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Dr Nisreen Alwan Wellcome Trust Clinical Research Fellow

Nutritional Epidemiology Group School of Food Science & Nutrition. An example of using data from multiple longitudinal studies to address a scientific hypothesis: Maternal iron in pregnancy and offspring’s cardiovascular risk. Dr Nisreen Alwan Wellcome Trust Clinical Research Fellow.

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Dr Nisreen Alwan Wellcome Trust Clinical Research Fellow

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  1. Nutritional Epidemiology Group School of Food Science & Nutrition An example of using data from multiple longitudinal studies to address a scientific hypothesis:Maternal iron in pregnancy and offspring’s cardiovascular risk Dr Nisreen Alwan Wellcome Trust Clinical Research Fellow

  2. Nutritional Epidemiology Group School of Food Science & Nutrition Background • Iron deficiency is a common problem during pregnancy • No solid evidence to support routine iron supplementation programmes duringpregnancy in relation to offspring outcomes • Maternal nutrition during pregnancy is potentially linked to chronic disease risk in the offspring

  3. Nutritional Epidemiology Group School of Food Science & Nutrition Maternal iron deficiency during pregnancy and offspring health: findings from animal studies McArdle et al (2006). Fetal programming: causes and consequences as revealed by studies of dietary manipulation in rats – a review. Placenta (27): 56-60.

  4. Nutritional Epidemiology Group School of Food Science & Nutrition Hypothesis Maternal iron deficiency during pregnancy is linked to increased cardiovascular risk in the offspring

  5. Nutritional Epidemiology Group School of Food Science & Nutrition Aim Assess the relationship between maternal iron status / intake during pregnancy and both short-term and long-term cardiovascular risk indicators in the offspring

  6. Letter of invitation Recruitment 12-18/52 28/52 36/52 24-hour recall Conception Delivery CAT1 CAT2 CAT3 1274 low-risk pregnancies in Leeds: 2003-06

  7. Nutritional Epidemiology Group School of Food Science & Nutrition The CARE study • Dietary iron intake <UK RNI (14.8 mg/day) = 80% • More likely to be younger, lower socioeconomic profile • Less likely to take supplements during the 1st trimester • 24%, 15% & 8% took iron-containing supplements in 1st, 2nd & 3rd trimester • Total iron intake from diet and supplements associated with customised birthweightcentile (adjusted change = 2.5 centiles/10 mg, 95% CI: 0.4, 4.6) Alwan, NA et al (2011). Dietary iron intake during early pregnancy and birth outcomes in a cohort of British women. Human Reproduction, 26, 911.

  8. Nutritional Epidemiology Group School of Food Science & Nutrition UKWCS (Iron and blood pressure study) • UKWCS – 1st phase 35,372 women 35-69 years at recruitment across UK, 2nd phase 15,000 • C282Y is a common mutation (around 13% of Europeans), homozygotes more likely to develop haemochromatosis • C282Y heterozygotes are asymptomatic but less likely to be iron-deficient • C282Y used as an instrument for the exposure of interest (maternal iron status) to control for confounding

  9. Nutritional Epidemiology Group School of Food Science & Nutrition UKWCS (Iron and blood pressure study)

  10. Nutritional Epidemiology Group School of Food Science & Nutrition Baby’s Vascular health and Iron in Pregnancy study • Pulse wave velocity is a strong predictor of CVD mortality in adults, and has been linked to CV risk factors such as lipids, body fat, blood pressure & glucose in children • Retrospective cohort design • Outcome – Neonatal arterial stiffness (Brachio-femoral PWV) • Exposure – body iron stores in early pregnancy (serum transferrin receptor /serum ferritin) Vicorder kit

  11. Nutritional Epidemiology Group School of Food Science & Nutrition ALSPAC • Exposures: maternal dietary intake at 32 weeks gestation (FFQ), maternal supplement intake during pregnancy, maternal haemoglobin during pregnancy, cord ferritin • Outcomes: Offspring’s pulse wave velocity and flow mediated dilatation at 10-12 years • Potential mediators: maternal BMI, gestational age, birthweight, offspring dietary iron intake (FFQ)

  12. Nutritional Epidemiology Group School of Food Science & Nutrition Thank you n.alwan@leeds.ac.uk

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