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2. Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis

Author

Voerman, Ellis, Santos, Susana, Golab, Bernadeta Patro, Amiano, Pilar, Ballester, Ferran, Barros, Henrique, Bergström, Anna, Charles, Marie-Aline, Chatzi, Leda, Chevrier, Cécile, Chrousos, George P, Corpeleijn, Eva, Costet, Nathalie, Crozier, Sarah, Devereux, Graham, Eggesbø, Merete, Ekström, Sandra, Fantini, Maria Pia, Farchi, Sara, Forastiere, Francesco, Georgiu, Vagelis, Godfrey, Keith M, Gori, Davide, Grote, Veit, Hanke, Wojciech, Hertz-Picciotto, Irva, Heude, Barbara, Hryhorczuk, Daniel, Huang, Rae-Chi, Inskip, Hazel, Iszatt, Nina, Karvonen, Anne M, Kenny, Louise C, Koletzko, Berthold, Küpers, Leanne K, Lagström, Hanna, Lehmann, Irina, Magnus, Per, Majewska, Renata, Mäkelä, Johanna, Manios, Yannis, McAuliffe, Fionnuala M, McDonald, Sheila W, Mehegan, John, Mommers, Monique, Morgen, Camilla S, Mori, Trevor A, Moschonis, George, Murray, Deirdre, Chaoimh, Carol Ní, Nohr, Ellen A, Andersen, Anne-Marie Nybo, Oken, Emily, Oostvogels, Adriëtte JJM, Pac, Agnieszka, Papadopoulou, Eleni, Pekkanen, Juha, Pizzi, Costanza, Polanska, Kinga, Porta, Daniela, Richiardi, Lorenzo, Rifas-Shiman, Sheryl L, Ronfani, Luca, Santos, Ana C, Standl, Marie, Stoltenberg, Camilla, Thiering, Elisabeth, Thijs, Carel, Torrent, Maties, Tough, Suzanne C, Trnovec, Tomas, Turner, Steve, van Rossem, Lenie, von Berg, Andrea, Vrijheid, Martine, Vrijkotte, Tanja GM, West, Jane, Wijga, Alet, Wright, John, Zvinchuk, Oleksandr, Sørensen, Thorkild IA, Lawlor, Debbie A, Gaillard, Romy, and Jaddoe, Vincent WV

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Nutrition and Dietetics, Reproductive Medicine, Nutrition, Prevention, Pediatric, Clinical Research, Obesity, Oral and gastrointestinal, Stroke, Reproductive health and childbirth, Cardiovascular, Generic health relevance, Metabolic and endocrine, Cancer, Australia, Body Mass Index, Cohort Studies, Data Analysis, Europe, Female, Gestational Weight Gain, Humans, North America, Overweight, Pediatric Obesity, Pregnancy, Risk Factors, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundMaternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact.Methods and findingsWe conducted an individual participant data meta-analysis of data from 162,129 mothers and their children from 37 pregnancy and birth cohort studies from Europe, North America, and Australia. We assessed the individual and combined associations of maternal pre-pregnancy BMI and gestational weight gain, both in clinical categories and across their full ranges, with the risks of overweight/obesity in early (2.0-5.0 years), mid (5.0-10.0 years) and late childhood (10.0-18.0 years), using multilevel binary logistic regression models with a random intercept at cohort level adjusted for maternal sociodemographic and lifestyle-related characteristics. We observed that higher maternal pre-pregnancy BMI and gestational weight gain both in clinical categories and across their full ranges were associated with higher risks of childhood overweight/obesity, with the strongest effects in late childhood (odds ratios [ORs] for overweight/obesity in early, mid, and late childhood, respectively: OR 1.66 [95% CI: 1.56, 1.78], OR 1.91 [95% CI: 1.85, 1.98], and OR 2.28 [95% CI: 2.08, 2.50] for maternal overweight; OR 2.43 [95% CI: 2.24, 2.64], OR 3.12 [95% CI: 2.98, 3.27], and OR 4.47 [95% CI: 3.99, 5.23] for maternal obesity; and OR 1.39 [95% CI: 1.30, 1.49], OR 1.55 [95% CI: 1.49, 1.60], and OR 1.72 [95% CI: 1.56, 1.91] for excessive gestational weight gain). The proportions of childhood overweight/obesity prevalence attributable to maternal overweight, maternal obesity, and excessive gestational weight gain ranged from 10.2% to 21.6%. Relative to the effect of maternal BMI, excessive gestational weight gain only slightly increased the risk of childhood overweight/obesity within each clinical BMI category (p-values for interactions of maternal BMI with gestational weight gain: p = 0.038, p < 0.001, and p = 0.637 in early, mid, and late childhood, respectively). Limitations of this study include the self-report of maternal BMI and gestational weight gain for some of the cohorts, and the potential of residual confounding. Also, as this study only included participants from Europe, North America, and Australia, results need to be interpreted with caution with respect to other populations.ConclusionsIn this study, higher maternal pre-pregnancy BMI and gestational weight gain were associated with an increased risk of childhood overweight/obesity, with the strongest effects at later ages. The additional effect of gestational weight gain in women who are overweight or obese before pregnancy is small. Given the large population impact, future intervention trials aiming to reduce the prevalence of childhood overweight and obesity should focus on maternal weight status before pregnancy, in addition to weight gain during pregnancy.

Published
2019

3. Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania

Author

Santos, Susana, Eekhout, Iris, Voerman, Ellis, Gaillard, Romy, Barros, Henrique, Charles, Marie-Aline, Chatzi, Leda, Chevrier, Cécile, Chrousos, George P, Corpeleijn, Eva, Costet, Nathalie, Crozier, Sarah, Doyon, Myriam, Eggesbø, Merete, Fantini, Maria Pia, Farchi, Sara, Forastiere, Francesco, Gagliardi, Luigi, Georgiu, Vagelis, Godfrey, Keith M, Gori, Davide, Grote, Veit, Hanke, Wojciech, Hertz-Picciotto, Irva, Heude, Barbara, Hivert, Marie-France, Hryhorczuk, Daniel, Huang, Rae-Chi, Inskip, Hazel, Jusko, Todd A, Karvonen, Anne M, Koletzko, Berthold, Küpers, Leanne K, Lagström, Hanna, Lawlor, Debbie A, Lehmann, Irina, Lopez-Espinosa, Maria-Jose, Magnus, Per, Majewska, Renata, Mäkelä, Johanna, Manios, Yannis, McDonald, Sheila W, Mommers, Monique, Morgen, Camilla S, Moschonis, George, Murínová, Ľubica, Newnham, John, Nohr, Ellen A, Andersen, Anne-Marie Nybo, Oken, Emily, Oostvogels, Adriëtte JJM, Pac, Agnieszka, Papadopoulou, Eleni, Pekkanen, Juha, Pizzi, Costanza, Polanska, Kinga, Porta, Daniela, Richiardi, Lorenzo, Rifas-Shiman, Sheryl L, Roeleveld, Nel, Santa-Marina, Loreto, Santos, Ana C, Smit, Henriette A, Sørensen, Thorkild IA, Standl, Marie, Stanislawski, Maggie, Stoltenberg, Camilla, Thiering, Elisabeth, Thijs, Carel, Torrent, Maties, Tough, Suzanne C, Trnovec, Tomas, van Gelder, Marleen MHJ, van Rossem, Lenie, von Berg, Andrea, Vrijheid, Martine, Vrijkotte, Tanja GM, Zvinchuk, Oleksandr, van Buuren, Stef, and Jaddoe, Vincent WV

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Health Sciences, Conditions Affecting the Embryonic and Fetal Periods, Pediatric, Nutrition, Obesity, Clinical Research, Prevention, Perinatal Period - Conditions Originating in Perinatal Period, Metabolic and endocrine, Reproductive health and childbirth, Good Health and Well Being, Adult, Body Mass Index, Europe, Female, Gestational Weight Gain, Humans, North America, Oceania, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Risk Factors, Weight gain, Charts, References, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundGestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies.MethodsWe used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape.ResultsWe observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications.ConclusionsGestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.

