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ALSPAC Study Team

Publications and source records attributed to ALSPAC Study Team.

At least 19 recordsLinked to original sources

Prenatal mood disturbance predicts sleep problems in infancy and toddlerhood.

BACKGROUND: Experimental animal data link prenatal stress with sleep disturbance in offspring, but the link in humans is unclear. AIMS: To investigate the link between prenatal maternal anxiety and depression and infant sleep disturbance from 6 to 30 months of age. STUDY DESIGN: Longitudinal prospective study of a large birth cohort from pregnancy to 30 months. Questionnaire measures of anxiety and depression were completed by mothers at 18 and 32 weeks gestation and at 8 weeks and 8 months postpartum. SUBJECTS: The ALSPAC cohort, a prospective community study of women in the UK who have been followed since pregnancy. OUTCOME MEASURES: Measures of total sleep time, number of awakenings, and broadly defined sleep problems were available on children at ages 6, 18, and 30 months. RESULTS: Reliable measures of total sleep time, nighttime awakenings, and sleep problems were identified at 6, 18, and 30 months. Higher levels of prenatal maternal anxiety and depression predicted more sleep problems at 18 and 30 months, after controlling for postnatal mood and obstetric and psychosocial covariates; the association was not restricted to clinical extremes. No link with total sleep time was observed. CONCLUSIONS: Mood disturbance in pregnancy has persisting effects on sleep problems in the child, a finding that is consistent with experimental animal research. The findings add to a growing literature showing that maternal prenatal stress, anxiety, and depression may have lasting effects on child development.

Adult↗

Child maltreatment in the "children of the nineties": a cohort study of risk factors.

AIM: To analyze the multiple factors affecting the risk of maltreatment in young children within a comprehensive theoretical framework. METHODS: The research is based on a large UK cohort study, the Avon Longitudinal Study of Parents and Children. Out of 14,256 children participating in the study, 293 were investigated by social services for suspected maltreatment and 115 were placed on local child protection registers prior to their 6th birthday. Data on the children have been obtained from obstetric data and from a series of parental questionnaires administered during pregnancy and the first 3 years of life. Risk factors have been analyzed using an hierarchical approach to logistic regression analysis. RESULTS: In the stepwise hierarchical analysis, young parents, those with low educational achievement, and those with a past psychiatric history or a history of childhood abuse were all more likely to be investigated for maltreatment, or to have a child placed on the child protection register, with odds ratios between 1.86 and 4.96 for registration. Examining strength of effect, the highest risks were found with indicators of deprivation (3.24 for investigation and 11.02 for registration, after adjusting for parental background factors). Poor social networks increased the risk of both investigation (adjusted OR 1.93) and registration (adjusted OR 1.90). Maternal employment seemed to reduce the risk of both outcomes but adjusted odds ratios were no longer significant for registration. After adjusting for higher order confounders, single parents and reordered families were both at higher risk of registration. Reported domestic violence increased the risk of investigation and registration but this was no longer significant after adjusting for higher order variables. Low birthweight children were at higher risk of registration as were those whose parents reported few positive attributes of their babies. CONCLUSIONS: This study supports previous research in the field demonstrating that a wide range of factors in the parental background, socio-economic and family environments affect the risk of child maltreatment. By combining factors within a comprehensive ecological framework, we have demonstrated that the strongest risks are from socio-economic deprivation and from factors in the parents' own background and that parental background factors are largely, but not entirely, mediated through their impact on socio-economic factors.

Child↗

Council tax valuation band predicts breast feeding and socio-economic status in the ALSPAC study population.

