). WM and MR-Egger analyses show consistent results. There was evidence for thirteen and eight effects of insomnia and duration in multivariable only and three and one, respectively, in MR only.
Conclusions
Insomnia symptoms lead to higher levels of an inflammatory marker (glycoprotein acetyls) and longer sleep duration leads to higher creatinine levels.
Key messages
We found no evidence of widespread metabolic disruption by sleep traits.
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Affiliation(s)
- Neil Goulding
- MRC Integrative Epidemiological Unit, University Of Bristol, United Kingdom
- Population Health Sciences, University of Bristol, United Kingdom
| | - Maxime Bos
- Department of Internal Medicine, Leiden University Medical Center, The Netherlands
- Department of Epidemiology, Erasmus MC – University Hospital Rotterdam, The Netherlands
| | - Diana van Heemst
- Department of Internal Medicine, Leiden University Medical Center, The Netherlands
| | - Raymond Noordam
- Department of Internal Medicine, Leiden University Medical Center, The Netherlands
| | - Deborah Lawlor
- MRC Integrative Epidemiological Unit, University Of Bristol, United Kingdom
- Population Health Sciences, University of Bristol, United Kingdom
- Bristol NIHR Biomedical Research Centre, United Kingdom
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19
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Clayton G, Howe L, O’Keeffe L, Lewandowski A, Lawlor D, Fraser A. 1518Preterm birth and trajectories of cardiometabolic health measures from birth to adulthood. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Preterm birth is associated with increased cardiovascular disease risk, but it is unclear when this risk emerges. We compared life course trajectories from birth to adulthood of multiple cardiometabolic health measures in adults born preterm compared with term.
Methods
Multilevel models were used to compare trajectories from birth to age 25 years of BMI, fat mass, lean mass, systolic and diastolic blood pressure (BP), lipids, glucose and insulin, between participants born preterm (N = 311-560) and term (N = 5365-9262) in a contemporary UK birth cohort study. We also investigated gestational age as a continuum.
Results
Systolic and diastolic BP were higher at age 7 (mean predicted differences 0.8mmHg; 95%CI -0.1, 1.7 and 0.7mmHg; 95%CI 0.03, 1.3, respectively). The difference in SBP persisted and in DBP disappeared by 25 years. Preterm participants had lower BMI between 7 and 18 years, but by age 25, there was no difference. Lean mass and fat mass (measured from age 9 only) trajectories were consistent with BMI. HDL-c was higher, and triglycerides lower at birth in those born preterm, but this difference disappeared by 25 years. No other differences were found.
Conclusions
There were few, modest differences in cardiometabolic health measures during early life in those born preterm versus term. All disappeared by age 25, except SBP. Longer follow-up is needed to establish if and when trajectories diverge.
Key messages
By age 25, there were no differences in measures of cardiometabolic health between people born preterm and term except for a higher SBP in those born preterm.