Published
2018

4. Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis

Author

Golab, Bernadeta Patro, Santos, Susana, Voerman, Ellis, Lawlor, Debbie A, Jaddoe, Vincent WV, Gaillard, Romy, Authors, MOCO Study Group, Barros, Henrique, Bergström, Anna, Charles, Marie-Aline, Chatzi, Leda, Chevrier, Cécile, Chrousos, George P, Corpeleijn, Eva, Costet, Nathalie, Crozier, Sarah, Devereux, Graham, Eggesbø, Merete, Ekström, Sandra, Fantini, Maria P, Farchi, Sara, Forastiere, Francesco, Georgiu, Vagelis, Godfrey, Keith M, Gori, Davide, Hanke, Wojciech, Hertz-Picciotto, Irva, Heude, Barbara, Hryhorczuk, Daniel, Inskip, Hazel, Ibarluzea, Jesus, Kenny, Louise C, Küpers, Leanne K, Lagström, Hanna, Lehmann, Irina, Lenters, Virissa, Llop, Sabrina Llop, Magnus, Per, Majewska, Renata, Mäkelä, Johanna, Manios, Yannis, McAuliffe, Fionnuala M, McDonald, Sheila W, Mehegan, John, Mommers, Monique, Morgen, Camilla S, Moschonis, George, Murray, Deirdre, Chaoimh, Carol Ní, Nøhr, Ellen A, Andersen, Anne-Marie Nybo, Oken, Emily, Oostvogels, Adriëtte JJM, Pac, Agnieszka, Papadopoulou, Eleni, Pizzi, Costanza, Polanska, Kinga, Porta, Daniela, Richiardi, Lorenzo, Rifas-Shiman, Sheryl L, Rusconi, Franca, Santos, Ana C, Smit, Henriette A, Sørensen, Thorkild IA, Standl, Marie, Stoltenberg, Camilla, Sunyer, Jordi, Taylor, Michelle, Thiering, Elisabeth, Thijs, Carel, Torrent, Maties, Tough, Suzanne C, Trnovec, Tomas, Turner, Steve, van Rossem, Lenie, von Berg, Andrea, Vrijheid, Martine, Vrijkotte, Tanja, West, Jane, Wright, John, and Zvinchuk, Oleksandr

Subjects
Nutrition, Contraception/Reproduction, Pediatric, Obesity, Prevention, Clinical Research, Cardiovascular, Perinatal Period - Conditions Originating in Perinatal Period, Diabetes, Aetiology, 2.1 Biological and endogenous factors, Metabolic and endocrine, Reproductive health and childbirth, Adolescent, Animals, Body Mass Index, Child, Child, Preschool, Diabetes, Gestational, Europe, Female, Humans, Hypertension, Pregnancy-Induced, Life Style, North America, Pediatric Obesity, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Risk Factors, MOCO Study Group Authors
Abstract

BackgroundGestational diabetes and gestational hypertensive disorders are associated with offspring obesity, but the role of maternal adiposity in these associations remains unclear. We aimed to investigate whether these pregnancy complications affect the odds of offspring obesity independently of maternal obesity.MethodsWe did an individual participant data (IPD) meta-analysis of mother-offspring pairs from prospective birth cohort studies that had IPD on mothers with singleton liveborn children born from 1989 onwards and had information available about maternal gestational diabetes, gestational hypertension or pre-eclampsia, and childhood body-mass index (BMI). We applied multilevel mixed-effects models to assess associations of gestational diabetes, gestational hypertension, and pre-eclampsia with BMI SD scores and the odds of overweight and obesity throughout childhood, adjusting for lifestyle characteristics (offspring's sex, maternal age, educational level, ethnicity, parity, and smoking during pregnancy). We then explored the extent to which any association was explained by maternal pre-pregnancy or early-pregnancy BMI.Findings160 757 mother-offspring pairs from 34 European or North American cohorts were analysed. Compared with uncomplicated pregnancies, gestational diabetes was associated with increased odds of overweight or obesity throughout childhood (odds ratio [OR] 1·59 [95% CI 1·36 to 1·86] for early childhood [age 2·0-4·9 years], 1·41 [1·26 to 1·57] for mid childhood [5·0-9·9 years], and 1·32 [0·97 to 1·78] for late childhood [10·0-17·9 years]); however, these associations attenuated towards the null following adjustment for maternal BMI (OR 1·35 [95% CI 1·15 to 1·58] for early childhood, 1·12 [1·00 to 1·25] for mid childhood, and 0·96 [0·71 to 1·31] for late childhood). Likewise, gestational hypertension was associated with increased odds of overweight throughout childhood (OR 1·19 [95% CI 1·01 to 1·39] for early childhood, 1·23 [1·15 to 1·32] for mid childhood, and 1·49 [1·30 to 1·70] for late childhood), but additional adjustment for maternal BMI largely explained these associations (1·01 [95% CI 0·86 to 1·19] for early childhood, 1·02 [0·95 to 1·10] for mid childhood, and 1·18 [1·03 to 1·36] for late childhood). Pre-eclampsia was associated with decreased BMI in early childhood only (difference in BMI SD score -0·05 SD score [95% CI -0·09 to -0·01]), and this association strengthened following additional adjustment for maternal BMI.InterpretationAlthough lowering maternal risk of gestational diabetes, gestational hypertension, and pre-eclampsia is important in relation to maternal and fetal pregnancy outcomes, such interventions are unlikely to have a direct impact on childhood obesity. Preventive strategies for reducing childhood obesity should focus on maternal BMI rather than on pregnancy complications.FundingEU's Horizon 2020 research and innovation programme (LifeCycle Project).

Published
2018

12. MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

Author

Aberer, Werner, Adachi, Mitsuru, Agache, Ioana, Akdis, Cezmi, Akdis, Mubeccel, Annesi-Maesano, Isabella, Ansotegui, Ignacio J., Anto, Josep M., Arshad, S. Hasan, Baiardini, Ilaria, Baigenzhin, Abay K., Barbara, Cristina, Bateman, Eric D., Beghé, Bianca, Bel, Elisabeth H., Ben Kheder, Ali, Bennoor, Kazi S., Benson, Michael, Bernstein, David, Michael, Bewick, Thomas, Bieber, Bindslev-Jensen, Carsten, Bjermer, Leif, Blain, Hubert, Boner, Attilio, Bonini, Matteo, Bonini, Sergio, Bosse, Isabelle, Bouchard, Jacques, Boulet, Louis-Philippe, Bourret, Rodolphe A., Bousquet, Philippe J., Braido, Fulvio, Briggs, Andrew H., Brightling, Christopher E., Buhl, Roland, Burney, Peter, Bush, Andrew, Caballero-Fonseca, Fernando, Caimmi, Davide P., Camargos, Paulo, Camuzat, Thierry, Carlsen, Kai-Hakon, Carr, Warner, Casale, Thomas B., Sarabia, Alfonso Cepeda, Chatzi, Leda, Chen, Yuzhi, Chiron, Raphaël, Chkhartishvili, Ekaterine, Chuchalin, Alexander, Ciprandi, Georgio, Cirule, Ieva, Correia de Sousa, Jaime, Costa, David, Crooks, George, Custovic, Adnan, Dahlen, Sven-Erik, Darsow, Ulf, De Blay, Frédéric, De Manuel Keenoy, Esteban, Dedeu, Tony, Deleanu, Diana, Denburg, Judah, Didier, Alain, Dinh-Xuan, Anh-Tuan, Dokic, Dejan, Douagui, Habib B., Dubakiene, Ruta, Durham, Stephen, Dykewicz, Mark, El-Gamal, Yehia, Emuzyte, Regina, Fink-Wagner, Antje, Fiocchi, Alessandro, Forastiere, Francesco, Gamkrelidze, Amiran, Gemicioğlu, Bilun, Gereda, Jose E., Gerth van Wijk, Roy, Gotua, Maia, Grisle, Ineta, Guzmán, M. Antonieta, Haahtela, Tari, Heinrich, Joachim, Hellquist-Dahl, Birthe, Horak, Friedrich, Howarth, Peter H., Humbert, Marc, Hyland, Michael, Ivancevich, Juan-Carlos, Jares, Edgardo J., Johnston, Sebastian L., Jonquet, Olivier, Joos, Guy, Jung, Ki-Suck, Just, Jocelyne, Jutel, Marek, Kaidashev, Igor P., Khaitov, Musa, Kalayci, Omer, Kalyoncu, Fuat, Keith, Paul, Khaltaev, Nikolai, Kleine-Tebbe, Jorg, Klimek, Ludger, N'Goran, Bernard Koffi, Kolek, Vitezlav, Koppelman, Gerard H., Kowalski, Marek, Kull, Inger, Kvedariene, Violeta, Lambrecht, Bart, Lau, Susanne, Laune, Daniel, Le Thi Tuyet, Lan, Li, Jing, Lieberman, Phillipe, Lipworth, Brian J., Renaud, Louis, Magard, Yves, Magnan, Antoine, Mahboub, Bassam, Majer, Ivan, Makela, Mika, Manning, Peter J., Masjedi, Mohamad R., Maurer, Marcus, Mavale-Manuel, Sandra, Melén, Erik, Melo-Gomes, Elisabete, Mercier, Jacques, Merk, Hans, Miculinic, Neven, Mihaltan, Florin, Milenkovic, Branislava, Mohammad, Yousser, Molimard, Mathieu, Momas, Isabelle, Montilla-Santana, Anna, Morais-Almeida, Mario, Mösges, Ralph, Nadif, Rachel, Namazova-Baranova, Leyla, Neffen, Hugo, Nekam, Kristof, Neou, Angelos, Niggemann, Bodo, Nyembue, Dieudonné, O'Hehir, Robyn, Ohta, Ken, Okamoto, Yoshitaka, Okubo, Kim, Ouedraogo, Solange, Paggiaro, Pier-Luigi, Pali-Schöll, Isabella, Palmer, Stephen, Panzner, Petr, Papi, Alberto, Park, Hae-Sim, Pavord, Ian, Pawankar, Ruby, Pfaar, Oliver, Picard, Robert, Pigearias, Bernard, Pin, Isabelle, Plavec, Davor, Pohl, Wolfgang, Popov, Todor, Postma, Dirkje S., Potter, Paul, Poulsen, Lars K., Rabe, Klaus F., Raciborski, Filip, Pontal, Françoise Radier, Reitamo, Sakari, Repka-Ramirez, Maria-Susana, Robalo-Cordeiro, Carlos, Roberts, Graham, Rodenas, Francisco, Rolland, Christine, Rodriguez, Miguel Roman, Romano, Antonino, Rosado-Pinto, José, Rosario, Nelson A., Rosenwasser, Larry, Rottem, Menachem, Sanchez-Borges, Mario, Sastre-Dominguez, Joaquim, Schmid-Grendelmeier, Peter, Serrano, Eli, Simons, F. Estelle R., Sisul, Juan-Carlos, Skrindo, Ingebjorg, Smit, Henriette A., Solé, Dirceu, Sooronbaev, Talant, Spranger, Otto, Stelmach, Rafael, Strandberg, Timo, Sunyer, Jordi, Thijs, Carel, Todo-Bom, Ana-Maria, Triggiani, Massimo, Valenta, Rudolf, Valero, Antonio L., van Hage, Marianne, Vandenplas, Olivier, Vezzani, Giorgio, Vichyanond, Pakit, Viegi, Giovanni, Wagenmann, Martin, Wahn, Ulrich, De Yun, Wang, Williams, Denis, Wright, John, Yawn, Barbara P., Yiallouros, Panayiotis, Yusuf, Osman M., Zar, Heather J., Zernotti, Mario, Zhang, Luo, Zhong, Nanshan, Zidarn, Mihaela, Bousquet, Jean, Schünemann, Holger J., Hellings, Peter W., Arnavielhe, Sylvie, Bachert, Claus, Bedbrook, Anna, Bergmann, Karl-Christian, Bosnic-Anticevich, Sinthia, Brozek, Jan, Calderon, Moises, Canonica, G. Walter, Chavannes, Niels H., Cox, Linda, Chrystyn, Henry, Cruz, Alvaro A., Dahl, Ronald, De Carlo, Giuseppe, Demoly, Pascal, Devillier, Phillipe, Dray, Gérard, Fletcher, Monica, Fokkens, Wytske J., Fonseca, Joao, Gonzalez-Diaz, Sandra N., Grouse, Lawrence, Keil, Thomas, Kuna, Piotr, Larenas-Linnemann, Désirée, Lodrup Carlsen, Karin C., Meltzer, Eli O., Mullol, Jaoquim, Muraro, Antonella, Naclerio, Robert N., Palkonen, Susanna, Papadopoulos, Nikolaos G., Passalacqua, Giovanni, Price, David, Ryan, Dermot, Samolinski, Boleslaw, Scadding, Glenis K., Sheikh, Aziz, Spertini, François, Valiulis, Arunas, Valovirta, Erkka, Walker, Samantha, Wickman, Magnus, Yorgancioglu, Arzu, and Zuberbier, Torsten

