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ALSPAC Study Team

Publications and source records attributed to ALSPAC Study Team.

At least 37 records · Page 2Linked to original sources

Maternal age in pregnancy and offspring blood pressure in childhood in the Avon Longitudinal Study of Parents and Children (ALSPAC).

Associations between maternal age in pregnancy and offspring blood pressure (BP) at age 7(1/2) were investigated in 7623 singletons from the Avon Longitudinal Study of Parents and Children (ALSPAC). In models adjusted for age and sex there was an inverse relationship between maternal age and BP in children: beta = -0.06 mmHg per year of maternal age (95% CI -0.10 to -0.01, P = 0.02) for systolic BP and beta = -0.04 (95% CI -0.07 to -0.01, P = 0.02) for diastolic BP. However, this association disappeared after adjustment for confounding factors: beta = -0.02 mmHg per year of maternal age (95% CI -0.07 to 0.04, P = 0.5) for systolic BP and beta = -0.03 (95% CI -0.07 to 0.01, P = 0.2) for diastolic BP. We conclude that there is no evidence of a relationship between maternal age in pregnancy and childhood BP in this contemporary birth cohort.

Adult↗

Nocturnal enuresis: a survey of parental coping strategies at 7 1/2 years.

BACKGROUND: Childhood nocturnal enuresis is a potentially distressing experience. Parents have been found to adopt many approaches designed to help their child become dry at night. This study sought to understand, through a large cohort of children at 7 1/2 years of age, the strategies parents adopt, both during the child's development and currently, to help their child overcome bed-wetting. METHODS: A longitudinal cohort of 13,971 children with expected date of delivery between April 1991-December 1992, in the County of Avon (Bristol) formed the population study group. At 7 1/2 years parents were asked, as part of a regular self-report questionnaire, what methods they had tried or were currently using to help their child stop bed-wetting. Eleven options were supplied. RESULTS: Of 8269 parents responding to the questionnaire, 3376 (40.8%) indicated they had tried at least one of 11 strategies, with restricting night-time fluids and lifting being the predominant methods employed. Amongst strategies employed in the past, lifting and showing displeasure were used significantly more by parents of children with nocturnal enuresis than by those with children dry at 7 1/2 years. However, a greater proportion of parents of dry children encouraged their offspring to toilet more regularly in the daytime than parents of those with nocturnal enuresis or infrequent wetting. In terms of treatment interventions, the enuresis alarm had been employed with 19.2% and medication with 13.1% of those with nocturnal enuresis, although only 31.9% of those with nocturnal enuresis had seen a health worker. The results are discussed in relation to preventative and clinical implications.

Adaptation, Psychological↗

Prenatal paracetamol exposure and risk of asthma and elevated immunoglobulin E in childhood.

BACKGROUND: We recently found that paracetamol (acetaminophen) use in late pregnancy was associated with an increased risk of early wheezing in the offspring. OBJECTIVE: To see whether use of paracetamol in late pregnancy is associated with an increased risk of asthma, wheezing and other atopic outcomes in the child at school age. METHODS: In the population-based Avon Longitudinal Study of Parents and Children, we measured associations of paracetamol and aspirin use in late pregnancy (20-32 weeks) with asthma, hayfever, eczema (n = 8511) and wheezing (8381) in the offspring at 69-81 months, and with atopy (positive skin prick test to Dermatophagoides pteronyssinus, cat or grass, n = 6527) and blood total IgE (n = 5148) at 7 years. We used logistic and linear regression to analyse binary outcomes and log-transformed IgE, respectively, controlling for potential confounders. RESULTS: Use of paracetamol, but not aspirin, in late pregnancy was positively associated with asthma (odds ratios (ORs), comparing children whose mothers took paracetamol 'sometimes' and 'most days/daily' with those whose mothers never took it, 1.22 (95% confidence interval (CI): 1.06-1.41) and 1.62 (95% CI: 0.86-3.04), respectively; P trend = 0.0037), wheezing (ORs 1.20 (95% CI: 1.02-1.40) and 1.86 (95% CI: 0.98-3.55), respectively; P trend = 0.011), and total IgE (geometric mean ratios 1.14 (95% CI: 1.03-1.26) and 1.52 (95% CI: 0.98-2.38), respectively; P trend = 0.0034), but not hayfever, eczema or skin test positivity. The proportion of asthma attributable to paracetamol use in late pregnancy, assuming a causal relation, was 7%. CONCLUSION: Paracetamol exposure in late gestation may cause asthma, wheezing and elevated IgE in children of school age.