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Affiliation(s)
- Gemma Clayton
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - Laura Howe
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - Linda O’Keeffe
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Public Health, University College Cork, Cork, Ireland
| | - Adam Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Deborah Lawlor
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - Abigail Fraser
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
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20
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Purkayastha M, Roberts SA, Gardiner J, Brison DR, Nelson SM, Lawlor D, Luke B, Sutcliffe A. Cohort profile: a national, population-based cohort of children born after assisted conception in the UK (1992-2009): methodology and birthweight analysis. BMJ Open 2021; 11:e050931. [PMID: 34281932 PMCID: PMC8291329 DOI: 10.1136/bmjopen-2021-050931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To generate a large cohort of children born after assisted reproductive technology (ART) in the UK between 1992 and 2009, their naturally conceived siblings (NCS) and matched naturally conceived population (NCP) controls and linking this with health outcome data to allow exploration of the effects of ART. The effects of fresh and frozen embryo transfer on birth weight (BW) were analysed to test the validity of the cohort. PARTICIPANTS Children recorded on the Human Fertilisation and Embryology Authority (HFEA) register as being born after ART between 1992 and 2009, their NCS and matched NCP controls linked to Office for National Statistics birth registration dataset (HFEA-ONS cohort). This cohort was further linked to the UK Hospital Episode Statistics database to allow monitoring of the child's post-natal health outcomes up to 2015 (HFEA-ONS-HES subcohort). FINDINGS TO DATE The HFEA-ONS cohort consisted of 75 348 children born after non-donor ART carried out in the UK between 1 April 1992 and 31 July 2009 and successfully linked to birth registration records, 14 763 NCS and 164 823 matched NCP controls. The HFEA-ONS-HES subcohort included 63 877 ART, 11 343 NCS and 127 544 matched NCP controls further linked to health outcome data. The exemplar analysis showed that children born after fresh embryo transfers were lighter (BW difference: -131 g, 95% CI: -140 to -123) and those born after frozen embryo transfers were heavier (BW difference: 35 g, 95% CI: 19 to 52) than the NCP controls. The within-sibling analyses were directionally consistent with the population control analyses, but attenuated markedly for the fresh versus natural conception (BW difference: -54 g; 95% CI: -72 to -36) and increased markedly for the frozen versus natural conception (BW difference: 152 g; 95% CI: 113 to 190) analyses. FUTURE PLANS To use this cohort to explore the relationship between ART conception and short-term and long-term health outcomes in offspring.
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Affiliation(s)
- Mitana Purkayastha
- Population, Policy & Practice Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
| | - Stephen A Roberts
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Julian Gardiner
- Population, Policy & Practice Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
- Department of Education, University of Oxford, Oxford, UK
| | - Daniel R Brison
- Department of Reproductive Medicine, St Mary's Hospital, Manchester, UK
| | - Scott M Nelson
- Department of Obstetrics & Gynaecology, School of Medicine, Dentistry & Nursing, Reproductive & Maternal Medicine, University of Glasgow, Glasgow, UK
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol Bristol Population Health Science Institute, Bristol, UK
| | - Barbara Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Alastair Sutcliffe
- Population, Policy & Practice Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
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21
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Birmingham K, Gregory S, Iles-Caven Y, Fraser A, Lawlor D, Boyd A, Northstone K, Golding J. The mother during pregnancy and the puerperium: Detailed data abstracted from the clinical obstetric records of ALSPAC pregnancies. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16603.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: When the Avon Longitudinal Study of Parents and Children (ALSPAC) was planned, it was assumed that the clinical obstetric data would be easily accessible from the newly developed National Health Service computerised ‘STORK’ system. Pilot studies, however, showed that, although fairly accurate in regard to aspects of labour and delivery, it was, at the time (1990-2), inadequate for identifying the full antenatal and postnatal details of clinical complications and treatments of the women in the Study. Methods: A scheme was therefore developed to train research staff to find and abstract relevant details from clinical records onto proformas designed for the purpose. Extracting such data proved very time consuming (up to six hours for complicated pregnancies) and consequently expensive. Funding for the enterprise was obtained piecemeal using specific focussed grants to extract data for subsamples of the Study, including a random sample to serve as controls. Results: To date, detailed records have been completed for 8369 pregnancies, and a further 5336 (13,705 in total) have complete details on specific prenatal areas, including serial measures of maternal blood pressure, proteinuria and weight. In this Data Note we describe the information abstracted from the obstetric medical records concerning the mother during pregnancy, labour, delivery and the first two weeks of the puerperium. Information abstracted relating to the fetus (including fetal monitoring, presentation, method of delivery) and neonate (signs of asphyxia, resuscitation, treatment and well-being) will be described in a further Data Note. Conclusions: These data add depth to ALSPAC concerning ways in which the signs and symptoms, procedures and treatments of the mother prenatally, intrapartum and postnatally, may impact on the long-term health and development of both mother and child. They augment the data collected from the mothers’ questionnaires and the ‘STORK’ digital hospital data.
