M. van Eijsden

Antenatal maternal anxiety is associated with problem behaviour at age five

BACKGROUND Developmental programming by maternal stress during pregnancy is found to influence behavioural development in the offspring. AIM To prospectively investigate the association between antenatal maternal anxiety and childrens behaviour rated by their mothers and teachers. METHODS In a large, community based birth-cohort (the ABCD-study) antenatal maternal state-anxiety (M = 36.7, SD = 9.8) was measured around the 16th week of gestation. Five years later, 3,446 mothers and 3,520 teachers evaluated 3,758 childrens overall problem behaviour, emotional symptoms, conduct problems, hyperactivity/inattention problems, peer relationship problems and pro-social behaviour. RESULTS Hierarchical multiple regression analysis using a large number of potential covariates revealed that children of mothers who reported higher levels of anxiety during their pregnancy showed more overall problem behaviour, hyperactivity/inattention problems, emotional symptoms, peer relationship problems, conduct problems and showed less pro-social behaviour when mothers rated their childs behaviour. When teachers rated child behaviour, children showed more overall problem behaviour and less pro-social behaviour that was related to antenatal anxiety. The childs sex moderated the association between antenatal anxiety with overall problem behaviour and hyperactivity/inattention problems when reported by the mother. In boys, exposure to antenatal anxiety was associated with a stronger increase in overall problem behaviour compared to girls. Furthermore, antenatal anxiety was significantly related to an increase in hyperactivity/inattention problems in boys, while this was not the case in girls. CONCLUSIONS Exposure to antenatal maternal anxiety is associated with childrens problem behaviour, with different outcome patterns for both sexes. Nevertheless, effect sizes in this study were small.

Ethnic differences in preterm birth and its subtypes: the effect of a cumulative risk profile

Objective  To explore the effect of potentially explanatory risk factors on ethnic differences in the prevalence of preterm birth (PTB) and its subtypes.

Folic acid knowledge and use in a multi‐ethnic pregnancy cohort: the role of language proficiency

Objective  To investigate the role of language proficiency as determinant of folic acid knowledge and use in a multi‐ethnic pregnancy cohort.

Comparison of growth between native and immigrant infants between 0-3 years from the Dutch ABCD cohort

Background: In the Netherlands separate reference charts have been developed for native and immigrant groups to deal with differences in growth patterns in later childhood. The use of these charts, however, is complicated by methodological issues; they do not represent all large Dutch immigrant groups in separate charts despite the differences that have been suggested and the evidence of ethnic disparities in growth dates back to 1997. Aim: Anthropometric measurements from a contemporary multi-ethnic cohort study were created to quantify differences in childhood growth by creating growth charts, separately for boys and girls between the ages of 0–3 years. Subjects and methods: The infants modelled in the charts had a mother born in the Netherlands (n = 3107), Suriname (n = 225), Turkey (n = 203) and Morocco (n = 336). Charts with and without correction for country of origin of the mother were created by using the LMST method. Results: All models including the covariate country of origin of the mother fitted the data better (p < 0.0005), but the observed differences were small. Conclusion: Most remarkable differences were found in the BMI and weight measurements for age charts. Especially girls from mothers born in Turkey and Morocco had an increasingly heavier weight for their age than girls from mothers born in the Netherlands.

Vitamin B12 and folate status in early pregnancy and cardiometabolic risk factors in the offspring at age 5-6 years: findings from the ABCD multi-ethnic birth cohort.

To explore whether maternal vitamin B12 and folate status during early pregnancy are associated with cardiometabolic risk factors in the offspring at age 5–6.

Weight loss in pregnancy and cardiometabolic profile in childhood: findings from a longitudinal birth cohort

To investigate the consequences of weight loss in pregnancy on pregnancy outcomes and cardiometabolic profile in childhood.

No associations of prenatal maternal psychosocial stress with fasting glucose metabolism in offspring at 5–6 years of age

Highly prevalent maternal psychosocial complaints are accompanied by increases in glucocorticoid stress hormones, which may predispose the offspring for type 2 diabetes and cardiovascular disease later in adulthood. The aim of the current research is to study whether prenatal maternal psychosocial stress is associated with parameters of blood glucose metabolism in their children aged 5-6 years. The study design was a prospective birth cohort (the Amsterdam Born Children and their Development study, the Netherlands). Depressive symptoms, pregnancy-related anxiety, parenting daily hassles and job strain were recorded by questionnaire (gestational week 16). A cumulative score was also calculated. Possible sex differences in the associations were considered. The subjects were 1952 mother-child pairs. Outcome measures were fasting glucose (n=1952), C-peptide and insulin resistance (HOMA2-IR) (n=1478) in the children at the age of 5-6 years. The stress scales, single and cumulative, were not associated with glucose/C-peptide/insulin resistance (all P>0.05). We did not find evidence for sex differences. In conclusion, we did not find evidence for an association between psychosocial stress during early pregnancy and parameters of glucose metabolism in offspring at the age of 5-6 years. Differences emerging later in life or in response to a metabolic challenge should not be ruled out.