Acetaminophen↗

Prevalence of latex allergy in the community at age 7 years.

BACKGROUND: Latex allergy has been highlighted as a problem in children during the last decade based on a number of case series of children with particular problems such as spina bifida. The actual prevalence of latex allergy in the general United Kingdom population is unclear. OBJECTIVE: To estimate the prevalence of childhood latex allergy in the general population. METHODS: The Avon Longitudinal Study of Parents and Children is a geographically based cohort that has been prospectively followed since birth. The children were invited for skin prick testing at 7 years of age. RESULTS: Four subjects out of 1877 tested were sensitized to latex. None had a history of clinical reactions to latex. CONCLUSION: This study suggests that the prevalence of latex sensitization and clinical latex allergy in the general childhood population are very low, 0.2% (95% confidence interval 0.1-0.6%) and 0.0% (0-0.2%), respectively.

Child↗

Relationship between aeroallergen and food allergen sensitization in childhood.

BACKGROUND: Previous studies measuring the prevalence of allergen sensitization have been relatively small and used small numbers of allergens. To effectively evaluate children with atopic disease, we need an accurate knowledge of which allergens are important. OBJECTIVE: To measure the prevalence of sensitization within a large unselected birth cohort, to examine the associations between sensitization to different allergens and determine whether atopy can be defined by a small panel of allergens. METHODS: The Avon Longitudinal Study of Parents and Children is a population-based birth cohort of 13,638 singletons surviving to 4 weeks of age. The cohort was skin tested at 7 years of age to house dust mite (Dermatophagoides pteronyssinus), grass pollens, cat, peanuts, mixed tree nuts and egg and one of three other panels: animal danders, foods or aeroallergens. Sensitization was defined as a weal diameter of > or =3 mm. The strength of associations between sensitization to different allergens was tested by calculating the odds ratio adjusted for sensitization to D. pteronyssinus and grass pollen and gender. RESULTS: Valid data were obtained from 6412 singletons. Sensitization was most common to aeroallergens: grass pollens (8.5%), D. pteronyssinus (7.8%), cat (4.9%), D. farinae (3.6%), dog (2.7%), horse (1.4%), rabbit (1.4%). Of the foods tested, the most common sensitization was to peanut (1.4%) and mixed tree nuts (1.0%). More than 95% of subjects with sensitization to any of the 29 allergens tested were sensitized to one of grass, D. pteronyssinus or cat allergen. There were strong associations of multiple sensitizations both within and between different allergen classes (pollens, animals, foods, peanut and tree nuts). CONCLUSIONS: Seven-year-old children in the UK are primarily sensitized to aeroallergens, but also to peanuts and tree nuts. There are strong associations between sensitization within allergen groups as well as between allergen groups. Further studies are required to observe whether similar associations are seen with clinical allergy to these allergens.

Air Pollution↗

Could associations between breastfeeding and insulin-like growth factors underlie associations of breastfeeding with adult chronic disease? The Avon Longitudinal Study of Parents and Children.