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Affiliation(s)
- Tony Blakely
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia.
| | - Neil Pearce
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - John Lynch
- School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Shyamali Dharmage
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Melissa Russell
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Deborah Lawlor
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Rebecca Bentley
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
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23
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Joshi R, Hingorani A, Engmann J, Dale C, Gaunt T, Jefferis B, Lawlor D, Price J, Papacosta O, Shah T, Tillin T, Chaturvedi N, Kivimaki M, Kuh D, Kumari M, Hughes A, Whincup P, Casas J, Humphries S, Schmidt A, Wannamethee S. Establishing reference intervals for triglyceride containing lipoprotein sub-fraction metabolites measured using nuclear magnetic resonance spectroscopy in a UK population. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
OBJECTIVE Independent temporal external validation of the improving partial risk adjustment in surgery model (PRAIS-2) to predict 30-day mortality in patients undergoing paediatric cardiac surgery. DESIGN Retrospective analysis of prospectively collected data. SETTING Paediatric cardiac surgery. INTERVENTION PRAIS-2 validation was carried out using a two temporally different single centre (Bristol, UK) cohorts: Cohort 1 surgery undertaken from April 2004 to March 2009 and Cohort 2 from April 2015 to July 2019. For each subject PRAIS-2 score was calculated according to the original formula. PARTICIPANTS A total of 1352 (2004-2009) and 1197 (2015-2019) paediatric cardiac surgical procedures were included in the Cohort 1 and Cohort 2, respectively (median age at the procedure 6.3 and 7.1 months). PRIMARY AND SECONDARY OUTCOME MEASURES PRAIS-2 performance was assessed in terms of discrimination by means of ROC (receiver operating characteristic) curve analysis and calibration by using the calibration belt method. RESULTS PRAIS-2 score showed excellent discrimination for both cohorts (AUC 0.72 (95%CI: 0.65 to 0.80) and 0.88 (95%CI: 0.82 to 0.93), respectively). While PRAIS-2 was only marginally calibrated in Cohort 1, with a tendency to underestimate risk in lowrisk and overestimate risk in high risk procedures (P-value = 0.033), validation in Cohort 2 showed good calibration with the 95% confidence belt containing the bisector for predicted mortality (P-value = 0.143). We also observed good prediction accuracy in the non-elective procedures (N = 483;AUC 0.78 (95%CI 0.68 to 0.87); Calibration belt containing the bisector (P-value=0.589). CONCLUSIONS In a single centre UK-based cohort, PRAIS-2 showed excellent discrimination and calibration in predicting 30-day mortality in paediatric cardiac surgery including in those undergoing non-elective procedures. Our results support a wider adoption of PRAIS-2 score in the clinical practice.
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Affiliation(s)
- Lucia Cocomello
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Massimo Caputo
- Bristol Heart Institute, University of Bristol, Bristol, UK
| | - Rosie Cornish
- Population Health Science, Bristol Medical School University of Bristol, Bristol, United Kingdom
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit, Department of Social Medicine, University of Bristol, Bristol, UK
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25
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Frysz M, Tobias J, Lawlor D, Aspden R, Gregory J, Ireland A. Associations between prenatal indicators of mechanical loading and proximal femur shape: Findings from the UK Avon Longitudinal Study of Parents and Children (ALSPAC). Bone Rep 2020. [DOI: 10.1016/j.bonr.2020.100676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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26