BACKGROUND: Breast-feeding rates in the UK are known to vary by maternal socio-economic status but the latter function is imperfectly defined. We test if CTVB (Council Tax Valuation Band - a categorical assessment of UK property values and amenities governing local tax levies) of maternal address predicts, in a large UK regional sample of births, (a) breast-feeding (b) personal and socio-economic attributes of the mothers. METHODS: Retrospective study of a subset (n.1390 selected at random) of the ALSPAC sample (Avon Longitudinal Study of Parents and Children), a large, geographically defined cohort of mothers followed from early pregnancy to 8 weeks post-delivery. Outcome measures are attitudes to breast-feeding prior to delivery, breast-feeding intention and uptake, demographic and socio-economic attributes of the mothers, CTVB of maternal home address at the time of each birth. Logistic regression analysis, categorical tests. RESULTS STUDY SAMPLE: 1360 women divided across the CTVBs--at least 155 in any band or band aggregation. CTVB predicted only one belief or attitude--that bottle-feeding was more convenient for the mother. However only 31% of 'CTVB A infants' are fully breast fed at 4 weeks of life whereas for 'CTVB E+ infants' the rate is 57%. CTVB is also strongly associated with maternal social class, home conditions, parental educational attainment, family income and smoking habit. CONCLUSION: CTVB predicts breast-feeding rates and links them with social circumstances. CTVB could be used as the basis for accurate resource allocation for community paediatric services: UK breast-feeding rates are low and merit targeted promotion.

Adult↗

Sex-specific, male-line transgenerational responses in humans.

Transgenerational effects of maternal nutrition or other environmental 'exposures' are well recognised, but the possibility of exposure in the male influencing development and health in the next generation(s) is rarely considered. However, historical associations of longevity with paternal ancestors' food supply in the slow growth period (SGP) in mid childhood have been reported. Using the Avon Longitudinal Study of Parents and Children (ALSPAC), we identified 166 fathers who reported starting smoking before age 11 years and compared the growth of their offspring with those with a later paternal onset of smoking, after correcting for confounders. We analysed food supply effects on offspring and grandchild mortality risk ratios (RR) using 303 probands and their 1818 parents and grandparents from the 1890, 1905 and 1920 Overkalix cohorts, northern Sweden. After appropriate adjustment, early paternal smoking is associated with greater body mass index (BMI) at 9 years in sons, but not daughters. Sex-specific effects were also shown in the Overkalix data; paternal grandfather's food supply was only linked to the mortality RR of grandsons, while paternal grandmother's food supply was only associated with the granddaughters' mortality RR. These transgenerational effects were observed with exposure during the SGP (both grandparents) or fetal/infant life (grandmothers) but not during either grandparent's puberty. We conclude that sex-specific, male-line transgenerational responses exist in humans and hypothesise that these transmissions are mediated by the sex chromosomes, X and Y. Such responses add an entirely new dimension to the study of gene-environment interactions in development and health.

Adult↗

The predictive value of early life total immunoglobulin E measurement in identifying atopic children in a population-based birth cohort study.

Atopy is common and the prevalence amongst children is rising. Measurements in early childhood that can predict subsequent development of atopy could be clinically useful for targeting preventive measures. We used the Children in Focus (CiF) subgroup of a large population-based birth cohort study (the Avon Longitudinal Study of Parents and Children) to investigate whether total immunoglobulin E (IgE) measured at 12 and 18 months could predict subsequent development of atopy at 5 yr of age. Atopy was determined by positive skin prick test (> or = 3 mm wheal) to one or more of 14 inhalant and food allergens. Prevalence of skin prick positivity to any allergen was 14.5% (104 of 715; 95% CI: 12.0-17.1%). Total IgE levels were significantly higher at 12 months of age (p < 0.0005) but not 18 months of age in those children subsequently atopic. The highest positive predictive value was 41% with an IgE measurement of >51 kU/l, with a sensitivity of 13.5% and a specificity of 95.8%. Although significant differences in early life IgE measurements were seen, the extent of overlap was great, such that the overall performance of IgE at 12 months as a screening test for atopy was poor.

Child, Preschool↗

Haemoglobin A1c is not a surrogate for glucose and insulin measures for investigating the early life and childhood determinants of insulin resistance and Type 2 diabetes in healthy children. An analysis from the Avon Longitudinal Study of Parents and Children (ALSPAC).

