J.P. van Wouwe

Unchanged prevalence of Down syndrome in the Netherlands: results from an 11-year nationwide birth cohort

This study aims to evaluate trends in prevalence of Down syndrome (DS) births in the Netherlands over an 11‐year period and how they have been affected by maternal age and introduction of prenatal screening.

Ascorbic acid supplementation and copper status in rats.

The effect of a high concentration (1%, w/w) of ascorbic acid in a Cu-adequate (150 μmol/kg) purified diet was studied in rats. After 6 wk, ascorbic acid had significantly reduced Cu concentrations in muscle and bone. The estimated whole body content of Cu in rats fed ascorbic acid was reduced by 20%. Within 1 d after oral administration of64Cu, the recovery of the dose in feces was increased in rats fed ascorbic acid, suggesting that the vitamin depresses intestinal absorption of Cu.After intraperitoneal (ip) administration of64Cu, the rate of loss of the dose from the body was decreased in rats fed ascorbic acid. This study suggests that the ascorbic acid induces a decreased efficiency of intestinal Cu absorption, which in turn triggers mechanisms to preserve Cu in the body stores. This is supported by the observation that the feeding of a Cu-deficient diet (5 μmol/kg) had similar effects, although more pronounced.

The Attitudes and Intention to Participate in Hemoglobinopathy Carrier Screening in The Netherlands among Individuals from Turkish, Moroccan, and Surinamese Descent

Objective. To explore factors that influence intention to participate in hemoglobinopathy (HbP) carrier screening under Dutch subjects at risk, since HbP became more common in The Netherlands. Method. Structured interviews with 301 subjects from Turkish, Moroccan, or Surinamese ethnicity. Results. Half of the participants were familiar with HbP, 27% with carrier screening. Only 55% correctly answered basic knowledge items. After balanced information, 83% percent of subjects express intention to participate in HbP carrier screening. Intention to participate was correlated with (1) anticipated negative feelings, (2) valuing a physicians advice, and (3) beliefs on significance of carrier screening. Risk perception was a significant determinant, while respondents were unaware of HbP as endemic in their country of birth. Respondents preferred screening before pregnancy and at cost < 50€. Conclusion. These findings show the importance of informing those at risk by tailored health education. We propose easy access at no costs for those willing to participate in HbP carrier screening.

6 HOW TO DIAGNOSE ZINC-DEFICIENCY|[quest]|

Zinc-deficiency occurs in well-nourished children and is mostly of dietary origin. Vulnerability to infection, diarrhea, anorexia and growth retardation is its consequence. Easy reliable techniques to diagnose Zn-deficiency are not available. We have studied for this purpose:-].salivary-Zn (0.08±0.03), urinary-Zn (480±135 ppm/day) and plasma-Zn (0.86±0.15 ppm steady decreasing for 6 hr after 100 mg egg) in volunteers (in one person no plasma decrease) .-2.erythrocyte-Zn and in vitro uptake of 65-Zn in Zn-deficient rats (dietary-Zn v uptake r=0.99).-3.the behaviour of tracer Zn in mice (65-Zn, biological T½, excretion and distribution), and humans (69m-Zn figl). For pediatric use we have developed a stable-Zn loading test (68-Zn fig2). We expect the in vitro 65-Zn uptake by erythrocytes becomes a routine test to reliably diagnose Zn-deficiency.Zinc-deficiency occurs in well-nourished children and is mostly of dietary origin. Vulnerability to infection, diarrhea, anorexia and growth retardation is its consequence. Easy reliable techniques to diagnose Zn-deficiency are not available. We have studied for this purpose:-].salivary-Zn (0.08±0.03), urinary-Zn (480±135 ppm/day) and plasma-Zn (0.86±0.15 ppm steady decreasing for 6 hr after 100 mg egg) in volunteers (in one person no plasma decrease) .-2.erythrocyte-Zn and in vitro uptake of 65-Zn in Zn-deficient rats (dietary-Zn v uptake r=0.99).-3.the behaviour of tracer Zn in mice (65-Zn, biological T½, excretion and distribution), and humans (69m-Zn figl). For pediatric use we have developed a stable-Zn loading test (68-Zn fig2). We expect the in vitro 65-Zn uptake by erythrocytes becomes a routine test to reliably diagnose Zn-deficiency.

Normal hair zinc levels of children : Are they affected by drinking-water hardness?

From literature data, a negative correlation was derived between the normal average hair zinc levels of 5-yr-old children and the calcium levels in their drinking water (hair zinc level in mg/kg=−(0.158±0.003) calcium level in mg/L+134;r=0.993,n=6,p=0.0006). Exposure of hair samples of a 5-yr-old child to water with different levels of calcium and zinc did not provide evidence for an exogenous effect of calcium in drinking water on hair zinc levels. Thus, these results support Gibson’s hypothesis that calcium in hard drinking water interferes with Zn absorption.From literature data, a negative correlation was derived between the normal average hair zinc levels of 5-yr-old children and the calcium levels in their drinking water (hair zinc level in mg/kg=-(0.158±0.003) calcium level in mg/L+134;r=0.993,n=6,p=0.0006). Exposure of hair samples of a 5-yr-old child to water with different levels of calcium and zinc did not provide evidence for an exogenous effect of calcium in drinking water on hair zinc levels. Thus, these results support Gibsons hypothesis that calcium in hard drinking water interferes with Zn absorption.