Published
2016
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16. Association between COVID-19 Primary Vaccination and Severe Disease Caused by SARS-CoV-2 Delta Variant among Hospitalized Patients: A Belgian Retrospective Cohort Study

Author

Robalo, Queeny, De Mot, Laurane, Vandromme, Mathil, Van Goethem, Nina, Gabrio, Andrea, Chung, Pui Yan Jenny, Meurisse, Marjan, Belgian Collaborative Group On Covid-Hospital Surveillance, Catteau, Lucy, Thijs, Carel, Blot, Koen, FHML Methodologie & Statistiek, RS: CAPHRI - R1 - Ageing and Long-Term Care, Epidemiologie, and RS: CAPHRI - R5 - Optimising Patient Care

Subjects
Pharmacology, Infectious Diseases, Drug Discovery, Immunology, Pharmacology (medical), SARS-CoV-2, COVID-19, Delta, hospitalized, vaccine, brand
Abstract

We aimed to investigate vaccine effectiveness against progression to severe COVID-19 (acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission and/or death) and in-hospital death in a cohort of hospitalized COVID-19 patients. Mixed effects logistic regression analyses were performed to estimate the association between receiving a primary COVID-19 vaccination schedule and severe outcomes after adjusting for patient, hospital, and vaccination characteristics. Additionally, the effects of the vaccine brands including mRNA vaccines mRNA-1273 and BNT162b2, and adenovirus-vector vaccines ChAdOx1 (AZ) and Ad26.COV2.S (J&J) were compared to each other. This retrospective, multicenter cohort study included 2493 COVID-19 patients hospitalized across 73 acute care hospitals in Belgium during the time period 15 August 2021–14 November 2021 when the Delta variant (B1.617.2) was predominant. Hospitalized COVID-19 patients that received a primary vaccination schedule had lower odds of progressing to severe disease (OR (95% CI); 0.48 (0.38; 0.60)) and in-hospital death (OR (95% CI); 0.49 (0.36; 0.65)) than unvaccinated patients. Among the vaccinated patients older than 75 years, mRNA vaccines and AZ seemed to confer similar protection, while one dose of J&J showed lower protection in this age category. In conclusion, a primary vaccination schedule protects against worsening of COVID-19 to severe outcomes among hospitalized patients.

Published
2023

18. Early-life respiratory tract infections and the risk of school-age lower lung function and asthma

Author

van Meel, Evelien R, Mensink-Bout, Sara M, den Dekker, Herman T, Ahluwalia, Tarunveer S, Annesi-Maesano, Isabella, Arshad, Syed Hasan, Baïz, Nour, Barros, Henrique, von Berg, Andrea, Bisgaard, Hans, Bønnelykke, Klaus, Carlsson, Christian J, Casas, Maribel, Chatzi, Leda, Chevrier, Cecile, Dalmeijer, Geertje, Dezateux, Carol, Duchen, Karel, Eggesbø, Merete, van der Ent, Cornelis, Fantini, Maria, Flexeder, Claudia, Frey, Urs, Forastiere, Fransesco, Gehring, Ulrike, Gori, Davide, Granell, Raquel, Griffiths, Lucy J, Inskip, Hazel, Jerzynska, Joanna, Karvonen, Anne M, Keil, Thomas, Kelleher, Cecily, Kogevinas, Manolis, Koppen, Gudrun, Kuehni, Claudia E, Lambrechts, Nathalie, Lau, Susanne, Lehmann, Irina, Ludvigsson, Johnny, Magnus, Maria Christine, Mélen, Erik, Mehegan, John, Mommers, Monique, Nybo Andersen, Anne-Marie, Nystad, Wenche, Pedersen, Eva S L, Pekkanen, Juha, Peltola, Ville, Pike, Katharine C, Pinot de Moira, Angela, Pizzi, Costanza, Polanska, Kinga, Popovic, Maja, Porta, Daniela, Roberts, Graham, Santos, Ana Cristina, Schultz, Erica S, Standl, Marie, Sunyer, Jordi, Thijs, Carel, Toivonen, Laura, Uphoff, Eleonora, Usemann, Jakob, Vafeidi, Marina, Wright, John, de Jongste, Johan C, Jaddoe, Vincent W V, Duijts, Liesbeth, IRAS OH Epidemiology Chemical Agents, Salvy-Córdoba, Nathalie, The Generation R Study Group, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Herlev and Gentofte Hospital, Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), St Mary's Hospital [London], University Hospital Southampton NHS Foundation Trust, Departamento de Ciências da Saúde Pública e Forenses e Educação Médica [Porto, Portugal], Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto-Universidade do Porto = University of Porto, ISPUP-EPIUnit, University of Porto Medical School and Institute of Public Health, Marien-Hospital Wesel gGmbH, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), University of Southern California (USC), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], Barts & The London School of Medicine and Dentistry, Linköping university hospital, Norwegian Institute of Public Health [Oslo] (NIPH), Alma Mater Studiorum University of Bologna (UNIBO), Helmholtz Zentrum München = German Research Center for Environmental Health, University Children’s Hospital Basel = Hôpital pédiatrique universitaire des deux Bâle [Bâle, Suisse] (UKBB), Lazio Regional Health Service [Rome], Institute for Risk Assessment Sciences [Utrecht, The Netherlands] (IRAS), Utrecht University [Utrecht], MRC Integrative Epidemiology Unit [Bristol, Royaume-Uni] (MRC IEU), University of Bristol [Bristol], Swansea University Medical School [Swansea, Royaume-Uni], Swansea University, University of Southampton, Nofer Institute of Occupational Medicine (NIOM), Finnish Institute for Health and Welfare [Helsinki, Finland] (FIHW), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Würzburg = Universität Würzburg, Bavarian Health and Food Safety Authority, School of Public Health, Physiotherapy and Sports Science [Dublin, Irlande], University College Dublin [Dublin] (UCD), National School of Public Health [Athens], IMIM-Hospital del Mar, Generalitat de Catalunya, Flemish Institute for Technological Research (VITO), Institute of Social and Preventive Medicine [Bern] (ISPM), Universität Bern [Bern] (UNIBE), Bern University Hospital [Berne] (Inselspital), Helmholtz Zentrum für Umweltforschung = Helmholtz Centre for Environmental Research (UFZ), Sach's Children's Hospital [Stockholm], Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], University of Copenhagen = Københavns Universitet (UCPH), TKK Helsinki University of Technology (TKK), Turku University Hospital (TYKS), Bristol Royal Hospital for Children, Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Department of Medical Sciences [Turin, Italy] (DMS), Università degli studi di Torino = University of Turin (UNITO), The David Hide Asthma and Allergy Research Centre, St Mary's Hospital-University Hospital Southampton NHS Foundation Trust, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, German Research Center for Environmental Health - Helmholtz Center München (GmbH), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK, University of Crete [Heraklion] (UOC), Epidemiologie, RS: CAPHRI - R5 - Optimising Patient Care, Pediatrics, Epidemiology, IRAS OH Epidemiology Chemical Agents, and Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK (BIHR)