AIMS: Research into early life and childhood determinants of insulin resistance and Type 2 diabetes are complicated by requirements for fasting blood samples and glucose tolerance tests. We investigated haemoglobin A(1c) (HbA(1c)), a marker of glycaemia measured in non-fasting blood, as an alternative. METHODS: HbA(1c) was measured in 1645 children aged 9-11 years without diabetes from the Avon Longitudinal Study of Parents and Children. Thirty-nine children had two HbA(1c) measurements. Data on parental, child and potential confounding factors were collected prospectively from questionnaires, medical records and direct examination. Data from a shortened 30-min oral glucose tolerance test were available for 431 children at age 8 years. Body composition was measured by dual-energy X-ray absorptiometry. RESULTS: Mean (sd) HbA(1c) was 4.91(0.29)%. HbA(1c) increased with age and was higher in boys compared with girls, non-white compared with white children, and in children with anaemia. Mean difference between repeated HbA(1c) measurements was 0.01%. HbA(1c) was weakly positively associated with fasting glucose (beta = 0.066%/mmol/l, P = 0.05), but was not associated with 30-min glucose, fasting or 30-min insulin, or homeostasis model assessment-insulin resistance. HbA(1c) was weakly inversely associated with weight sd score (beta =-0.02%/unit, P = 0.004), body mass index sd score (beta = -0.02%/unit, P = 0.002), and total body fat (beta = -0.003%/kg, P = 0.06) and lean mass (beta = -0.011%/kg, P = 0.01), but was not associated with birthweight or breastfeeding. CONCLUSIONS: HbA(1c) is not a good marker of fasting or post-load glucose and insulin measures in healthy children, and is not a viable alternative to these measures for investigating the determinants of insulin resistance and Type 2 diabetes in children.

Biomarkers↗

Stability in cognition across early childhood. A developmental cascade.

Children confront the formidable task of assimilating information in the environment and accommodating their cognitive structures to that information. Developmental science is concerned equally with two distinctive features of these processes: children's group mean level of performance through time and the standing of individual children through time. Prevailing opinion since the inception of the mental-measurement movement has been that individual development is unstable-that individual children change unpredictably in their abilities. We report results of a large-scale controlled, multivariate, prospective, microgenetic, 4-year longitudinal study that reveals a statistically significant cascade of species-typical cognitive abilities from infancy to childhood. Infancy is a recognizable starting point of life; we find that to a small but significant degree, infancy also represents a setting point in the life of the individual.

Child↗

Dietary energy intake at the age of 4 months predicts postnatal weight gain and childhood body mass index.

OBJECTIVE: Rapid infant weight gain has been shown to predict later obesity risk; however, it is unclear which factors influence infant diet and weight gain. The objective of this study was to determine whether different feeding patterns and energy intakes that are provided to infants affect body weight and BMI later in childhood. METHODS: This representative birth cohort study was conducted in the United Kingdom. Energy intake at age 4 months was estimated from 1-day unweighed dietary records in 881 infants and related to their childhood weight gain and BMI. RESULTS: Among formula- or mixed-fed infants (N = 582), energy intake was higher in first-born infants (mean +/- SE: 2730 +/- 29.4 kJ/day; n = 263) than in subsequent-born infants (2620.8 +/- 25.2 kJ/day; n = 296). Energy intake at 4 months was also higher in infants who were given solid foods earlier (1-2 months: 2805.6 +/- 50.4 kJ/day, n = 89; 2-3 months: 2658.6 +/- 25.2 kJ/day, n = 339; 4+ months: 2587.2 +/- 46.2 kJ/day, n = 111). Higher energy intake at 4 months predicted greater weight gain between birth to age 1, 2, or 3 years and larger body weight and BMI at ages 1 to 5 years. No significant associations were seen in breastfed infants (N = 299). CONCLUSIONS: Among formula- or mixed-fed infants, dietary energy intake at age 4 months predicted postnatal weight gain and childhood obesity risk. Both prenatal and postnatal factors may influence infant energy intake and postnatal weight gain.

Birth Weight↗

The prevalence of childhood dysphonia: a cross-sectional study.