OBJECTIVE: The influence of infant feeding method (breast/formula) on growth factor levels could underlie associations of breastfeeding with childhood growth and risk factors for cardiovascular disease. We investigated associations of having been breastfed with serum IGF-I and IGFBP-3 in childhood. METHODS: Prospective birth cohort study (subsample of the Avon Longitudinal Study of Parents and Children, UK) based on 871 children born in 1991/1992 who underwent clinical follow-up and blood tests at age 7-8 years. A total of 488 (56%) children had complete data. RESULTS: In children with complete data, the age- and sex-standardized IGF-I levels of those who were partially or exclusively breastfed were 6.1 and 13.8 ng/ml higher, respectively, than those who were never breastfed (increase in IGF-I levels per category of breastfeeding exclusivity: 7.1 ng/ml; 95% CI: 0.3-13.9; P = 0.04). In models also controlling for birthweight, gestational age, mother's age, and socioeconomic and dietary factors, the breastfeeding-IGF-I association was attenuated (regression coefficient: 3.3 ng/ml; -4.2-10.7; P = 0.4); further adjustment for IGFBP-3 made little difference (regression coefficient: 4.1 ng/ml; -2.8-10.9; P = 0.2). There was little evidence for an association between breastfeeding and IGFBP-3 or the molar ratio IGF-I/IGFBP-3. CONCLUSIONS: The positive association between breastfeeding and IGF-I could be due to residual confounding or to chance. Nevertheless, the magnitude of the fully adjusted effect estimate and the novelty of the association suggest that larger studies should now be conducted to confirm or refute the hypothesis that variations in IGF-I by infant feeding mode explain associations of breastfeeding with health in later life.

Breast Feeding↗

Food and nutrient intakes of a population sample of 7-year-old children in the south-west of England in 1999/2000 - what difference does gender make?

OBJECTIVES: To describe the diet of schoolchildren aged 7 years, and identify gender differences in food and nutrient intakes. SUBJECTS: A cohort of children resident in the south-west of England in 1999/2000. METHODS: Diet was assessed using three 1-day unweighed food diaries. Nutrient intakes were compared with dietary reference values for this age group, and with children aged 7-10 years in the British National Diet and Nutrition Survey. Food and nutrient intakes were contrasted between boys and girls. RESULTS: Median nutrient intakes exceeded the reference nutrient intake (RNI) for most nutrients. Median intakes of iron and zinc were below the RNI. Median sodium intake was greater than the maximum set by the Scientific Advisory Committee on Nutrition. The mean energy intake for boys and girls, respectively, were 7.3 and 6.8 MJ, this is below the estimated average requirement. The percentage of energy from fat was 35.3% for boys and 36.1% for girls. Boys had higher iron intakes than girls, even after adjustment for energy intake. There were differences in the types of foods eaten between boys and girls; girls ate more fruit and vegetables (P = 0.001) and boys ate more breakfast cereals (P = 0.016). CONCLUSIONS: The dietary intakes of these 7-year-old children were adequate for most nutrients. However, a reduction in the sodium content of the diet would be advantageous. Fruit and vegetable consumption should be encouraged particularly among boys.

Child↗

Nocturnal enuresis at 7.5 years old: prevalence and analysis of clinical signs.

OBJECTIVE: To determine the prevalence of nocturnal enuresis (NE) in a large cohort of children at 7.5 years old, and to examine the frequency of variables such as gender, severity, associated elimination problems, and clinical signs within the identified group. SUBJECTS AND METHODS: Of an original cohort of 13 971 infants alive at 12 months, 11 251 who were still active in the Avon Longitudinal Study of Parents and Children (ALSPAC) survey, were followed at 91 months. The mother or main carer was given a questionnaire which asked, amongst other items, about the presence and frequency of bedwetting, other elimination problems, and signs related to the wetting behaviour; 8269 (73.5%) questionnaires were returned and 8151 contained information on the frequency of bedwetting. RESULTS: In all, 1260 children (15.5%) at 7.5 years wet the bed, but most wet once or less a week, and only 215 (2.6%) met the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) criteria of NE (wetting at least twice a week). A higher prevalence was reported in boys than girls and 266 children (3.3%) had both daytime wetting and bedwetting, with 189 (2.3%) having both daytime soiling and bedwetting. Daytime urgency increased with severity of bedwetting and occurred in 28.9% of children with NE. CONCLUSION: At 7.5 years old the incidence of bedwetting is high, but only 2.6% of this large population-based sample wet at a frequency meeting the definition of NE. Although a small percentage of children had both daytime wetting and bedwetting, the evidence suggests that these are discrete problems. Amongst children with NE, indicators of bladder overactivity were present, supporting the view of heterogeneity and the importance of individual assessment in deciding on appropriate treatment.

Chi-Square Distribution↗

Domestic violence risk during and after pregnancy: findings from a British longitudinal study.