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Sharp G, Schellhas L, Richardson S, Lawlor D. Time to cut the cord: recognizing and addressing the imbalance of DOHaD research towards the study of maternal pregnancy exposures - CORRIGENDUM. J Dev Orig Health Dis 2020; 11:96. [PMID: 31630697 DOI: 10.1017/s2040174419000655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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27
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Wang H, Lane J, Jones S, Dashti H, Ollila H, Wood A, van Hees V, Brumpton B, Winsvold B, Kantojärvi K, Palviainen T, Cade B, Sofer T, Song Y, Patel K, Anderson S, Bechtold D, Bowden J, Emsley R, Kyle S, Little M, Loudon A, Scheer F, Purcell S, Richmond R, Spiegelhalder K, Tyrrell J, Zhu X, Hublin C, Kaprio J, Kristiansson K, Sulkava S, Paunio T, Hveem K, Nielsen J, Willer C, Zwart JA, Strand L, Frayling T, Ray D, Lawlor D, Rutter M, Weedon M, Redline S, Saxena R. Genome-wide association analysis of self-reported daytime sleepiness identifies 42 loci that suggest biological subtypes. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Charakida M, Georgiopoulos G, Dangardt F, Chiesa ST, Hughes AD, Rapala A, Davey Smith G, Lawlor D, Finer N, Deanfield JE. Response to ‘Does smoking or alcohol cause early vascular damage in teenage years?’. Eur Heart J 2019; 40:3497. [DOI: 10.1093/eurheartj/ehz608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Marietta Charakida
- Institute of Cardiovascular Science, University College London, UK
- Division of Imaging Sciences & Biomedical Engineering, King's College London, Lambeth Wing, St Thomas' Hospital, UK
| | - Georgios Georgiopoulos
- Division of Imaging Sciences & Biomedical Engineering, King's College London, Lambeth Wing, St Thomas' Hospital, UK
| | - Frida Dangardt
- Institute of Cardiovascular Science, University College London, UK
- Department of Paediatric Clinical Physiology, The Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Scott T Chiesa
- Institute of Cardiovascular Science, University College London, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, UK
| | - Alicia Rapala
- Institute of Cardiovascular Science, University College London, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicholas Finer
- Institute of Cardiovascular Science, University College London, UK
| | - John E Deanfield
- Institute of Cardiovascular Science, University College London, UK
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29
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Richmond R, Anderson E, Jones S, Munafo M, Frayling T, Weedon M, Lawlor D, Smith GD. 0824 Using Mendelian Randomization To Understand How Chronotype Influences Breast Cancer Risk. Sleep 2019. [DOI: 10.1093/sleep/zsz067.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rebecca Richmond
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
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30
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Kooblall M, Lawlor D. Pulmonary Rehabilitation: Getting back the “joie de vivre”. Ir Med J 2018; 111:846. [PMID: 30560641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- M Kooblall
- Respiratory Department, St Michaels Hospital, Dun Laoghaire, Co. Dublin
| | - D Lawlor
- Respiratory Department, St Michaels Hospital, Dun Laoghaire, Co. Dublin
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31
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Goncalves Soares A, Lawlor D, Crampin A. Sex and area differences in the association between adiposity and lipid profile in Sub-Saharan Africa: A comparison with a European population. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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32
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Taylor M, Borges M, Richmond R, Tyrrell J, Briggs C, Lawlor D. Assessing causality in associations between maternal adiposity and obstetric and perinatal outcomes: A Mendelian randomization study. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Cezard G, Smith L, Petherick E, Cameron N, West J, Lawlor D, Bhopal R. 1.11-P19Ethnic differences in early life adiposity trajectories between White British and Pakistani children: results from the Born in Bradford cohort study in the UK. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- G Cezard
