1 / 16

Manon van Eijsden

Maternal lifestyle & living conditions in pregnancy in relation to birth outcomes: results of the ABCD study. Manon van Eijsden. Congres Kennispoort Verloskunde, Dec 11th, 2008. Amsterdam Born Children & their Development (ABCD) study. Prospective community-based cohort study

maryam-ryan
Download Presentation

Manon van Eijsden

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Maternal lifestyle & living conditions in pregnancy in relation to birth outcomes: results of the ABCD study Manon van Eijsden Congres Kennispoort Verloskunde, Dec 11th, 2008

  2. Amsterdam Born Children & their Development (ABCD) study Prospective community-based cohort study Examining the role of early life factors (maternal/neonatal) in children’s health(developmental origins of health and disease hypothesis) Special focus on ethnic differences Improve prenatal care and improve children’s health at the earliest stage possible Reduce ethnic disparities in health and disease

  3. Data collection (2003 - present) Prenatal visit care provider 12373 PHASE 1 Pregnancy questionnaire Growth charts 7687 Blood sample 4389 Follow-up 7050 8266 8266 Birth outcomes Perinatal deaths Infant questionnaire PHASE 2 5218 Child questionnaire (parent) Child questionnaire (teacher) ABCD Consultation PHASE 3

  4. This presentation: maternal factors & birth outcomes • Relation between birth outcomes and: • Working conditions in pregnancy • Folic acid supplement use in pregnancy

  5. Methods (1) • sociodemographics • medical history, utilisation of care • lifestyle • supplement use • psychosocial stress (depression, anxiety, work-related stress) • nutrient status (vit A, D, B12, folate, Fe, Zn, Mg, Ca, n-3 & n-6 FA, antioxidant capacity) • hormones (cortisol, thyroid function) Pregnancy questionnaire & blood sampling

  6. Methods (2) Youth Health Care administration: - infant gender - birth weight - pregnancy duration

  7. Working conditions & birth outcomes Job strain score • Measures of working conditions: • working hours per week • hours working in standing position/walking • physical work load • job strain score (Karasek JCQ) high moderate low high job demands moderate low high moderate low • Outcomes: • - birth weight at term • small-for-gestational age • preterm delivery n(total) = 7424, n(employed) = 4772 job control n(total) = 6941, n(employed) = 4496 Vrijkotte et al, Am J Publ Health, in press; Vrijkotte et al, in preparation

  8. Work-related stress and birth weight * adjusted for parity, infant gender, pregnancy duration, maternal age, height, preexisting hypertension and diabetes, marital status, educational level, ethnicity, smoking, alcohol use, prepregnancy BMI and parenting stress

  9. Physical work load and preterm birth * adjusted for parity, smoking, alcohol use, previous miscarriage/stillbirth, previous preterm birth, ethnicity, hypertensive disorder, small for gestational age ** adjusted for parity, maternal age, previous preterm birth, ethnicity, hypertensive disorder, small for gestational age

  10. Folate depletion hypothesis: short interpregnancy interval → depletion of folate stores in the mother → growth restriction of the unborn child Pregnancy interval pregnancy pregnancy birth conception conception Am J Clin Nutr 2008;88:147-153 Folic acid supplement use and BW

  11. Interaction between interval and folic acid use (1) Birth weight in grams 1-3 4-6 7-9 10-12 13-15 16-18 19-21 22-24 (mo) (n=3153)

  12. Interaction between interval and folic acid use (2) 1-3 4-6 7-9 10-12 13-15 16-18 19-21 22-24 (mo)

  13. Summary: maternal factors & birth outcomes • Working conditions associated with lower birth weight & preterm birth • work-related stress → birth weight • stress in general and birth weight – increasing evidence • physical work load → induced PTB; needs confirmation • Short interpregnancy interval associated with lower birth weight • counteracted by folic acid supplement use • marker for folate depletion

  14. Implications for perinatal care “De ideale vroedvrouw is verloskundige, diëtist, en psycholoog in één” (proposition PhD thesis, june 2008) Screening for psychosocial health at 1st prenatal visit? Continued promotion of folic acid use? Addressing family planning already in pregnancy? Nutrition counselling for pregnant women?

  15. ABCD study groupMarcel van der Wal, PhDTanja Vrijkotte, PhDReinoud Gemke, professorBea vd Bergh, professorOdin vd Stelt, PhDGeertje Goedhart, MScMarieke de Beer, MScMarieke de Hoog, MscAimée van Dijk, MscEva Loomans, MScDatamanagement:Hans Reurs Acknowledgements Funding sources www.abcd-study.nl mveijsden@ggd.amsterdam.nl

  16. Ethnicity and work-related stress

More Related