A reference curve for relative weight loss for breast-fed infants to detect hypernatraemic dehydration

BACKGROUND/AIMS: To construct a reference growth chart for breast-fed infants between postnatal day 2 and 11 and to assess its validity in detecting infants with hypernatraemic dehydration. The participants are 1,544 healthy (exclusively) breast-fed infants with 3,075 measurements born during 2002 in three primary care midwife practices in the Netherlands and 83 cases of breast-fed infants with hypernatraemic dehydration obtained by a search of the literature.METHODS: Outcome measure was relative weight loss (weight loss compared to birth weight in %). A reference chart for relative weight loss was obtained by the LMS method, in which centiles are estimated by the Box-Cox power (L-curve), the median (M-curve) and the coefficient of variation (S-curve).RESULTS: The 0.6 centile (= -2.5 SDS) is -11.1% (2 days), -11.9% (3 days), -11.8% (4 days), -11.3% (5 days), -11.0% (6 days), -10.6% (7 days), -10.2% (8 days), -9.8% (9 days), -9.6% (10 days) and -9.5% (11 days). This centile is used as a test to detect children at risk of hypernatraemic dehydration. The test is considered positive if a breast-fed childs relative weight loss decreases below -2.5 SDS and negative if it stays above. Sensitivity (percentage of infants with hypernatraemic dehydration with a positive test) is 86%. Specificity is by definition 99.4%. Positive predictive value is 9.3%, assuming a prevalence of 7.1 per 10,000 breast-fed infants. Cases with a negative test have a mean plasma sodium concentration of 153 mmol/l and cases with a positive test have a mean sodium concentration of 163 mmol/l.CONCLUSIONS: A growth chart for relative weight loss for breast-fed infants in the first days after birth can be helpful to detect infants at risk of hypernatraemic dehydration.

Oral 65Zn Loading Test in Rats Fed Iri-Ob Diet with Various Zn Concentrations

The metal Zn is of biological importance as cofactor in enzymes, active in all major metabolic pathways. Deficiency of Zn is characterized by delay of cell multiplication and tissue growth. No specific biochemical indicator of deficiency is available. Homeostatic mechanisms in deficiency state have been proven by radiotracer whole body retention studies: the increase of biological halftime Tb is a reliable tool to diagnose (degrees of) Zn deficiency. Laboratory animals provide a suitable model to study the physiology of the homeostasis. Rats and mice react immediatelly with growth retardation when becoming Zn deficient (1). Available radiotracers for retention studies are 65Zn (Tf=235 day, ϒ-peak 1. 12 MeV) and 69Zn (Tf=12h, ϒ-peak 0.44 MeV).

PS-313 An Inquiry Into Alcohol Consumption During Pregnancy In The Netherlands (2007–2010)

Background and aims Alcohol consumption during pregnancy is associated with several adverse outcomes for the developing child, of which fetal alcohol syndrome (FAS) is the most well-known. In The Netherlands it is recommended not to drink any alcohol while pregnant. Our objective was to describe the prevalence and pattern of alcohol consumption during pregnancy in the Netherlands. Methods In 2007 and 2010 we undertook two nation-wide surveys amongst mothers who brought their infant aged ≤6 months to a well-baby clinic. Survey-data were weighted for educational attainments to represent national figures. Results In 2007 data were obtained from 2768 and in 2010 from 1448 women. Between 2007 and 2010, the frequency of drinking did not increase, but the amount per occasion did. Overall, 21% of women reported that they had drunk alcohol during pregnancy. Of women who drank alcohol during the first 3 months, 25% reported 1–3 drinking occasions per month; 7% reported weekly intake, and 0.5% reported daily intake of alcohol. Binge drinking (≥6 drinks/occasion) while pregnant was reported by 8%. In 2007, 53% had <1, 40% had 1–3, and 7% had ≥3 drinks/occasion. In 2010 this was respectively 4%, 83%, and 13%. As compared to the first three months, in the last six months of pregnancy alcohol intake was somewhat less. Alcohol consumption in pregnancy was more prevalent amongst older (≥35 years of age), higher educated women, and amongst women who reported that they had smoked tobacco products while pregnant (adj. OR 2.06; 95% CI 1.51–2.73). Conclusions Despite current recommendations, in 2007 and 2010, 21% of Dutch women drank alcohol while pregnant.

Primaire preventie van overgewicht: gevoelige leeftijdsintervallen en predictie. Het Terneuzen Geboorte Cohort

In het Terneuzen Onderzoek naar Preventie zijn overgewicht en cardiometabole risicofactoren op jongvolwassen leeftijd bestudeerd in relatie tot de veranderingen in body mass index (BMI) tussen de geboorte en 18-jarige leeftijd. Deze studie is gebaseerd op het Terneuzen Geboorte Cohort, waarbij prospectief verkregen gegevens zijn verkregen via de jeugdgezondheidszorg (JGZ) van GGD Zeeland. Bij de analyses is gebruik gemaakt van de brokenstickmethode en van lineaire en logistische regressieanalyses. Het leeftijdsinterval 2-6 jaar was het meest voorspellend voor overgewicht en de meeste cardiometabole uitkomsten op jongvolwassen leeftijd. Deze resultaten vragen speciale aandacht van de JGZ voor een stijgende BMI-standaarddeviatiescore (SDS) gedurende het leeftijdsinterval 2-6 jaar, ook als er nog geen sprake is van overgewicht. Hierbij kunnen predictie-instrumenten nuttig zijn. Het monitoren en stabiliseren van de BMI SDS gedurende dit leeftijdsinterval draagt waarschijnlijk niet alleen bij aan de preventie van overgewicht op jongvolwassen leeftijd, maar ook aan een goede cardiometabole gezondheidstoestand op latere leeftijd.

Unchanged prevalence of Down syndrome in the Netherlands

This study aims to evaluate trends in prevalence of Down syndrome (DS) births in the Netherlands over an 11‐year period and how they have been affected by maternal age and introduction of prenatal screening.