- University of St Andrews, Scotland
| | - L Smith
- University of Leeds, United Kingdom
| | | | - N Cameron
- Loughborough University, United Kingdom
| | - J West
- Bradford Institute for Health Research, United Kingdom
| | - D Lawlor
- University of Bristol, United Kingdom
| | - R Bhopal
- University of Edinburgh, United Kingdom
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Huang Z, Fonseca R, Sharman J, Chaturvedi N, Smith G, Lawlor D, Howe L, Park C, Hughes A, Schultz M, Schultz M. 2.7 FITNESS MODIFIES THE ASSOCIATION BETWEEN EXERCISE BLOOD PRESSURE AND LEFT-VENTRICULAR MASS IN ADOLESCENCE. Artery Res 2018. [DOI: 10.1016/j.artres.2018.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Lawlor D, Richmond R, Warrington N, McMahon G, Davey Smith G, Bowden J, Evans DM. Using Mendelian randomization to determine causal effects of maternal pregnancy (intrauterine) exposures on offspring outcomes: Sources of bias and methods for assessing them. Wellcome Open Res 2017; 2:11. [PMID: 28405635 PMCID: PMC5386135 DOI: 10.12688/wellcomeopenres.10567.1] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2017] [Indexed: 01/10/2023] Open
Abstract
Mendelian randomization (MR), the use of genetic variants as instrumental variables (IVs) to test causal effects, is increasingly used in aetiological epidemiology. Few of the methodological developments in MR have considered the specific situation of using genetic IVs to test the causal effect of exposures in pregnant women on postnatal offspring outcomes. In this paper, we describe specific ways in which the IV assumptions might be violated when MR is used to test such intrauterine effects. We highlight the importance of considering the extent to which there is overlap between genetic variants in offspring that influence their outcome with genetic variants used as IVs in their mothers. Where there is overlap, and particularly if it generates a strong association of maternal genetic IVs with offspring outcome via the offspring genotype, the exclusion restriction assumption of IV analyses will be violated. We recommend a set of analyses that ought to be considered when MR is used to address research questions concerned with intrauterine effects on post-natal offspring outcomes, and provide details of how these can be undertaken and interpreted. These additional analyses include the use of genetic data from offspring and fathers, examining associations using maternal non-transmitted alleles, and using simulated data in sensitivity analyses (for which we provide code). We explore the extent to which new methods that have been developed for exploring violation of the exclusion restriction assumption in the two-sample setting (MR-Egger and median based methods) might be used when exploring intrauterine effects in one-sample MR. We provide a list of recommendations that researchers should use when applying MR to test the effects of intrauterine exposures on postnatal offspring outcomes and use an illustrative example with real data to demonstrate how our recommendations can be applied and subsequent results appropriately interpreted.
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Affiliation(s)
- Deborah Lawlor
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Rebecca Richmond
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Nicole Warrington
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
- School of Women’s and Infants’ Health, The University of Western Australia, Perth, Australia
| | - George McMahon
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jack Bowden
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - David M Evans
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