OBJECTIVE: The objectives of this study were to examine the rates of domestic violence reported during and after pregnancy and to assess the importance of family adversity. DESIGN: Prospective longitudinal cohort study. SETTING: Bristol Avon, Southwest England. POPULATION: Seven thousand five hundred and ninety-one pregnant women with due dates between 1.4.91 and 31.12.92. METHODS: Questionnaires administered at 18 weeks of gestation and 8 weeks, 8 months, 21 months and 33 months postpartum. MAIN OUTCOME MEASURES: The experience of emotional or physical cruelty by an intimate partner at each time point. RESULTS: Fewer women reported domestic violence victimization during pregnancy than they did postpartum (18 weeks of gestation: 1% physical cruelty, 4.8% emotional cruelty, 5.1% any victimization; 33 months postpartum: 2.9% physical, 10.8% emotional, 11% any victimization). Women who reported being victimized during pregnancy also reported significantly higher levels of social adversity during pregnancy. The number of social adversities reported during pregnancy also predicted postpartum victimization. Women who reported only one adversity during pregnancy were 2.73 (95% CI, 2.16-3.45) times more likely to report physical victimization at 33 months postpartum. Women who reported 5 adversities during pregnancy were 14.69 (95% CI, 7.35-29.37) times more likely to report such victimization at 33 months postpartum. For emotional cruelty, women who reported only one adversity during pregnancy were 2.10 (95% CI 1.80-2.46) times more likely to report emotional victimization at 33 months postpartum and 6.10 (95% CI 3.51-10.59) times more likely to report such victimization when five or more adversities were present during pregnancy. CONCLUSIONS: Levels of social adversity reported in pregnancy are important predictors of concurrent and future victimization. Screening for social adversity factors could help identify women at high risk for future domestic violence.

Adolescent↗

Maternal diet in pregnancy and offspring blood pressure.

Associations between maternal nutrient intakes in late pregnancy and offspring blood pressure at 7(1/2) years were investigated in 6944 singletons from the Avon Longitudinal Study of Parents and Children. The only finding was a weak inverse association with omega-3 fatty acids that was lost after adjustment for potential confounders, suggesting that diet in pregnancy does not influence offspring blood pressure in well-nourished populations.

Blood Pressure↗

Maternal diet in pregnancy and offspring height, sitting height, and leg length.

STUDY OBJECTIVE: To examine the association between maternal diet in pregnancy and offspring height, sitting height, and leg length. DESIGN: Cohort study. SETTING: South west England. PARTICIPANTS: 6663 singletons (51% male) enrolled in the Avon longitudinal study of parents and children, with information on their mother's diet in late pregnancy (obtained by food frequency questionnaire) and their own height recorded at age 7.5 years. MAIN RESULTS: Before adjustment, maternal magnesium, iron, and vitamin C were the nutrients most consistently associated with offspring height and its components. However, adjusting for potential confounders weakened all relations considerably. For example, a standard deviation (SD) increase in magnesium intake was associated with a 0.10 (-0.07, 0.14) SD unit increase in height before adjustment, which was reduced to 0.05 (0.01, 0.08) SD units after adjustment, and a SD unit increase in iron intake was associated with 0.08 (0.05, 0.12) and 0.04 (0.01, 0.08) SD unit increases in height before and after adjustment respectively. No other dietary variables were associated with height or its components after adjustment. CONCLUSIONS: These findings do not provide evidence that maternal diet in pregnancy has an important influence on offspring height, sitting height, or leg length in well nourished populations, although effects may emerge as offspring become older.

Anthropometry↗

Does birth weight predict childhood diet in the Avon longitudinal study of parents and children?

