T. G. M. Vrijkotte

Late start of antenatal care among ethnic minorities in a large cohort of pregnant women

Objectives  The objectives of this study were to investigate the difference in timing of the first antenatal visit between ethnic groups and to explore the contribution of several noneconomic risk factors.

Effect of screening for red cell antibodies, other than anti‐D, to detect hemolytic disease of the fetus and newborn: a population study in the Netherlands

BACKGROUND: Hemolytic disease of the fetus and newborn (HDFN) is a severe disease, resulting from maternal red cell (RBC) alloantibodies directed against fetal RBCs. The effect of a first‐trimester antibody screening program on the timely detection of HDFN caused by antibodies other than anti‐D was evaluated.

Contribution of overweight and obesity to the occurrence of adverse pregnancy outcomes in a multi‐ethnic cohort: population attributive fractions for Amsterdam

Please cite this paper as: Djelantik A, Kunst A, van der Wal M, Smit H, Vrijkotte T. Contribution of overweight and obesity to the occurrence of adverse pregnancy outcomes in a multi‐ethnic cohort: population attributive fractions for Amsterdam. BJOG 2011; DOI: 10.1111/j.1471‐0528.2011.03205.x.

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.

Is psychosocial stress in first ongoing pregnancies associated with pre-eclampsia and gestational hypertension?

Objective  Investigating the association of pre‐eclampsia and gestational hypertension with psychosocial stress in the first half of pregnancy.

The effect of neighbourhood income and deprivation on pregnancy outcomes in Amsterdam, The Netherlands

Background: Studies suggest that the neighbourhoods in which people live influence their health. The main objective of this study was to investigate the associations of neighbourhood-level income and unemployment/social security benefit on pregnancy outcomes: preterm delivery, small for gestational age (SGA), pregnancy-induced hypertension (PIH) and miscarriage/perinatal death in Amsterdam. Methods: A random sample of 7883 from 82 neighbourhoods in Amsterdam. Individual-level data from the Amsterdam Born Children and their Development (ABCD) study were linked to data on neighbourhood-level factors. Multilevel logistic regression was used to estimate odds ratios and neighbourhood-level variance. Results: After adjustment for individual-level factors, women living in low-income neighbourhoods (third, second and first quartiles) were more likely than women living in high-income neighbourhoods (fourth quartile) to have SGA births: OR 1.32 (95% CI 1.04 to 1.68), 1.42 (1.11 to 1.82) and 1.62 (1.25 to 2.08) respectively. Women living in the quartile of neighbourhoods with the highest unemployment/social security benefit were more likely than those living in the quartile with the lowest unemployment/social security benefit to have SGA births 1.36 (1.08 to 1.72). The neighbourhood-level variance was significant only for SGA births. No significant associations were found between neighbourhood-level factors and other pregnancy outcomes. Conclusion: The findings suggest that neighbourhood income and deprivation are related to SGA births. More research is needed to explore possible mechanisms underlying poor neighbourhood environment and pregnancy outcomes, in particular through stress mechanisms. Such information might be necessary to help improve maternal and fetal health.

Ethnic differences in TSH but not in free T4 concentrations or TPO antibodies during pregnancy

Objective  To describe the TSH, free T4 and thyroid peroxidase antibody (TPO‐Ab) concentrations during pregnancy among four ethnic groups and to determine reference values for these parameters during normal pregnancy.

Maternal pre-pregnancy body mass index explains infant’s weight and BMI at 14 months: results from a multi-ethnic birth cohort study

Objective: To investigate the association between (self-reported) maternal pre-pregnancy body mass index (pBMI), and child’s weight, height and BMI at age 14 months. Design: Prospective multi-ethnic community-based cohort study. Setting: Amsterdam, The Netherlands. Participants: 8266 pregnant women from the Amsterdam Born Children and their Development study, filled out a questionnaire covering socio-demographic data, obstetric history, lifestyle, dietary habits and psychosocial factors, 2 weeks after their first antenatal visit. 7730 gave birth to a viable term singleton infant with information on birth weight, gender and pregnancy duration. Growth data were available for 3171 of these children. Main outcome measures: Weight (g), height (cm) and BMI (kg/m2) of the child at age 14 months. Results: pBMI was linearly associated with weight and BMI of the child at age 14 months. One unit increase in pBMI resulted in an increment of 29 g (95% CI 19 to 39) in weight and 0.041 kg/m2 (95% CI 0.030 to 0.053) in BMI. The effect size decreased after adjustment for birth weight (weight: β coefficient 19 g, 95% CI 10 to 28; BMI: β coefficient 0.034 kg/m2, 95% CI 0.023 to 0.046) and hardly changed after adjustment for all other variables (weight: β coefficient 21 g, 95% CI 11 to 30; BMI: β coefficient 0.031 kg/m2, 95% CI 0.019 to 0.043). pBMI was not related to height. Conclusions: pBMI is an independent determinant of weight and BMI of the child at age 14 months. At least one third of this effect is mediated through birth weight.

Risk factors for the presence of non-rhesus D red blood cell antibodies in pregnancy.

Objective  To identify risk factors for the presence of non‐rhesus D (RhD) red blood cell (RBC) antibodies in pregnancy. To generate evidence for subgroup RBC antibody screening and for primary prevention by extended matching of transfusions in women <45 years.

Risk factors for RhD immunisation despite antenatal and postnatal anti‐D prophylaxis

Objective To identify risk factors for Rhesus D (RhD) immunisation in pregnancy, despite adequate antenatal and postnatal anti‐D prophylaxis in the previous pregnancy. To generate evidence for improved primary prevention by extra administration of anti‐D Ig in the presence of a risk factor.