Subjects
Pulmonary and Respiratory Medicine, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Vital Capacity, Infant, 610 Medicine & health, ALSPAC, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Asthma, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 360 Social problems & social services, Child, Preschool, Forced Expiratory Volume, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Humans, Prospective Studies, Child, Preschool, Lung, Respiratory Tract Infections
Abstract

Background: Early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking. Our objective was to examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school age. Methods: We used individual participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow at 75% of FVC (FEF75%) and asthma at a median (range) age of 7 (4-15) years. Results: Children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV1, FEV1/FVC and FEF75% (z-score range: -0.09 (95% CI -0.14- -0.04) to -0.30 (95% CI -0.36- -0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR range: 2.10 (95% CI 1.98-2.22) to 6.30 (95% CI 5.64-7.04) and 1.25 (95% CI 1.18-1.32) to 1.55 (95% CI 1.47-1.65), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as a proxy for early-life asthma. Conclusions: Our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower respiratory tract infections. A comprehensive list of grant funding is available on the ALSPAC website (www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). BAMSE: BAMSE was funded by the Swedish Research Council, the Swedish Heart Lung Foundation, ALF Region Stockholm and SFO Epidemiology Karolinska Institutet. E. Mélen is supported by a European Research Council grant (TRIBAL, 757919). BiB (Born in Bradford): BiB is only possible because of the enthusiasm and commitment of the children and parents in BiB. We are grateful to all the participants, practitioners and researchers who have made BiB happen. The BiB study presents independent research commissioned by the National Institute for Health Research Collaboration for Applied Health Research and Care (NIHR CLAHRC) and the Programme Grants for Applied Research funding scheme (RP-PG-0407-10044). Core support for BiB is also provided by the Wellcome Trust (WT101597MA). BILD: This study was funded by the Swiss National Science Foundation (320030_163311). CoNER: Funds were obtained from the special programme (Programmi speciali – Art.12 bis, comma 6 D.lgs.229/99 Sanitaria e della Vigilanza sugli Enti) funded by the Italian Ministry of Health. Approval for the study was obtained from the Ethics Committee of the S. Orsola-Malpighi Teaching Hospital in April 2004 (52/2004/U/Tess). COPSAC 2000 and COPSAC 2010: All funding received by COPSAC is listed on www.copsac.com. The Lundbeck Foundation (R16-A1694), Ministry of Health (903516), Danish Council for Strategic Research (0603-00280B) and Capital Region Research Foundation have provided core support to the COPSAC research centre. We express our deepest gratitude to the children and families of the COPSAC 2000 and COPSAC 2010 cohort studies for all their support and commitment. We acknowledge and appreciate the unique efforts of the COPSAC research team. DNBC (Danish National Birth Cohort): The authors would like to thank the participants, the first Principal Investigator of DNBC, Jørn Olsen, the scientific managerial team and DNBC secretariat for being, establishing, developing and consolidating the DNBC. The DNBC was established with a significant grant from the Danish National Research Foundation. Additional support was obtained from the Danish Regional Committees, Pharmacy Foundation, Egmont Foundation, March of Dimes Birth Defects Foundation, Health Foundation and other minor grants. The DNBC Biobank has been supported by the Novo Nordisk Foundation and Lundbeck Foundation. Follow-up of mothers and children has been supported by the Danish Medical Research Council (SSVF 0646, 271-08-0839/06-066023, O602-01042B, 0602-02738B), Lundbeck Foundation (195/04, R100-A9193), Innovation Fund Denmark 0603-00294B (09-067124), Nordea Foundation (02-2013-2014), Aarhus Ideas (AU R9-A959-13-S804), University of Copenhagen Strategic Grant (IFSV 2012) and Danish Council for Independent Research (DFF-4183-00594, DFF-4183-00152). A. Pinot de Moira is funded by a Lundbeck Foundation grant (R264-2017-3099). EDEN: We thank the EDEN mother–child cohort study group (I. Annesi-Maesano, J.Y. Bernard, J. Botton, M.A. Charles, P. Dargent-Molina, B. de Lauzon-Guillain, P. Ducimetière, M. de Agostini, B. Foliguet, A. Forhan, X. Fritel, A. Germa, V. Goua, R. Hankard, B. Heude, M. Kaminski, B. Larroque†, N. Lelong, J. Lepeule, G. Magnin, L. Marchand, C. Nabet, F. Pierre, R. Slama, M.J. Saurel-Cubizolles, M. Schweitzer and O. Thiebaugeorges). We thank all funding sources for the EDEN study (not allocated for the present study but for the cohort): Foundation for Medical Research (FRM), National Agency for Research (ANR), National Institute for Research in Public health (IRESP: TGIR cohorte santé 2008 programme), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A) and Human Nutrition National Research Programs, Paris-Sud University, Nestlé, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007-2013, HELIX, ESCAPE, ENRIECO, MeDALL projects), Diabetes National Research Program (in collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle Générale de l'Education Nationale complementary health insurance (MGEN), French national agency for food security, and French speaking association for the study of diabetes and metabolism (ALFEDIAM). The funding source had no involvement in the conception of the present study. FLEHS: This study was conducted within the framework of the Flemish Centre of Expertise on Environment and Health, funded by the Dept of the Environment of the Flemish Government, Flemish Agency of Care and Health, and Flemish Dept of Economy, Science and Innovation. GASPII: The GASPII cohort was funded by the Italian Ministry of Health (2001), the research leading to these results has received funding from the European Community's Seventh Framework Program under grant agreement 261357 (MeDALL). Generation R: This study was funded by Erasmus MC Rotterdam, Erasmus University Rotterdam and the Netherlands Organisation for Health Research and Development. V.W.V. Jaddoe received a grant from the European Research Council (ERC-2014-CoG-648916). L. Duijts received funding from cofunded ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL), Horizon 2020 (696295; 2017), the Netherlands Organisation for Health Research and Development (ZonMw; 529051014; 2017), Science Foundation Ireland (SFI/16/ERA-HDHL/3360), and European Union (ALPHABET project). The project received funding from the European Union's Horizon 2020 research and innovation programme (LIFECYCLE, 733206, 2016; EUCAN-Connect 824989; ATHLETE, 874583). The researchers are independent from the funders. The study sponsors had no role in the study design, data analysis, interpretation of data or writing of this report. Generation XXI: Generation XXI was supported by the European Regional Development Fund (ERDF) through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology (FCT), Portuguese Ministry of Science, Technology and Higher Education, and by the Unidade de Investigação em Epidemiologia – Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (UIDB/04750/2020), Administração Regional de Saúde Norte (Regional Dept of Ministry of Health) and Fundação Calouste Gulbenkian. A.C. Santos is founded by FCT Investigator contracts IF/01060/2015. GINI: The GINIplus study was mainly supported for the first 3 years by the Federal Ministry for Education, Science, Research and Technology (interventional arm) and Helmholtz Zentrum München (former GSF) (observational arm). The 4- and 6-year follow-up examinations of the GINIplus study were covered from the respective budgets of the five study centres (Helmholtz Zentrum München (former GSF), Research Institute at Marien-Hospital, Wesel, LMU Munich, TU Munich and from 6 years onwards also from IUF – Leibniz Research Institute for Environmental Medicine at the University of Düsseldorf). HUMIS: We thank all mothers for participating in the HUMIS study. HUMIS was funded by a grant from the Norwegian Research Council (226402). The HUMIS study was approved by the Norwegian Data Inspectorate (2002/1398) and by the Regional Ethics Committee for Medical Research in Norway (S-02122), and the specific use in the current study was approved by the Ethics Committee as well (2010/1259/REK sør-øst). INMA: Gipuzkoa: This study was funded by grants from Instituto de Salud Carlos III (FIS-PI09/00090, FIS-PI18/01142 including FEDER funds), CIBERESP, Dept of Health of the Basque Government (2013111089) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia and Beasain). Menorca: This study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; 97/0588; 00/0021-2, PI061756; PS0901958, PI14/00677 including FEDER funds), CIBERESP, Beca de la IV convocatoria de Ayudas a la Investigación en Enfemerdades Neurodegeneratives de La Caixa, and EC contract QLK4-CT-200-00263. Sabadell: This study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436; PI081151 including FEDER funds), Generalitat de Catalunya-CIRIT 1999SGR 00241 and Fundació La marató de TV3 (090430). ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya. M. Casas holds a Miguel Servet fellowship (CP16/00128) funded by Instituto de Salud Carlos III and cofunded by the European Social Fund “Investing in your future”. Valencia: This study was funded by grants from the European Union (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Spain: Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0041; FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/1213, PI07/0314, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, PI17/00663; Miguel Servet-FEDER CP11/00178, CP15/00025, CPII16/00051), Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, UGP-15-249), and Alicia Koplowitz Foundation 2017. Isle of Wight: This study was funded by grants from the National Institutes of Health USA (R01HL082925), Asthma UK (364), Isle of Wight NHS Trust and the British Medical Association. KOALA: The collection of data relevant for this study was funded by grants from the Netherlands Organisation for Health Research and Development (ZonMw; 2100.0090) and the Netherlands Asthma Foundation (3.2.03.48, 3.2.07.022). The researchers are independent from the funders. The funders had no role in the study design, data analysis, interpretation of data or writing of this report. We thank the children and parents for their participation in the KOALA study. LRC (Leicestershire Respiratory Cohorts): This study was funded by grants from the Swiss National Science Foundation (SNF: 320030-182628, 320030-162820, 3233-069348, 3200-069349) and Asthma UK 07/048. Lifeways Cross-Generation Cohort Study: This study was funded by the Health Research Board, Ireland, and the Irish Dept of Health and Children's Health Promotion Policy Unit. LISA: The LISA study was mainly supported by grants from the Federal Ministry for Education, Science, Research and Technology and in addition from Helmholtz Zentrum München (former GSF), Helmholtz Centre for Environmental Research – UFZ, Leipzig, Research Institute at Marien-Hospital Bad Honnef for the first 2 years. The 4-, 6-, 10- and 15-year follow-up examinations of the LISA study were covered from the respective budgets of the involved partners (Helmholtz Zentrum München (former GSF), Helmholtz Centre for Environmental Research – UFZ, Leipzig, Research Institute at Marien-Hospital Wesel, Pediatric Practice, Bad Honnef, IUF – Leibniz Research Institute for Environmental Medicine at the University of Düsseldorf) and in addition by a grant from the Federal Ministry for Environment (IUF Düsseldorf, FKZ 20462296). Further, the 15-year follow-up examination of the LISA study was supported by the Commission of the European Communities, the Seventh Framework Program: MeDALL project. This project has received funding from the European Research Council under the European Union’s Horizon 2020 research and innovation programme (949906). LucKi: LucKi is supported by Child and Youth Health Care Zuyderland, Public Health Service South Limburg and Maastricht University. We thank all parents and children for their participation in LucKi. LUKAS: This study was funded by research grants from the Academy of Finland (139021, 287675, 296814, 296817, 308254); Juho Vainio Foundation; EVO/VTR funding; Päivikki and Sakari Sohlberg Foundation; Farmers’ Social Insurance Institution (Mela); Finnish Cultural Foundation; Foundation for Pediatric Research; European Union QLK4-CT-2001-00250; and Finnish Institute for Health and Welfare, Finland. MAS-90: This study was funded by grants from the German Federal Ministry of Education and Research (MBMF; 07015633m 07ALE27, 01EE9405/5, 01EE9406) and the German Research Foundation (DFG; KE1462/2-1). Millennium Cohort Study: This study was funded by the Economic and Social Research Council and a consortium of UK government funders. We are grateful to the participating families and the Centre for Longitudinal Studies (CLS), UCL Institute of Education, for the use of these data and to the UK Data Service for making them available. However, neither CLS nor the UK Data Service bear any responsibility for the analysis or interpretation of these data. This work was supported by the Welcome Trust (187389/B/08/Z). MoBa: The Norwegian Mother, Father and Child Cohort Study is supported by the Norwegian Ministry of Health and Care Services and Ministry of Education and Research. We are grateful to all the participating families in Norway who take part in this ongoing cohort study. This research was supported by the Research Council of Norway through its Centres of Excellence funding scheme (262700). NINFEA: The authors are grateful to all the participants of the NINFEA cohort. The NINFEA study was partially funded by the Compagnia San Paolo Foundation. This research was partially funded by the European Union's Horizon 2020 research and innovation programme (LIFECYCLE, 733206). PELAGIE: We are grateful to the families who participated and continue to participate in the study. The cohort is supported by INSERM and received funding from the French National Research Agency, Fondation de France, French Agency for Food, Environmental and Occupational Health & Safety, National Institute for Public Health Surveillance (InVS), French Ministry of Labour, and French Ministry of Ecology. PIAMA: This study was funded by the Netherlands Organisation of Health Research and Development, Netherlands Organisation for Scientific Research, Netherlands Asthma Fund, Netherlands Ministry of Spatial Planning, Housing and the Environment, and Netherlands Ministry of Health, Welfare and Sport. REPRO_PL: This study was funded by the National Science Center Poland (DEC-2014/15/B/N27/00998). Rhea: This study was funded by the European Union Social Fund and the Hellenic Ministry of Health (“Program of prevention and early diagnosis of obesity and neurodevelopment disorders in preschool age children in the prefecture of Heraklion, Crete, Greece”; MIS 349580, NSRF 2007–2013). Additional funding from the National Institute of Environmental Health Sciences (NIEHS) supported L. Chatzi (R01ES030691, R01ES029944, R01ES030364, R21ES029681, R21ES028903, P30ES007048). STEPS: This study was funded by the University of Turku, Abo Akademi University, Turku University Hospital, Academy of Finland (123571, 140251, 277535) and Foundation for Pediatric Research Finland. SWS: This study was funded by the Medical Research Council, British Heart Foundation, Arthritis Research UK, Food Standards Agency, NIHR Southampton Biomedical Research Centre and the European Union's Seventh Framework Programme (FP7/2007–2013), project EarlyNutrition (289346), and the European Union's Horizon 2020 research and innovation programme (LIFECYCLE, 733206). WHISTLER: The WHISTLER birth cohort was supported with a grant from the Netherlands Organisation for Health Research and Development (2001-1-1322) and by an unrestricted grant from GlaxoSmithKline Netherlands. GlaxoSmithKline had no role in study design, in the collection, analysis and interpretation of data, in the writing of the report, and in the decision to submit the report for publication. WHISTLER-Cardio was supported with an unrestricted strategic grant from the University Medical Center Utrecht (UMCU).