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Mitchell RJ, Beck S, Cadell J, Combe J, Dawson E, Lawlor D, Marshall K, MacPherson M, Rennick L, Robinson S. A place standard for Scotland. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku162.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sweeting H, Whitley E, Hunt K, Teyhan A, Lawlor D. Gender differences in parent-reported child health among a UK cohort born 1991-2. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku161.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yasmin Y, McEniery C, Cleary S, Lam B, Kuper H, Endo Y, Kinra S, Chen D, Chandak G, Cockcroft J, Deanfield J, Lawlor D, Wilkinson I, O'Shaughnessy K. Genome‐wide scan for arterial stiffness identifies loci associated with aortic pulse wave velocity (912.5). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.912.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Y Yasmin
- Cambridge UniversityCambridgeUnited Kingdom
| | - C McEniery
- Cambridge UniversityCambridgeUnited Kingdom
| | - S Cleary
- Cambridge UniversityCambridgeUnited Kingdom
| | - B Lam
- Cambridge UniversityCambridgeUnited Kingdom
| | | | - Y Endo
- Cambridge UniversityCambridgeUnited Kingdom
| | | | - D Chen
- Cambridge UniversityCambridgeUnited Kingdom
| | | | | | | | - D Lawlor
- Bristol UniversityBristolUnited Kingdom
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Dangardt F, Charakida M, Khan T, Rapala A, Davey-Smith G, Lawlor D, Deanfield J. HIGHER ADIPOSITY EXPOSURE SINCE CHILDHOOD IS ASSOCIATED WITH INCREASED ARTERIAL STIFFNESS IN YOUNG FEMALES: THE ALSPAC STUDY. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61293-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hyppönen E, Cavadino A, Williams D, Fraser A, Vereczkey A, Fraser WD, Bánhidy F, Lawlor D, Czeizel AE. Vitamin D and pre-eclampsia: original data, systematic review and meta-analysis. Ann Nutr Metab 2014; 63:331-40. [PMID: 24603503 DOI: 10.1159/000358338] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 12/21/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Vitamin D may protect from pre-eclampsia through influences on immune modulation and vascular function. To evaluate the role of vitamin D in the development of pre-eclampsia, we conducted a systematic review and meta-analysis including novel data from 2 large-scale epidemiological studies. METHODS PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for prospective observational studies of association between vitamin D supplementation or status (measured by maternal 25-hydroxyvitamin D, 25(OH)D) with a subsequent risk of pre-eclampsia, or randomised controlled trials using vitamin D supplementation to prevent pre-eclampsia. The Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA) and the Avon Longitudinal Study of Parents and Children (ALSPAC) were included in meta-analyses with published studies. RESULTS Mothers receiving vitamin D supplementation earlier in pregnancy had lower odds of pre-eclampsia [pooled odds ratios (OR) 0.81 and 95% confidence interval (CI) 0.75-0.87, p = 2.4 × 10(-8), 2 studies] in the meta-analysis of published studies with HCCSCA. The meta-analysis of published studies with ALSPAC suggested an association between higher serum 25(OH)D levels and a reduced risk of pre-eclampsia (pooled OR 0.52 and 95% CI 0.30-0.89, p = 0.02, 6 studies). Randomised trials of supplementation were suggestive of protective association (pooled OR 0.66 and 95% CI 0.52-0.83, p = 0.001, 4 studies). CONCLUSIONS This study suggests that low maternal serum 25(OH)D concentrations increase pre-eclampsia risk and that vitamin D supplementation lowers this risk. The quality of evidence is insufficient to determine a causal association, which highlights the need for adequately powered clinical trials.
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Affiliation(s)
- Elina Hyppönen
- School of Population Health and Sansom Institute, University of South Australia, Adelaide, S.A., Australia