There is only very limited information on the prevalence of voice disorders, particularly for the pediatric population. This study examined the prevalence of dysphonia in a large cohort of children (n = 7389) at 8 years of age. Data were collected within a large prospective epidemiological study and included a formal assessment by one of five research speech and language therapists as well as a parental report of their child's voice. Common risk factors that were also analyzed included sex, sibling numbers, asthma, regular conductive hearing loss, and frequent upper respiratory infection. The research clinicians identified a dysphonia prevalence of 6% compared with a parental report of 11%. Both measures suggested a significant risk of dysphonia for children with older siblings. Other measures were not in agreement between clinician and parental reports. The clinician judgments also suggested significant risk factors for sex (male) but not for any common respiratory or otolaryngological conditions that were analyzed. Parental report suggested significant risk factors with respect to asthma and tonsillectomy. These results are discussed in detail.

Child↗

Obesity and bullying: different effects for boys and girls.

AIMS: To investigate whether weight category (underweight, average weight, overweight, and obese) at age 7.5 predicts bullying involvement at 8.5 years. Models were tested separately for boys and girls to investigate gender differences in association patterns. METHODS: Prospective cohort study in southwest England. Height and weight were measured in children at age 7.5 (n = 8210). BMI (kg/m2) was used to define underweight, average weight, overweight, and obese children, according to British age and gender specific growth reference data. Overt (n = 7083) and relational (n = 6932) bullying behaviour was assessed in children at age 8.5. RESULTS: After adjustment for parental social class, compared to average weight boys, obese boys were 1.66 (95% CI 1.04 to 2.66) times more likely to be overt bullies and 1.54 (1.12 to 2.13) times more likely to be overt victims. Obese girls were 1.53 (1.09 to 2.15) times more likely to be overt victims compared to average weight girls. CONCLUSIONS: Obesity is predictive of bullying involvement for both boys and girls. Preadolescent obese boys and girls are more likely to be victims of bullying because they deviate from appearance ideals. Other obese boys are likely to be bullies, presumably because of their physical dominance in the peer group.

Body Weight↗

Social position affects bone mass in childhood through opposing actions on height and weight.

UNLABELLED: We studied relationships between social position of the mother in pregnancy and bone mass of the child at age 9.9 years. The tendency for social position to increase bone area and bone mass through a positive influence on height was opposed by a negative effect of social position on weight and fat mass. INTRODUCTION: Evidence that social factors influence skeletal growth raises the possibility that bone mass acquisition in childhood is socially determined. MATERIALS AND METHODS: To clarify the role of social factors in bone mass acquisition in childhood, we studied relationships between these variables in the Avon Longitudinal Study of Parents and Children (ALSPAC). Measures of the mother's social position during pregnancy were linked to DXA results obtained at age 9.9 years in 6,702 children. Linear regression analyses were carried out after adjusting for age and gender. Because social position may affect height and weight of the child, analyses were repeated after adjusting for these additional variables. RESULTS: Measures of social position in pregnancy were unrelated to total body BMC in analyses adjusted for age and gender alone. However, after adjusting for height, which was positively related to social position, a strong negative association was observed between BMC and housing tenure (p < 0.001), maternal education (p < 0.001), paternal education (p < 0.001), and social class (p < 0.001). Similar results were obtained for bone area. After adjusting for weight as well as height, an association between social position and BMC and bone area was no longer observed. Hence, social position seems to exert opposing height- and weight-dependent effects on BMC and bone area in childhood. In further analyses, we found that adjusting for fat mass of the child led to similar results to those obtained with weight. CONCLUSIONS: Social position in childhood seems to be positively related to bone mass acquisition in childhood as a consequence of enhanced gain in height (i.e., longitudinal growth). However, this influence is counteracted by the tendency for increased fat deposition in those from a lower social position to increase bone area, presumably reflecting the stimulation of appositional bone growth.

Absorptiometry, Photon↗

Maternal age of menarche is not associated with asthma or atopy in prepubertal children.