Published
2022

20. Preterm birth, infant weight gain, and childhood asthma risk: A meta-analysis of 147,000 European children

Author

Sonnenschein-van der Voort, Agnes M.M., Arends, Lidia R., de Jongste, Johan C., Annesi-Maesano, Isabella, Arshad, S. Hasan, Barros, Henrique, Basterrechea, Mikel, Bisgaard, Hans, Chatzi, Leda, Corpeleijn, Eva, Correia, Sofia, Craig, Leone C., Devereux, Graham, Dogaru, Cristian, Dostal, Miroslav, Duchen, Karel, Eggesbø, Merete, van der Ent, C. Kors, Fantini, Maria P., Forastiere, Francesco, Frey, Urs, Gehring, Ulrike, Gori, Davide, van der Gugten, Anne C., Hanke, Wojciech, Henderson, A. John, Heude, Barbara, Iñiguez, Carmen, Inskip, Hazel M., Keil, Thomas, Kelleher, Cecily C., Kogevinas, Manolis, Kreiner-Møller, Eskil, Kuehni, Claudia E., Küpers, Leanne K., Lancz, Kinga, Larsen, Pernille S., Lau, Susanne, Ludvigsson, Johnny, Mommers, Monique, Nybo Andersen, Anne-Marie, Palkovicova, Lubica, Pike, Katharine C., Pizzi, Costanza, Polanska, Kinga, Porta, Daniela, Richiardi, Lorenzo, Roberts, Graham, Schmidt, Anne, Sram, Radim J., Sunyer, Jordi, Thijs, Carel, Torrent, Maties, Viljoen, Karien, Wijga, Alet H., Vrijheid, Martine, Jaddoe, Vincent W.V., and Duijts, Liesbeth

Published
2014
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21. Fish intake during pregnancy, fetal growth, and gestational length in 19 European birth cohort studies

Author

Leventakou, Vasiliki, Roumeliotaki, Theano, Martinez, David, Barros, Henrique, Brantsaeter, Anne-Lise, Casas, Maribel, Charles, Marie-Aline, Cordier, Sylvaine, Eggesbø, Merete, van Eijsden, Manon, Forastiere, Francesco, Gehring, Ulrike, Govarts, Eva, Halldórsson, Thorhallur I, Hanke, Wojciech, Haugen, Margaretha, Heppe, Denise HM, Heude, Barbara, Inskip, Hazel M, Jaddoe, Vincent WV, Jansen, Maria, Kelleher, Cecily, Meltzer, Helle Margrete, Merletti, Franco, Moltó-Puigmartí, Carolina, Mommers, Monique, Murcia, Mario, Oliveira, Andreia, Olsen, Sjúrður F, Pele, Fabienne, Polanska, Kinga, Porta, Daniela, Richiardi, Lorenzo, Robinson, Siân M, Stigum, Hein, Strøm, Marin, Sunyer, Jordi, Thijs, Carel, Viljoen, Karien, Vrijkotte, Tanja GM, Wijga, Alet H, Kogevinas, Manolis, Vrijheid, Martine, and Chatzi, Leda

Published
2014
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24. Validating the Children's Behavior Questionnaire in Dutch Children: Psychometric Properties and a Cross-Cultural Comparison of Factor Structures

Author

Sleddens, Ester F. C., Kremers, Stef P. J., Candel, Math J. J. M., De Vries, Nanne N. K., and Thijs, Carel

Abstract

In this article, we examined the factorial validity of the Dutch translation of the Children's Behavior Questionnaire (CBQ) and the Very Short Form scores. In addition, we conducted cross-cultural comparisons of temperament structure. In total, 353 parents of 6- to 8-year-olds completed the instrument. The original higher order factor structure of the different CBQ forms was generally replicated and represented the three broad dimensions of temperament: Surgency/Extraversion, Negative Affectivity, and Effortful Control. For the Standard Form, results demonstrated a relatively high degree of factor similarity of the Dutch sample with other cultures (e.g., China and Japan). The findings provide evidence for applicability of the CBQ in Western Europe as a promising instrument to comprehensively assess reactive and self-regulative temperamental dimensions in young children. (Contains 4 tables.)