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Cornell P, Trehane A, Thompson P, Rahmeh F, Greenwood M, Baqai TJ, Cambridge S, Shaikh M, Rooney M, Donnelly S, Tahir H, Ryan S, Kamath S, Hassell A, McCuish WJ, Bearne L, Mackenzie-Green B, Price E, Williamson L, Collins D, Tang E, Hayes J, McLoughlin YM, Chamberlain V, Campbell S, Shah P, McKenna F, Cornell P, Westlake S, Thompson P, Richards S, Homer D, Gould E, Empson B, Kemp P, Richards AG, Walker J, Taylor S, Bari SF, Alachkar M, Rajak R, Lawson T, O'Sullivan M, Samant S, Butt S, Gadsby K, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Edwards KR, Rowe I, Sanders T, Dunn K, Konstantinou K, Hay E, Jones LE, Adams J, White P, Donovan-Hall M, Hislop K, Barbosa Boucas S, Nichols VP, Williamson EM, Toye F, Lamb SE, Rodham K, Gavin J, Watts L, Coulson N, Diver C, Avis M, Gupta A, Ryan SJ, Stangroom S, Pearce JM, Byrne J, Manning VL, Hurley M, Scott DL, Choy E, Bearne L, Taylor J, Morris M, Dures E, Hewlett S, Wilson A, Adams J, Larkin L, Kennedy N, Gallagher S, Fraser AD, Shrestha P, Batley M, Koduri G, Scott DL, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, Gill P, Ferguson AM, Ibrahim F, Scott DL, Lempp H, Tierney M, Fraser A, Kennedy N, Barbosa Boucas S, Hislop K, Dziedzic K, Arden N, Burridge J, Hammond A, Stokes M, Lewis M, Gooberman-Hill R, Coales K, Adams J, Nutland H, Dean A, Laxminarayan R, Gates L, Bowen C, Arden N, Hermsen L, Terwee CB, Leone SS, vd Zwaard B, Smalbrugge M, Dekker J, vd Horst H, Wilkie R, Ferguson AM, Nicky Thomas V, Lempp H, Cope A, Scott DL, Simpson C, Weinman J, Agarwal S, Kirkham B, Patel A, Ibrahim F, Barn R, Brandon M, Rafferty D, Sturrock R, Turner D, Woodburn J, Rafferty D, Paul L, Marshall R, Gill J, McInnes I, Roderick Porter D, Woodburn J, Hennessy K, Woodburn J, Steultjens M, Siddle HJ, Hodgson RJ, Hensor EM, Grainger AJ, Redmond A, Wakefield RJ, Helliwell PS, Hammond A, Rayner J, Law RJ, Breslin A, Kraus A, Maddison P, Thom JM, Newcombe LW, Woodburn J, Porter D, Saunders S, McCarey D, Gupta M, Turner D, McGavin L, Freeburn R, Crilly A, Lockhart JC, Ferrell WR, Goodyear C, Ledingham J, Waterman T, Berkin L, Nicolaou M, Watson P, Lillicrap M, Birrell F, Mooney J, Merkel PA, Poland F, Spalding N, Grayson P, Leduc R, Shereff D, Richesson R, Watts RA, Roussou E, Thapper M, Bateman J, Allen M, Kidd J, Parsons N, Davies D, Watt KA, Scally MD, Bosworth A, Wilkinson K, Collins S, Jacklin CB, Ball SK, Grosart R, Marks J, Litwic AE, Sriranganathan MK, Mukherjee S, Khurshid MA, Matthews SM, Hall A, Sheeran T, Baskar S, Muether M, Mackenzie-Green B, Hetherington A, Wickrematilake G, Williamson L, Daniels LE, Gwynne CE, Khan A, Lawson T, Clunie G, Stephenson S, Gaffney K, Belsey J, Harvey NC, Clarke-Harris R, Murray R, Costello P, Garrett E, Holbrook J, Teh AL, Wong J, Dogra S, Barton S, Davies L, Inskip H, Hanson M, Gluckman P, Cooper C, Godfrey K, Lillycrop K, Anderton T, Clarke S, Rao Chaganti S, Viner N, Seymour R, Edwards MH, Parsons C, Ward K, Thompson J, Prentice A, Dennison E, Cooper C, Clark E, Cumming M, Morrison L, Gould VC, Tobias J, Holroyd CR, Winder N, Osmond C, Fall C, Barker D, Ring S, Lawlor D, Tobias J, Davey Smith G, Cooper C, Harvey NC, Toms TE, Afreedi S, Salt K, Roskell S, Passey K, Price T, Venkatachalam S, Sheeran T, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kingsbury D, Quartier P, Patel G, Arora V, Kupper H, Mozaffarian N, Kearsley-Fleet L, Baildam E, Beresford MW, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Saunders E, Baildam E, Chieng A, Davidson J, Foster H, Gardner-Medwin J, Wedderburn L, Thomson W, Hyrich K, McErlane F, Beresford M, Baildam E, Chieng SE, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Thomson W, Hyrich K, Rooney M, Finnegan S, Gibson DS, Borg FA, Bale PJ, Armon K, Cavelle A, Foster HE, McDonagh J, Bale PJ, Armon K, Wu Q, Pesenacker AM, Stansfield A, King D, Barge D, Abinun M, Foster HE, Wedderburn L, Stanley K, Morrissey D, Parsons S, Kuttikat A, Shenker N, Garrood T, Medley S, Ferguson AM, Keeling D, Duffort P, Irving K, Goulston L, Culliford D, Coakley P, Taylor P, Hart D, Spector T, Hakim A, Arden N, Mian A, Garrood T, Magan T, Chaudhary M, Lazic S, Sofat N, Thomas MJ, Moore A, Roddy E, Peat G, Rees F, Lanyon P, Jordan N, Chaib A, Sangle S, Tungekar F, Sabharwal T, Abbs I, Khamashta M, D'Cruz D, Dzifa Dey I, Isenberg DA, Chin CW, Cheung C, Ng M, Gao F, Qiong Huang F, Thao Le T, Yong Fong K, San Tan R, Yin Wong T, Julian T, Parker B, Al-Husain A, Yvonne Alexander M, Bruce I, Jordan