OP62 The Influence of Prenatal Maternal and Paternal Anxiety and Depression on Cardiovascular Biomarkers in the Child at age 10: Findings from the Avon Longitudinal Study of Parents and Children (ALSPAC)

Background The aim of the current study was to investigate whether exposure to prenatal maternal anxiety and depression influenced later offspring glucose, lipid and inflammatory markers via intrauterine mechanisms. Methods Data from a prospective birth cohort based in the South West of England were used. Our analysis included 2839 mother-children duos and 2361 father-child duos for outcomes assessed at mean age 9.9 years (non-fasting cholesterol, triglycerides, low density and high density lipoprotein cholesterol (LDLc and HDLc), C-reactive protein (CRP) and interleukin 6 (IL–6) and 2011 and 1726 parent-child duos for outcomes at mean age 15.4 years (fasting glucose, insulin, lipids and CRP). We compared associations of maternal exposures with offspring outcomes to those of the same paternal exposures with offspring outcomes. The rationale for this comparison was that if maternal depression/anxiety influenced offspring outcomes via intrauterine mechanisms we would expect stronger maternal compared with paternal associations. We also examined whether any association of exposures during pregnancy reflected a postnatal effect, with persistence of depression/anxiety into the postnatal period. Results Maternal anxiety at 18 and 32 weeks gestation, and maternal depression at 32 weeks gestation were associated with increased CRP in children at 9.9 years (mean difference (95% CI): 0.031 (0.005 to 0.057), 0.030 (0.004 to 0.056), and 0.021 (0.003 to 0.040) respectively), but not at 15.4 years. These associations remained when adjusting for potential confounders (maternal age, ethnicity, pre-pregnancy BMI, parity, social class, smoking and alcohol consumption). Paternal anxiety and depression (measured at 18 weeks gestation)were also associated with increased CRP in children at 9.9 years (mean difference (95% CI): 0.039 (0.003 to 0.076) and 0.026 (0–0.052) respectively), but not at 15.4 years. The magnitudes of the paternal associations were similar to those seen in mothers. Maternal and paternal postnatal depression/anxiety symptoms were also associated with offspring CRP at age 9.9 and appeared to explain much of the antenatal association. There were no consistent associations between maternal or paternal anxiety or depression during the antenatal or postnatal periods and any of offspring glucose, insulin, IL-6 or lipids at either age. Conclusion We have found evidence of a relationship between maternal and paternal anxiety and depression during pregnancy and CRP levels in childhood, which does not persist to adolescence. Our results suggest that these associations are unlikely to be explained by intrauterine mechanisms and may be explained by shared familial confounding or postnatal effects.

218 Socioeconomic Status in Relation to Lipid and Glucose Metabolism in Early Childhood. The ABCD-Study

Objective The objective of this study was to explore the relations of socioeconomic status to lipid and glucose metabolism as indicators of cardiovascular health in 5–6 year olds. Methods In 1308 5–6 year old ethnic Dutch children from the ABCD cohort study, lipids (cholesterol, LDL-C, HDL-C, triglycerides), glucose and C-peptide (n = 974) were measured after an overnight-fast. Insulin resistance was calculated with HOMA. Using linear regression the association of lipid and glucose metabolism to socioeconomic status as indicated by maternal education and income adequacy was examined. Results There were no differences in cholesterol, HDL-C, LDL-C, and triglycerides between socioeconomic groups. However, children with low educated mothers had on average a higher glucose (p=0.01), C-peptide (p = 0.001), and insulin resistance (p = 0.001) compared to children with high educated mothers. These associations could not be explained by birth weight, maternal BMI, breastfeeding duration, and physical activity. Childhood BMI partly explains these associations, but after adjustment for BMI the association between maternal education and markers of the glucose metabolism remained significant (models controlled for age, height, and sex). Conclusion Socioeconomic status appears to be an independent risk factor for cardiovascular function and seems to emerge in early childhood. In absence of underlying mechanisms these empirical findings are relevant for public health care and further explanatory research.