Published
2011
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26. Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: A meta-analysis of 150 000 European children

Author

IRAS OH Epidemiology Chemical Agents, van Meel, Evelien R, Mensink-Bout, Sara M, den Dekker, Herman T, Ahluwalia, Tarunveer S, Annesi-Maesano, Isabella, Arshad, Syed Hasan, Baïz, Nour, Barros, Henrique, von Berg, Andrea, Bisgaard, Hans, Bønnelykke, Klaus, Carlsson, Christian J, Casas, Maribel, Chatzi, Leda, Chevrier, Cecile, Dalmeijer, Geertje, Dezateux, Carol, Duchen, Karel, Eggesbø, Merete, van der Ent, Cornelis, Fantini, Maria, Flexeder, Claudia, Frey, Urs, Forastiere, Fransesco, Gehring, Ulrike, Gori, Davide, Granell, Raquel, Griffiths, Lucy J, Inskip, Hazel, Jerzynska, Joanna, Karvonen, Anne M, Keil, Thomas, Kelleher, Cecily, Kogevinas, Manolis, Koppen, Gudrun, Kuehni, Claudia E, Lambrechts, Nathalie, Lau, Susanne, Lehmann, Irina, Ludvigsson, Johnny, Magnus, Maria Christine, Mélen, Erik, Mehegan, John, Mommers, Monique, Nybo Andersen, Anne-Marie, Nystad, Wenche, Pedersen, Eva S L, Pekkanen, Juha, Peltola, Ville, Pike, Katharine C, Pinot de Moira, Angela, Pizzi, Costanza, Polanska, Kinga, Popovic, Maja, Porta, Daniela, Roberts, Graham, Santos, Ana Cristina, Schultz, Erica S, Standl, Marie, Sunyer, Jordi, Thijs, Carel, Toivonen, Laura, Uphoff, Eleonora, Usemann, Jakob, Vafeidi, Marina, Wright, John, de Jongste, Johan C, Jaddoe, Vincent W V, Duijts, Liesbeth, IRAS OH Epidemiology Chemical Agents, van Meel, Evelien R, Mensink-Bout, Sara M, den Dekker, Herman T, Ahluwalia, Tarunveer S, Annesi-Maesano, Isabella, Arshad, Syed Hasan, Baïz, Nour, Barros, Henrique, von Berg, Andrea, Bisgaard, Hans, Bønnelykke, Klaus, Carlsson, Christian J, Casas, Maribel, Chatzi, Leda, Chevrier, Cecile, Dalmeijer, Geertje, Dezateux, Carol, Duchen, Karel, Eggesbø, Merete, van der Ent, Cornelis, Fantini, Maria, Flexeder, Claudia, Frey, Urs, Forastiere, Fransesco, Gehring, Ulrike, Gori, Davide, Granell, Raquel, Griffiths, Lucy J, Inskip, Hazel, Jerzynska, Joanna, Karvonen, Anne M, Keil, Thomas, Kelleher, Cecily, Kogevinas, Manolis, Koppen, Gudrun, Kuehni, Claudia E, Lambrechts, Nathalie, Lau, Susanne, Lehmann, Irina, Ludvigsson, Johnny, Magnus, Maria Christine, Mélen, Erik, Mehegan, John, Mommers, Monique, Nybo Andersen, Anne-Marie, Nystad, Wenche, Pedersen, Eva S L, Pekkanen, Juha, Peltola, Ville, Pike, Katharine C, Pinot de Moira, Angela, Pizzi, Costanza, Polanska, Kinga, Popovic, Maja, Porta, Daniela, Roberts, Graham, Santos, Ana Cristina, Schultz, Erica S, Standl, Marie, Sunyer, Jordi, Thijs, Carel, Toivonen, Laura, Uphoff, Eleonora, Usemann, Jakob, Vafeidi, Marina, Wright, John, de Jongste, Johan C, Jaddoe, Vincent W V, and Duijts, Liesbeth

Published
2022

27. Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children

Author

van Meel, Evelien R., Mensink-Bout, Sara M., den Dekker, Herman T., Ahluwalia, Tarunveer S., Annesi-Maesano, Isabella, Arshad, Syed Hasan, Baiz, Nour, Barros, Henrique, von Berg, Andrea, Bisgaard, Hans, Bonnelykke, Klaus, Carlsson, Christian J., Casas, Maribel, Chatzi, Leda, Chevrier, Cecile, Dalmeijer, Geertje, Dezateux, Carol, Duchén, Karel, Eggesbo, Merete, van der Ent, Cornelis, Fantini, Maria, Flexeder, Claudia, Frey, Urs, Forastiere, Fransesco, Gehring, Ulrike, Gori, Davide, Granell, Raquel, Griffiths, Lucy J., Inskip, Hazel, Jerzynska, Joanna, Karvonen, Anne M., Keil, Thomas, Kelleher, Cecily, Kogevinas, Manolis, Koppen, Gudrun, Kuehni, Claudia E., Lambrechts, Nathalie, Lau, Susanne, Lehmann, Irina, Ludvigsson, Johnny, Magnus, Maria Christine, Melen, Erik, Mehegan, John, Mommers, Monique, Andersen, Anne-Marie Nybo, Nystad, Wenche, Pedersen, Eva S. L., Pekkanen, Juha, Peltola, Ville, Pike, Katharine C., de Moira, Angela Pinot, Pizzi, Costanza, Polanska, Kinga, Popovic, Maja, Porta, Daniela, Roberts, Graham, Santos, Ana Cristina, Schultz, Erica S., Standl, Marie, Sunyer, Jordi, Thijs, Carel, Toivonen, Laura, Uphoff, Eleonora, Usemann, Jakob, Vafeidi, Marina, Wright, John, de Jongste, Johan C., Jaddoe, Vincent W. V., Duijts, Liesbeth, van Meel, Evelien R., Mensink-Bout, Sara M., den Dekker, Herman T., Ahluwalia, Tarunveer S., Annesi-Maesano, Isabella, Arshad, Syed Hasan, Baiz, Nour, Barros, Henrique, von Berg, Andrea, Bisgaard, Hans, Bonnelykke, Klaus, Carlsson, Christian J., Casas, Maribel, Chatzi, Leda, Chevrier, Cecile, Dalmeijer, Geertje, Dezateux, Carol, Duchén, Karel, Eggesbo, Merete, van der Ent, Cornelis, Fantini, Maria, Flexeder, Claudia, Frey, Urs, Forastiere, Fransesco, Gehring, Ulrike, Gori, Davide, Granell, Raquel, Griffiths, Lucy J., Inskip, Hazel, Jerzynska, Joanna, Karvonen, Anne M., Keil, Thomas, Kelleher, Cecily, Kogevinas, Manolis, Koppen, Gudrun, Kuehni, Claudia E., Lambrechts, Nathalie, Lau, Susanne, Lehmann, Irina, Ludvigsson, Johnny, Magnus, Maria Christine, Melen, Erik, Mehegan, John, Mommers, Monique, Andersen, Anne-Marie Nybo, Nystad, Wenche, Pedersen, Eva S. L., Pekkanen, Juha, Peltola, Ville, Pike, Katharine C., de Moira, Angela Pinot, Pizzi, Costanza, Polanska, Kinga, Popovic, Maja, Porta, Daniela, Roberts, Graham, Santos, Ana Cristina, Schultz, Erica S., Standl, Marie, Sunyer, Jordi, Thijs, Carel, Toivonen, Laura, Uphoff, Eleonora, Usemann, Jakob, Vafeidi, Marina, Wright, John, de Jongste, Johan C., Jaddoe, Vincent W. V., and Duijts, Liesbeth