BACKGROUND: Maternal sex hormones in pregnancy can theoretically influence the developing fetal immune system and modulate the subsequent development of atopic disorders. Early onset of menarche has been linked to increased oestrogen levels in adult women. A study was undertaken to examine the association between early onset menarche in pregnant women and asthma and atopic status of their children at 7 years of age. METHODS: The Avon Longitudinal Study of Parents and Children (ALSPAC) is a longitudinal birth cohort study in which pregnant women, resident in Avon (UK), were recruited on the basis of an expected date of delivery between 1 April 1991 and 31 December 1992. Maternal age at menarche was assessed from prenatal questionnaires administered to the women. Clinical outcomes in the children were based on mothers' responses to self-completion questionnaires and included asthma, eczema, and hay fever. The atopic status of the child was objectively assessed by skin prick tests to a panel of common aeroallergens at the age of 7 years. Analyses used multivariable logistic regression with a diverse range of possible confounders. RESULTS: Complete data were available on 5765 woman and child pairs. The prevalence of ever reported asthma to 7 years was 20.4%, eczema 58.6%, hay fever 12.1%, and atopy (defined as any positive (>2 mm weal) response) was present in 20.6%. There were no significant differences in mean age of menarche between mothers of children with and without each of the primary outcomes. Adjusted odds ratios (95% CI) for the latest age of menarche (16+ years) compared with the lowest (<12 years) reference group were 1.41 (1.00 to 1.99) for asthma, 0.98 (0.73 to 1.91) for eczema, 0.95 (0.62 to 1.44) for hay fever, and 0.98 (0.68 to 1.42) for atopy. CONCLUSION: No consistent association was found between maternal age at menarche and asthma, eczema, hay fever or atopy in their children during early childhood.

Adolescent↗

Common polymorphism in H19 associated with birthweight and cord blood IGF-II levels in humans.

BACKGROUND: Common genetic variation at genes that are imprinted and exclusively maternally expressed could explain the apparent maternal-specific inheritance of low birthweight reported in large family pedigrees. We identified ten single nucleotide polymorphisms (SNPs) in H19, and we genotyped three of these SNPs in families from the contemporary ALSPAC UK birth cohort (1,696 children, 822 mothers and 661 fathers) in order to explore associations with size at birth and cord blood IGF-II levels. RESULTS: Both offspring's and mother's H19 2992C>T SNP genotypes showed associations with offspring birthweight (P = 0.03 to P = 0.003) and mother's genotype was also associated with cord blood IGF-II levels (P = 0.0003 to P = 0.0001). The offspring genotype association with birthweight was independent of mother's genotype (P = 0.01 to P = 0.007). However, mother's untransmitted H19 2992T allele was also associated with larger birthweight (P = 0.04) and higher cord blood IGF-II levels (P = 0.002), suggesting a direct effect of mother's genotype on placental IGF-II expression and fetal growth. The association between mother's untransmitted allele and cord blood IGF-II levels was more apparent in offspring of first pregnancies than subsequent pregnancies (P-interaction = 0.03). Study of the independent Cambridge birth cohort with available DNA in mothers (N = 646) provided additional support for mother's H19 2992 genotype associations with birthweight (P = 0.04) and with mother's glucose levels (P = 0.01) in first pregnancies. CONCLUSION: The common H19 2992T allele, in the mother or offspring or both, may confer reduced fetal growth restraint, as indicated by associations with larger offspring birth size, higher cord blood IGF-II levels, and lower compensatory early postnatal catch-up weight gain, that are more evident among mother's smaller first-born infants.

Birth Weight↗

Influence of age and carriage status on salivary IgA to Neisseria meningitidis.

Asymptomatic carriage of Neisseria meningitidis is common (5-35% of individuals) while the incidence of invasive meningococcal disease is fairly low (<1-5 per 100,000 per annum in Europe). Naturally acquired protective immunity may account for this difference. In this study, we investigated the relationship between anti-meningococcal salivary IgA and age and carriage. We showed that salivary IgA to a range of meningococcal antigens increased successively with age with some specificity for commonly circulating serosubtypes. In a group of 258 students 37 (14%) of whom were carriers of N. meningitidis serogroup B, higher levels of specific IgA were associated with carriage. Stratified analysis revealed a positive relationship between smoking and specific anti- N. meningitidis IgA independent of current carriage, weighted odds ratio (OR) 4.1 (95% CI 1.1-18) and OR 3.8 (95% CI 0.96-16) for reference strains B:1:P1.14 and B:4:P1.5,4 respectively. These data implicate IgA as a factor in host defence from meningococcal invasion, although the precise mechanisms remain uncertain.

