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The Danish National Birth Cohort Marin Strøm, MSc, PhD Post Doc & Scientific Secretary

The Danish National Birth Cohort Marin Strøm, MSc, PhD Post Doc & Scientific Secretary. The Danish National Birth Cohort (DNBC) a longitudinal conception-to-death study aims to investigate associations between early-life factors and diseases in a life-course perspective

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The Danish National Birth Cohort Marin Strøm, MSc, PhD Post Doc & Scientific Secretary

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  1. The Danish National Birth Cohort Marin Strøm, MSc, PhD Post Doc & Scientific Secretary

  2. The Danish National Birth Cohort (DNBC) a longitudinal conception-to-death study aims to investigate associations between early-life factors and diseases in a life-course perspective holds data from several data sweeps during pregnancy and early childhood, including an FFQ during pregnancy and follow-up at child age 7 - as well as data from national administrative registers Holds 2 blood samples from the mother taken during pregnancy and 1 from the umbilical cord Currently (2010-14) collects data from the 11-year-old participants as well as from their mothers in two separate questionnaires and further follow up is underway

  3. All pregnant women in Denmark 1996-2002 100% Appr. 30% do not receive an invitation Appr. 10% do not fulfill inclusion criteria Appr. 60% receive an invitation 100% Appr. 40% choose not to participate Appr. 60% are enrolled in the study Total: 101.042 participants 100% 1st interview: 92.892 92% of total 4th interview: 65.764 65% of total FFQ: 70,183 69% of total 3rd interview: 70.296 70% of total 2nd interview: 87.802 87% of total DNBC Sampling

  4. Data collections in the DNBC %92 %86 %87 %69 %69 %65 %62 %50

  5. Biological samples

  6. Food Frequency Questionnaire during pregnancy 19 pages long ~300 food items One month back in time (from gw25) Fixed time categories Fixed food item names Food supplements Ref: Olsen SF et al. Paed Perin Epi 2007

  7. Access to data : www.dnbc.dk

  8. Linkage to other sources • The DNBC is a national registry, owned by the Danish National Board of Health • Individual level linkage via population registries allow us to: • follow the individual from birth to grave • follow diseases through generations (gene/environment) • follow millions of individuals Birth characteristics Diseases Prescribed medication Vaccinations School performance Family, place of living Education, employment Biological specimens CPR-number

  9. Ongoing data collection:11 y child questionnaire • Self-reported exposureinfo on: • Social relationships (family/peers) • School environment • Sleeping habits • Eating habits (FFQ) • Physical (in)activity • Traffic safety • Smoking and alcohol • Dental hygiene • Self-reported outcomeinfo on: • Global health (SOCS) • Sleeping disorders • Eating disorders • Musculoskeletal problems • Child’s strengths and difficulties (SDQ) • Depression, self-injuries (DAWBA) • Psychotic symptoms/Schizophrenia (PLIKS) • Puberty (Tanner stages)

  10. Ongoing data collection:11 y child questionnaire • Parent-reported exposureinfo on: • Organic food • Vitamins/Dietary supplements • Sun and sunscreen • Medication/Vaccination • Chlorine exposure • Housing and indoor air pollution • Hereditary factors (family disease history) • Parental factors (alcohol, smoking,anthropometrics, mental health) • Parent-reported outcomeinfo on: • Asthma/Allergy/Eczema (ISAAC) • Disabilities/Physical impairment • Infections • Diabetes/Celiac disease • Vision and hearing impairment • Enuresis • Tics (DAWBA) • Obesity (anthropometric measures)

  11. Current status in the 11-year follow-up • The 11-year follow-up was launched in July 2010 • To the end of 2014 invitations are sent to approx. 350 families every week • In case of no-reply reminders are sent out 4 and 8 weeks after the invitation • effort to increase participation: win quick-reply prizes when answering within 4 weeks after invitation

  12. AHEAD GDM studyA study of long-term HEAlth after the Development of Gestational Diabetes Mellitus An ongoing substudy of the DNBC Collaboration between Rigshospitalet (Allan Vaag, Louise G Grunnet and others) Statens Serum Institut (Sjúrdur F Olsen and others) Harvard School of Public Health (Frank Hu and others) NIH / NICHD (Cuilin Zhang and others)

  13. AHEAD GDM study: Objectives To describe the association between mother’s GDM and child’s risk for developing T2D and metabolic disorders influence of specific dietary components during pregnancy on the risk for developing T2D in the child influence of physical activity during pregnancy on the propensity for developing T2D in the child underlying epigenetic mechanisms that may mediate effects of maternal factors (GDM, diet, physical activity) on T2D propensity in the offspring

  14. Study subjects ~1500 children to GDM and control mothers (aged 9-15 years) recruited from DNBC Aarhus Copenhagen Smaller sites/mobile clinic

  15. Clinical examination Children Anthropometry: weight, height, waist, hip, head circumference Blood pressure and heart rate Fasting blood samples (glucose, insulin, C-peptide, incretin, leptin, adiponectine) DEXA scanning Urine sample Online questionnaire (diet, physical activity) Mothers Weight, height, waist, hip, blood pressure and heart rate OGTT (fasting blood samples and DNA, PAX genes) DEXA scanning Urine (endocrine disrupting chemicals) and toenail samples (trace metals incl magnesium, chromium) Online questionnaire and FFQ

  16. Puberty study Launched few weeks ago Aim: investigate reasons for early puberty ~20000 children invited to fill in Q on puberty stage Repeated every 6 mo Web based, focused Q FFQ14 Will be launched Jan 2013 Assess diet & physical activity in teenagers 14y All DNBC children asked to fill in Q Web based, built on GUTS  adapted to DK Planned: FFQ in mothers Further follow up of DNBC children

  17. Thank you for your attention! www.dnbc.dk

  18. Clinical examination Standardization 3 days prior to visit - No hard physical activity No alcohol consumption The day before the examination All participants will be asked to eat a small meal at 8 PM Following the small meal: Not eat, drink and smoke On the day of visit Transport to the hospital by car or public transport – no bicycle No steps – take the elevator

  19. Enrolment plan RH Esbjerg Århus Næstved (20-21) RH Esbjerg (16.11) Århus Nykøbing F/Nakskov (10-11) Odense RH Odense (114 total) Århus Holbæk (4 days) RH Århus Herning (136 cases total) Aalborg (121 total) Århus Herning Aalborg Thisted (32 total) Århus Herning Aalborg Follow up Bornholm(9 total) Follow up October November December January February March April

  20. PRELIMINARY PARTICIPATION RATES: CPH: 178/(160+18+19+65+7)268= 68% Århus: 58% Næstved: 61%

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