Abstract

Background Early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking. Our objective was to examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school age. Methods We used individual participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow at 75% of FVC (FEF75%) and asthma at a median (range) age of 7 (4-15) years. Results Children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV1, FEV1/FVC and FEF75% (z-score range: -0.09 (95% CI -0.14- -0.04) to -0.30 (95% CI -0.36- -0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR range: 2.10 (95% CI 1.98-2.22) to 6.30 (95% CI 5.64-7.04) and 1.25 (95% CI 1.18-1.32) to 1.55 (95% CI 1.47-1.65), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as a proxy for early-life asthma. Conclusions Our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower respiratory tract infections., Funding Agencies|Swedish Research Council [K2005-72X-11242-11A, K2008-69X-20826-01-4]; Swedish Child Diabetes Foundation (Barndiabetesfonden); JDRF Wallenberg Foundation [K 98-99D-12813-01A]; Medical Research Council of Southeast Sweden (FORSS); Swedish Council for Working Life and Social Research [FAS2004-1775]; Ostgota Brandstodsbolag; UK Medical Research Council; Wellcome [217065/Z/19/Z]; University of Bristol; Swedish Heart Lung Foundation; ALF Region Stockholm; SFO Epidemiology Karolinska Institutet; European Research Council [757919, ERC-2014-CoG-648916]; Programme Grants for Applied Research funding scheme [RP-PG-0407-10044]; Wellcome Trust [WT101597MA]; Swiss National Science Foundation [320030_163311, SNF: 320030-182628, 320030-162820, 3233-069348, 3200-069349]; Italian Ministry of Health; Lundbeck Foundation [R16-A1694, 195/04, R100-A9193, R264-2017-3099]; Ministry of Health [903516]; Danish Council for Strategic Research [0603-00280B]; Capital Region Research Foundation; Danish National Research Foundation; Danish Regional Committees; Egmont Foundation; March of Dimes Birth Defects Foundation; Novo Nordisk Foundation; Danish Medical Research Council [SSVF 0646, 271-08-0839/06-066023, O602-01042B, 0602-02738B]; Innovation Fund Denmark [0603-00294B (09-067124)]; Nordea Foundation [02-2013-2014]; University of Copenhagen; Danish Council for Independent Research [DFF-4183-00594, DFF-4183-00152]; Foundation for Medical Research (FRM); National Institute for Research in Public health; French Ministry of Health (DGS); French Ministry of Research; INSERM Bone and Joint Diseases National Research (PRO-A) and Human Nutrition National Research Programs; French National Institute for Health Education (INPES); European Union [733206]; Diabetes National Research Program; Mutuelle Generale de lEducation Nationale complementary health insurance (MGEN); French national agency for food security; European Community [261357]; Erasmus MC Rotterdam; Erasmus University Rotte

Published
2022
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28. Fish and seafood consumption during pregnancy and the risk of asthma and allergic rhinitis in childhood: a pooled analysis of 18 European and US birth cohorts

Author

Stratakis, Nikos, Roumeliotaki, Theano, Oken, Emily, Ballester, Ferran, Barros, Henrique, Basterrechea, Mikel, Cordier, Sylvaine, de Groot, Renate, den Dekker, Herman T, Duijts, Liesbeth, Eggesbø, Merete, Pia Fantini, Maria, Forastiere, Francesco, Gehring, Ulrike, Gielen, Marij, Gori, Davide, Govarts, Eva, Inskip, Hazel M, Iszatt, Nina, Jansen, Maria, Kelleher, Cecily, Mehegan, John, Moltó-Puigmartí, Carolina, Mommers, Monique, Oliveira, Andreia, Olsen, Sjurdur F, Pelé, Fabienne, Pizzi, Costanza, Porta, Daniela, Richiardi, Lorenzo, Rifas-Shiman, Sheryl L, Robinson, Sian M, Schoeters, Greet, Strøm, Marin, Sunyer, Jordi, Thijs, Carel, Vrijheid, Martine, Vrijkotte, Tanja GM, Wijga, Alet H, Kogevinas, Manolis, Zeegers, Maurice P, and Chatzi, Leda

Published
2017
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30. The Behavioral Determinants of Breast-Feeding in the Netherlands: Predictors for the Initiation of Breast-Feeding

Author

Kools, Els J., Thijs, Carel, and de Vries, Hein

Abstract

The aim of this study was to evaluate the behavioral determinants of the initiation of breast-feeding at birth. The prospective cohort study used the attitude, social influence, self-efficacy (ASE) model in 373 pregnant women in five child health care centers. Prenatally, 72% of the women had the intention to breast-feed, and 73% actually started with breast-feeding at birth. Mothers who initiated breast-feeding differed in almost all the attitude, social influence, and self-efficacy determinants from mothers who initiated formula feeding. Intention was a very strong predictor of the initiation of breast-feeding. The components of the ASE model predicted the initiation of breast-feeding. Hence, the results may be used to tailor future interventions aimed at promoting breast-feeding. (Contains 4 tables and 1 figure.)

Published
2005
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31. Toothbrushing at School: Effects on Toothbrushing Behaviour, Cognitions and Habit Strength

Author

Wind, Marianne, Kremers, Stef, Thijs, Carel, and Brug, Johannes

Abstract

Purpose: To assess the impact of a school-based toothbrushing intervention aimed at encouraging primary school children to brush their teeth daily at school, on cognitions, toothbrushing behaviour and habit strength. Design/methodology/approach: The effects of an intervention were examined in a quasi-experimental trial among 296 fifth-graders in seven schools. The schools were randomly assigned to be an intervention group or a control group. Children in the intervention schools brushed their teeth at school under supervision. Effects on toothbrushing behaviour were assessed with written questionnaires before, during, immediately after, and one year after the intervention period. Effects on cognitions and habit strength were assessed one year after the intervention period. Analyses of variance were conducted to detect differences in frequency of toothbrushing, cognitions about toothbrushing, and habit strength. Findings: During the intervention period, brushing teeth at school resulted in a significant increase in frequency of toothbrushing. However, these effects had not been maintained at one-year follow-up. No effects on cognitions about toothbrushing or on habit strength were found. Research limitations/implications: When supports that facilitate healthy behaviour are implemented we recommend evaluating effects on habit strength, by assessment both before and after the intervention. Originality/value: This paper suggests that when habit-inducing supports and cues cease then people find it hard to sustain change. This may be of importance when designing and evaluating health-promoting interventions. (Contains 1 table.)

Published
2005
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32. Comparison of parent reported physician diagnosed asthma and general practitioner registration.

Author

Eijkemans, Marianne, Mommers, Monique, and Thijs, Carel

Subjects
WHEEZE, GENERAL practitioners, ASTHMA in children, ASTHMA, PHYSICIANS, PARENTS, EPIDEMIOLOGICAL research
Abstract

To compare parent reported physician diagnosed asthma from questionnaires for epidemiological purposes, to general practitioner (GP) recorded childhood asthma. This study was embedded in the KOALA Birth Cohort Study with regular follow-up by ISAAC core questions on asthma in 2834 children in two different recruitment groups, with 'conventional' lifestyles or 'alternative' lifestyles. At age 11–13 years these data were linked to data extracted from GP records. We compared parent reported physician diagnosed asthma, asthma medication use, and current asthma with GP recorded asthma diagnosis and medication. Two different combinations of questions were used to define current asthma (i.e. ISAAC and MeDALL based definition). Among 958 children with information provided both by the parents and GPs, 98 children (10.2%) had parent reported physician diagnosed asthma, 115 children (12.0%) had a GP recorded asthma diagnosis (Cohen's kappa 0.49; 95% CI 0.40 to 0.57). Discrepant cases showed that asthma symptoms at an early age led to different labeling between parents and GP. The agreement between ISAAC based definition and MeDALL based definition was excellent (Cohen's kappa 0.82; 95% CI 0.74 to 0.88). Parent reported physician diagnosed asthma and GP recorded childhood asthma had only moderate agreement, and is possibly influenced by labeling early transient wheeze as asthma diagnosis. It is important that parent reported physician diagnosed asthma is combined with additional questions such as current asthma symptoms and asthma medication use, as used in ISAAC or MeDALL based current asthma, in order to obtain reliable information for epidemiological research. [ABSTRACT FROM AUTHOR]

Published
2023
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33. European Birth Cohorts for Environmental Health Research

Author

Vrijheid, Martine, Casas, Maribel, Bergström, Anna, Carmichael, Amanda, Cordier, Sylvaine, Eggesbø, Merete, Eller, Esben, Fantini, Maria P., Fernández, Mariana F., Fernández-Somoano, Ana, Gehring, Ulrike, Grazuleviciene, Regina, Hohmann, Cynthia, Karvonen, Anne M., Keil, Thomas, Kogevinas, Manolis, Koppen, Gudrun, Krämer, Ursula, Kuehni, Claudia E., Magnus, Per, Majewska, Renata, Andersen, Anne-Marie Nybo, Patelarou, Evridiki, Petersen, Maria Skaalum, Pierik, Frank H., Polanska, Kinga, Porta, Daniela, Richiardi, Lorenzo, Santos, Ana Cristina, Slama, Rémy, Sram, Radim J., Thijs, Carel, Tischer, Christina, Toft, Gunnar, Trnovec, Tomáš, Vandentorren, Stephanie, Vrijkotte, Tanja G.M., Wilhelm, Michael, Wright, John, and Nieuwenhuijsen, Mark

Published
2012

46. Combining HPAEC-PAD, PGC-LC-MS, and 1D 1H NMR to Investigate Metabolic Fates of Human Milk Oligosaccharides in 1-Month-Old Infants : A Pilot Study

Author

Gu, Fangjie, Kate, Geert A., Ten, Arts, Ilja C.W., Penders, John, Thijs, Carel, Lindner, Cordula, Nauta, Arjen, Leusen, Ellen, Van, Leeuwen, Sander S., Van, Schols, Henk A., Gu, Fangjie, Kate, Geert A., Ten, Arts, Ilja C.W., Penders, John, Thijs, Carel, Lindner, Cordula, Nauta, Arjen, Leusen, Ellen, Van, Leeuwen, Sander S., Van, and Schols, Henk A.