Adolescent↗

Prenatal risk factors for Caesarean section. Analyses of the ALSPAC cohort of 12,944 women in England.

BACKGROUND: There has been an escalation in Caesarean section rates globally. Numerous prenatal factors have been associated with elective and emergency Caesarean section, some of which may be amenable to change. METHODS: A population-based cohort of 12,944 singleton, liveborn, term pregnancies were used to investigate risk factors for Caesarean section using multivariable logistic regression modelling. Numerous prenatal factors were investigated for their associations with the following outcomes: first, with Caesarean section (both elective and emergency) compared with vaginal delivery (spontaneous and assisted); second, for their associations with elective Caesarean section compared with attempted vaginal delivery; and finally emergency Caesarean section compared with spontaneous vaginal delivery. RESULTS: 11,791 women had vaginal delivery and 1153 had Caesarean section (685 emergency, 468 elective). Non-cephalic (breech) presentation (all Caesareans odds ratio (OR) 36.6, 95% confidence interval (CI) 26.8-50.0; elective Caesarean OR 86.4, 95% CI 58.5-127.8; emergency Caesarean OR 9.58, 95% CI 6.06-15.1) and previous Caesarean section (all Caesareans OR 27.8, 95% CI 20.9-37.0, elective Caesarean OR 54.4, 95% CI 38.4-77.5; emergency Caesarean OR 13.0, 95% CI 7.76-21.7) were associated in all analyses with an increased risk of Caesarean section. Extremes of neonatal birthweight were associated with an increased risk of Caesarean section (all Caesareans and emergency section) compared with vaginal delivery as was increasing neonatal head circumferences. In all analyses increasing maternal age (OR 1.07 per year, 95 % CI 1.04-1.09; OR 1.04 per year, 95 % CI 1.01-1.08; OR 1.11 per year, 95% CI 1.08-1.15) was independently associated with increased odds of Caesarean section. Increasing parity was associated with a decrease in risk for all Caesareans and emergency section (OR 0.63, 95% CI 0.53-0.75 and OR 0.46, 95% CI 0.33-0.63, respectively), as was the outcome of the last pregnancy being a live child. Increasing gestation was independently associated with a decreased risk of both all Caesareans and elective Caesarean (OR 0.86, 95% CI 0.80-0.93 and OR 0.52, 95% CI 0.46-0.58 respectively), whereas diabetes mellitus was associated with increased risk. These variables were not associated with emergency section. However, epidural use was associated with an increased risk of emergency Caesarean (OR 6.49, 95% CI 4.78-8.82) while being in a preferred labour position decreased the risk (OR 0.59, 95% CI 0.49-0.73). CONCLUSIONS: A careful exploration of risk factors may allow us to identify reasons for the increasing rates of Caesarean section and the marked variation between institutions.

Adult↗

Factors moderating change in depressive symptoms in women following separation: findings from a community study in England.

BACKGROUND: Previous studies suggest that separation is a major stressful life event that is linked with marked increases in depressive symptoms. Little is known, however, about the sources of variation in depressive symptoms following separation. METHOD: This study examines factors moderating the effect of separation on depressive symptoms in women participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, longitudinal study of a large community sample in the west of England. Data on marital/partner status, depression, and hypothesized moderating factors were available on women (n = 8264), assessed on two occasions approximately 12 months apart. RESULTS: Over this 1-year period, 2.7% of women experienced a separation. As expected, those who experienced a separation between assessment periods reported, on average, a significant increase in depressive symptoms, approximately 0.25 of a S.D. However, there were marked individual differences in response to separation, with 56.1% showing a increase of 0.5 S.D. or more and 21.0% showing an decrease of 0.5 S.D. or more in depressive symptoms following separation. Regression analyses identified several factors that moderated response to separation; specifically, the effect of separation on depressive symptoms was less for women who were in a cohabiting (non-marital) relationship and for women who experienced elevated marital conflict prior to separation. CONCLUSION: The results underscore the wide variation in responses to separation and document the need to consider context in interpreting the effects of major life events on depressive symptoms.

Adult↗