N, Abbs I, D'cruz D, McDonald G, Miguel L, Hall C, Isenberg DA, Magee A, Butters T, Jury E, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Yee CS, Toescu V, Hickman R, Leung MH, Situnayake D, Bowman S, Gordon C, Lazarus MN, Isenberg DA, Ehrenstein M, Carter LM, Isenberg DA, Ehrenstein MR, Chanchlani N, Gayed M, Yee CS, Gordon C, Ball E, Rooney M, Bell A, Reynolds JA, Ray DW, O'Neill T, Alexander Y, Bruce I, Sutton EJ, Watson KD, Isenberg D, Rahman A, Gordon C, Yee CS, Lanyon P, Jayne D, Akil M, D'Cruz D, Khamashta M, Lutalo P, Erb N, Prabu A, Edwards CJ, Youssef H, McHugh N, Vital E, Amft N, Griffiths B, Teh LS, Zoma A, Bruce I, Durrani M, Jordan N, Sangle S, D'Cruz D, Pericleous C, Ruiz-Limon P, Romay-Penabad Z, Carrera-Marin A, Garza-Garcia A, Murfitt L, Driscoll PC, Giles IP, Ioannou Y, Rahman A, Pierangeli SS, Ripoll VM, Lambrianides A, Heywood WE, Ioannou J, Giles IP, Rahman A, Stevens C, Dures E, Morris M, Knowles S, Hewlett S, Marshall R, Reddy V, Croca S, Gerona D, De La Torre Ortega I, Isenberg DA, Leandro M, Cambridge G, Reddy V, Cambridge G, Isenberg DA, Glennie M, Cragg M, Leandro M, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Croca SC, Isenberg DA, Giles I, Ioannou Y, Rahman A, Artim Esen B, Pericleous C, MacKie I, Ioannou Y, Rahman A, Isenberg DA, Giles I, Skeoch S, Haque S, Pemberton P, Bruce I. BHPR: Audit and Clinical Evaluation * 103. Dental Health in Children and Young Adults with Inflammatory Arthritis: Access to Dental Care. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Carslake D, Tynelius P, May M, Fraser A, Sterne J, Smith GD, Lawlor D, Rasmussen F. Associations of mortality rates with height using son's height as an instrumental variable. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.143586.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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West J, Lawlor D, Fairley L, Wright J. Birth size differences between white British and Pakistani origin infants by generation: Results from the Born in Bradford cohort study. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.143586.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lawlor D. O2-2.3 Using genetic variants as instrumental variables in cohort studies. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976a.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hardy R, Matthews F, Kuh D, Lawlor D, Sayer AA, Benzeval M. O2-2.2 Measurement and modelling of functional trajectories across the life course. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976a.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Petherick E, Fairley L, Parslow R, Raynor P, Leon D, Lawlor D, Wright J. P1-286 Are differences in self-reported health behaviours in early pregnancy associated with ethnicity? Preliminary results from the born in Bradford birth cohort study. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976e.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chittleborough C, Lawlor D, Lynch J. P1-112 Antenatal prediction of poor maternal and child outcomes: implications for selection into intensive parenting support programs. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976d.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wiles N, Haase A, Lawlor D, Ness A, Riddoch C, Lewis G. P2-327 Physical activity and depression in adolescents: cross-sectional results from the ALSPAC cohort. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Williams D, Fraser A, Fraser W, Sattar N, Hingorani A, Deanfield J, Smith GD, Lawlor D. P2-330 Associations of 25-hydroxyvitamin D2 and D3 with cardiovascular risk factors in childhood: a cross-sectional analysis in the Avon Longitudinal Study of Parents and Children (ALSPAC). Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gage S, Lawlor D, Tilling K, Tolppanen AM, Fraser A. P1-427 Associations of maternal weight gain in pregnancy with offspring cognition throughout childhood and adolescence. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976g.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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