Abstract

A solid-phase extraction procedure was optimized to extract 3-fucosyllactose and other human milk oligosaccharides (HMOs) from human milk samples separately, followed by absolute quantitation using high-performance anion-exchange chromatography-pulsed amperometric detection and porous graphitized carbon-liquid chromatography-mass spectrometry, respectively. The approach developed was applied on a pilot sample set of 20 human milk samples and paired infant feces collected at around 1 month postpartum. One-dimensional 1H nuclear magnetic resonance spectroscopy was employed on the same samples to determine the relative levels of fucosylated epitopes and sialylated (Neu5Ac) structural elements. Based on different HMO consumption patterns in the gastrointestinal tract, the infants were assigned to three clusters as follows: complete consumption; specific consumption of non-fucosylated HMOs; and, considerable levels of HMOs still present with consumption showing no specific preference. The consumption of HMOs by infant microbiota also showed structure specificity, with HMO core structures and Neu5Ac(α2-3)-decorated HMOs being most prone to degradation. The degree and position of fucosylation impacted HMO metabolization differently.

Published
2021

47. Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Author

Bousquet, Jean, Anto, Josep M., Czarlewski, Wienczyslawa, Haahtela, Tari, Fonseca, Susana C., Iaccarino, Guido, Blain, Hubert, Vidal, Alain, Sheikh, Aziz, Akdis, Cezmi A., Zuberbier, Torsten, Abdul Latiff, Amir Hamzah, Abdullah, Baharudin, Aberer, Werner, Abusada, Nancy, Adcock, Ian, Afani, Alejandro, Agache, Ioana, Aggelidis, Xenofon, Agustin, Jenifer, Akdis, Mubeccel, Al-Ahmad, Mona, Al-Zahab Bassam, Abou, Alburdan, Hussam, Aldrey-Palacios, Oscar, Alvarez Cuesta, Emilio, Alwan Salman, Hiba, Alzaabi, Ashraf, Amade, Salma, Ambrocio, Gene, Angles, Rosana, Annesi-Maesano, Isabella, Ansotegui, Ignacio J., Ara Bardajo, Paula, Arasi, Stefania, Arrais, Margarete, Arshad, Hasan, Artesani, Maria-Cristina, Asayag, Estrella, Bernstein, David, Chatzi, Lida, Chavannes, Niels H., Guldemond, Nick, Mommers, Monique, Papadopoulos, Nikos G., Reitsma, Sietze, Thijs, Carel, ARIA group, Bousquet, Jean, Anto, Josep M., Czarlewski, Wienczyslawa, Haahtela, Tari, Fonseca, Susana C., Iaccarino, Guido, Blain, Hubert, Vidal, Alain, Sheikh, Aziz, Akdis, Cezmi A., Zuberbier, Torsten, Abdul Latiff, Amir Hamzah, Abdullah, Baharudin, Aberer, Werner, Abusada, Nancy, Adcock, Ian, Afani, Alejandro, Agache, Ioana, Aggelidis, Xenofon, Agustin, Jenifer, Akdis, Mubeccel, Al-Ahmad, Mona, Al-Zahab Bassam, Abou, Alburdan, Hussam, Aldrey-Palacios, Oscar, Alvarez Cuesta, Emilio, Alwan Salman, Hiba, Alzaabi, Ashraf, Amade, Salma, Ambrocio, Gene, Angles, Rosana, Annesi-Maesano, Isabella, Ansotegui, Ignacio J., Ara Bardajo, Paula, Arasi, Stefania, Arrais, Margarete, Arshad, Hasan, Artesani, Maria-Cristina, Asayag, Estrella, Bernstein, David, Chatzi, Lida, Chavannes, Niels H., Guldemond, Nick, Mommers, Monique, Papadopoulos, Nikos G., Reitsma, Sietze, Thijs, Carel, and ARIA group

Abstract

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.

Published
2021

48. The Longitudinal Relationship Between Screen Time, Sleep and a Diagnosis of Attention-Deficit/Hyperactivity Disorder in Childhood

Author

Levelink, Birgit, van der Vlegel, Marjolein, Mommers, Monique, Gubbels, Jessica, Dompeling, Edward, Feron, Frans J.M., van Zeben-van der Aa, Dorothea M.C.B., Hurks, Petra, Thijs, Carel, Levelink, Birgit, van der Vlegel, Marjolein, Mommers, Monique, Gubbels, Jessica, Dompeling, Edward, Feron, Frans J.M., van Zeben-van der Aa, Dorothea M.C.B., Hurks, Petra, and Thijs, Carel

Abstract

Objective: To evaluate longitudinal associations between recreational screen time and sleep in early childhood, and attention-deficit/hyperactivity disorder (ADHD) at age 8 to 10 years. Method: Questionnaires from 2,768 mother-child pairs from the Dutch KOALA Birth Cohort Study were used. General estimating equation logistic regression analyses examined associations between screen time and sleep at age 2, 4, and 6, and ADHD at age 8 to 10. Linear regression analysis examined associations between television time, sleep and CBCL/2-3 scores at age 2. Results: Longitudinally, neither screen time nor sleep were associated with ADHD. Cross-sectionally, CBCL/2-3 externalizing symptom scores increased by 0.03 with every hour television time (95% CI 0.002–0.05) and increased by 0.02 per hour of less sleep (95% CI −0.03–−0.01). Conclusion: Despite an association with externalizing symptoms at age 2, screen time and sleep in early childhood were not associated with ADHD. Carefulness is warranted when extrapolating cross-sectional associations at early age to an ADHD diagnosis.

Published
2021

49. Influence of Alternative Lifestyles on Antibiotic Use during Pregnancy, Lactation and in Children

Author

Eras, Pien, Simões-Wüst, Ana Paula; https://orcid.org/0000-0002-4489-0952, Thijs, Carel; https://orcid.org/0000-0001-6646-5458, Eras, Pien, Simões-Wüst, Ana Paula; https://orcid.org/0000-0002-4489-0952, and Thijs, Carel; https://orcid.org/0000-0001-6646-5458

Abstract

Alternative lifestyles are likely to be associated with distinct usage of specific medicinal products. Our goal was to find out whether the intake of antibiotics during pregnancy and by children differs according to whether the mothers have alternative or conventional lifestyles. Therefore, we investigated the use of antibiotics by pregnant women and by children up to 11 years of age participating in the KOALA Birth Cohort Study. This cohort comprises two recruitment groups of mother–infant pairs, one with alternative lifestyles (selected via organic food shops, anthroposophic clinicians and midwives, anthroposophic under-five clinics, Rudolf Steiner schools and relevant magazines, n = 491) the other with conventional lifestyles (no selection based on lifestyle, n = 2343). Mothers in the alternative lifestyle group more frequently adhered to specific living rules and identified themselves with anthroposophy more than mothers in the conventional lifestyle group. The results revealed significant differences in antibiotic use during pregnancy and in children from 3 months to 10 years of age between the two groups. The rate of antibiotic use in children was consistently lower in the alternative lifestyle group than in the conventional lifestyle group. Antibiotic use in pregnancy was higher in low educated women, and maternal antibiotic use during lactation was higher after an instrumented delivery in hospital. Antibiotic use in the infant was higher when they had older sibs or were born in hospital, and lower in those who had been longer breastfed. After adjustment for these factors, the differences in antibiotic use between the alternative and conventional groups remained. The results suggest that an alternative lifestyle is associated with cautious antibiotic use during pregnancy, lactation and in children.

Published
2021

50. Organic food use, meat intake, and prevalence of gestational diabetes: KOALA birth cohort study

Author

Simões-Wüst, Ana Paula; https://orcid.org/0000-0002-4489-0952, Moltó-Puigmartí, Carolina, van Dongen, Martien C J M, Thijs, Carel; https://orcid.org/0000-0001-6646-5458, Simões-Wüst, Ana Paula; https://orcid.org/0000-0002-4489-0952, Moltó-Puigmartí, Carolina, van Dongen, Martien C J M, and Thijs, Carel; https://orcid.org/0000-0001-6646-5458

Abstract

Purpose: To evaluate whether consumption of organic food and reduced intake of meat products in pregnancy are associated with lower prevalence of gestational diabetes (GD). Methods: Women participating in the KOALA Birth Cohort Study with valid informed consent, a singleton pregnancy and information on their food intake were considered in this cross-sectional analysis. Participants with and without GD were compared with each other in terms of dietary characteristics (n = 37 and n = 2766, respectively). Multivariable logistic regression (LR) was used to adjust for relevant covariates. Results: Organic food consumption tended to be lower, although not significantly, in women with GD compared to women without GD, whereas consumption of meat was positively associated with GD prevalence. LR modelling showed that GD was significantly associated with higher consumption of meat and, in addition, also of cheese, after adjustment for other relevant covariates. GD was associated with some indicators of animal product intake, namely dietary animal to plant protein ratio and maternal plasma arachidonic acid (for the latter, data available for n = 16 and n = 1304, respectively). Food patterns of participants with GD were characterised by more meat products and less vegetarian products. Conclusions: Due to the low number of participants with GD, results have to be interpreted cautiously. Consumption of organic food during pregnancy does not seem to be markedly associated with a lower GD prevalence; lower intake of meat and cheese, irrespective of its origin (organic or conventional), does. The latter supports previous studies suggesting a causal association between consumption of animal products and GD. Keywords: Diet composition; Food patterns; Gestational diabetes; Meat consumption; Organic food.

Published
2021

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