Avon Longitudinal Study of Parents And...
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Avon Longitudinal Study of Parents And Children
Transcript of Avon Longitudinal Study of Parents And...
AvonLongitudinalStudy ofParentsAnd Children
Avon
ALSPACAvon
Defined geographical area
Low level of outward migration
Good mixture of:Social backgroundHousingUrban/rural
Enthusiastic health professionals
Supportive teachers and employers
Differences between children in Avon & rest of BritainBlood pressure NSHeight NSWeight NSHead circumference NSIQ NSEducational ability NSBehaviour score NS
ParentsAges NS
Education levels NS
Social class **Ethnic group NS
Mother’s blood pressure NS
Mother’s depression NS
OVERALL OBJECTIVE
To understand the ways in which the physical and social environment interact, over time, with genetic inheritance to affect health, behaviour and development in children and then into adulthood.
ENVIRONMENTAL INFLUENCES
Diet andLifestyle
Pollutants Housing
Psychosocial
conditionsParenting
Medical &Dental care
Day Care Schooling
Health behaviou
r
COMPLEXINTERACTIONS± GENOTYPICVARIATION
OUTCOMES WILL INCLUDE:
Growth, Metabolism & Physiological Traits relevant toAdult OnsetDisease
Accidents and injuries
Asthma EczemaAtopy Allergies
Mood, Behaviour and Temperament
Sexual Development & Reproduction
Motor & Mental Ability and Achievement
Infection
Obesity
Diabetes & coronary heart disease
Schizophrenia & other psychiatric disorders
Employment
Criminality
Drug & alcoholabuse
ALSPAC
Inclusion criteria EDD 1.4.91-31.12.92
Mother resident in Avon
Enrolled pregnancies 14,541(740 abortions/deaths) (~85% of total
eligible)
Being followed 13,801 mothers13,971 children
ALSPAC DATA
Self completion questionnaires
Health records
Biological samples
Environmental monitoring
Education records
Hands on assessments
CHILD BASED QUESTIONNAIRES
Age(mths)
Eligible Refused & Other*
Sent Response
1 14010 2.5% 13659 90.4%6 13994 3.6% 13491 85.2%
15 13983 5.5% 13217 83.8%18 13982 6.7% 13040 85.3%24 13980 8.3% 12826 81.3%30 13977 9.3% 12683 81.4%38 13977 10.5% 12510 79.7%42 13974 11.0% 12434 80.9%
* Includes lost to follow up and mothers who requested no questionnaires for the moment
ALSPAC DATA
Self completion questionnaires
Health records
Biological samples
Environmental monitoring
Education records
Hands on assessments
Health Records
Pregnancy, labour, delivery and the puerperium
Community records: size, feeding, immunisation, referral, developmental assessment
Outpatient consultations
Casualty attendance
Inpatient episodes
Post-mortem examination
ALSPAC DATA
Self completion questionnaires
Health records
Biological samples
Environmental monitoring
Education records
Hands on assessments
Biological samplesMaternal bloodMaternal urine
Cord blood
Placenta
Piece of cord
Hair and nails
Teeth
Child’s blood
Saliva
Urine
ALSPAC DATA
Self completion questionnaires
Health records
Biological samples
Environmental monitoring
Education records
Hands on assessments
ALSPAC Environmental Monitoring
Electromagnetic radiation
Outdoor air pollutants
Indoor air pollutants
Noise
Environmental influences on development
and health:The weatherPollutionWaterRadiationHygieneHousingSocio-economic circumstancesStress – physical and psychologicalSchoolingDietMedicationParenting behaviour
ALSPAC DATA
Self completion questionnaires
Health records
Biological samples
Environmental monitoring
Education records
Hands on assessments
Hands on assessments
3 year old development
Stepfamilies
Lesbian parents
Twins and language development
Children in Focus
Yearly tests on whole cohort
The 7 year hands – on tests
AnthropmetryBlood pressure, pulse rateVisionHearingAllergiesFine and gross motor abilityInterview with mother to assess history of day care placementsReading, spelling and phoneme awarenessDietBlood sample
The 8 year hands – on tests
Cognitive function (WISC –III)Short-term memorySpeech & languageNonverbal accuracy (DANVA)Measures of attentionLung function & bronchial hyper-responsivenessTympanometry & otoacousticemissionsInterview – Self-esteem
Locus of controlBullying behaviourGender behaviour
BoneDensity
Value of Comprehensive nature
Potential confounding factors (e.g. smoking, nutrition, family dynamics) in one study are the prime focus of interest in another study.
Integration of gene/environment, and gene/gene interactions in defining causal pathways.
Integrated consent for studies
Value of Longitudinal Studies
Reduces recall bias
Temporal resolution of associations (into antecedents)
Changes over time as a diagnostic criterion
Child’s reported alcohol intake
6 months
2.5%
15 months
11.4%
24 months
12.7%
38 months
41.7%
~38 months
Examples of the detailed data available
At 6 months:
49% had had herbal drinks
20% were drinking cows’ milk
9% were having tea to drink
42% were eating raw apples
19% were eating raw carrot
Information obtained on the diets of the ALSPAC population(*10% subgroup only;
FF = food frequency; DD = dietary diary)
Time point Child Mother Father
Pregnancy1 ← FF FF4 weeks FF - -
4 months DD* - -6 months FF - -8 months DD* - -15 months FF - -18 months DD* - -3 years FF - -3½ years DD* - -4 years FF FF FF5 years DD* - -6 years FF - -7 years DD - -8 years FF FF FF
Factors independently associated with stereoacuity
(n=435)
Explanatory variable
BreastfeedingNever<4 monthsAt least 4 months
Oily Fish in PregnancyNoYes
Adjusted OR (95% CI)
1.0 Reference2.92 (1.58, 5.43)2.77 (1.54, 4.97)
1.0 Reference1.57 (1.00, 2.45)
Maternal DHA levels according to level of stereoacuity at 43m
Stereoacuity Mean (sd) 95% CI
Foveal 2.96 (1.44)N=57
2.57, 3.4
Macular 2.68 (1.45)N=79
2.36, 3.01
Peripheral 2.07 (1.33) 1.41, 2.73N=18
www.alspac.bris.ac.uk