STUDY OBJECTIVE: Low birth weight predicts cardiovascular disease in adulthood, and one possible explanation is that children with lower birth weight consume more fat than those born heavier. Therefore, the objective of this study was to investigate associations between birth weight and childhood diet, and in particular, to test the hypothesis that birth weight is inversely related to total and saturated fat intake. DESIGN: Prospective cohort study. SETTING: South west England. PARTICIPANTS: A subgroup of children enrolled in the Avon longitudinal study of parents and children, with data on birth weight and also diet at ages 8, 18, 43 months, and 7 years (1152, 998, 848, and 771 children respectively). MAIN RESULTS: Associations between birth weight and diet increased in strength from age 8 to 43 months, but had diminished by age 7 years. Fat, saturated fat, and protein intakes were inversely, and carbohydrate intake was positively associated with birth weight at 43 months of age, after adjusting for age, sex, and energy intake. After adjustment for other confounders, all associations were weakened, although there was still a suggestion of a relation with saturated fat (-0.48 (95% CI -0.97, 0.02) g/day per 500 g increase in birth weight. Similar patterns were seen in boys and girls separately, and when the sample was restricted to those with complete data at all ages. CONCLUSIONS: A small inverse association was found between birth weight and saturated fat intake in children at 43 months of age but this was not present at 7 years of age. This study therefore provides little evidence that birth weight modifies subsequent childhood diet.

Birth Weight↗

Early experiences and their relationship to maternal eating disorder symptoms, both lifetime and during pregnancy.

BACKGROUND: There is some evidence that early sexual abuse is an aetiological factor for eating disorder. However, there is sparse information from large-scale, non-clinical studies. AIMS: This study was designed to explore which early experiences, recalled during pregnancy, were associated with both lifetime and antenatal eating disorder symptoms in a community sample. METHOD: Univariate and multivariate analyses were conducted of data from questionnaires administered during pregnancy to a community sample of pregnant women. RESULTS: Recall of parental mental health problems and of early unwanted sexual experiences were independently associated with both lifetime eating problems, laxative use and vomiting during pregnancy, and marked concern during pregnancy over shape and weight. CONCLUSIONS: There are public health implications for these results. Eating disorders in mothers represent a risk for child development. It may be important to enquire during pregnancy about a history of eating problems and to provide the opportunity for early experiences to be discussed.

Adolescent↗

Performance of a self-report measure of the level of response to alcohol in 12- to 13-year-old adolescents.

OBJECTIVE: A low level of response (LR) to alcohol characterizes groups at high risk for alcoholism and predicts future heavier drinking and alcohol-related problems. Because LR might change with increasing age and years of drinking, there is a need to measure this phenotype as early as possible in the drinking career. METHOD: Data were generated from 1,106 12- to 13-year-old subjects in the Avon Longitudinal Study of Parents and Children (ALSPAC). Information about alcohol and other substance use and problems was obtained using a structured interview, and LR from the Self-Rating of the Effects of Alcohol (SRE) questionnaire. RESULTS: Drinking was reported by 80 (7.3% of all subjects) boys and girls. Boys comprised 62.5% of the sample; the mean (SD) age of subjects was 12.9 (0.16) years. Among those 80 drinkers, alcohol had been consumed on an average of 5.4 occasions over the prior 6 months, the average maximum drinks ever imbibed was about 3.3, and 23.8% had any of 26 possible alcohol-related problems. In this group, 36.3% had smoked cigarettes, and 12.5% had used marijuana. The First 5 SRE score among drinkers correlated with the maximum number of drinks consumed at one time at .61 (p < .001), the number of alcohol problems at .25 (p < .01) and the frequency of drinking at .29 (p < .01). When considered along with smoking and marijuana histories, sex and weight, the SRE score contributed significantly to the prediction of maximum drinks per occasion (beta = .60, p < .001) and drinking frequency (beta = .24, p < .05), with a trend (beta = .17, p = .08) for alcohol problems. CONCLUSION: These results support the conclusion that a low LR to alcohol correlates well with the maximum number of drinks consumed even early in the drinking career among individuals for whom acquired tolerance or other factors were unlikely to have explained the relationship.

Adolescent↗

The epidemiology of recurrent abdominal pain from 2 to 6 years of age: results of a large, population-based study.

OBJECTIVE: Recurrent abdominal pain (RAP) is one of the most common complaints of childhood and is associated with several adverse outcomes in adulthood. Few large, population-based, longitudinal studies have been conducted. The purpose of this study was to investigate the prevalence and epidemiologic features of RAP through early childhood. DESIGN: We report findings from a large, population-based, cohort study of childhood (the Avon Longitudinal Study of Parents And Children). The prevalence and continuity of RAP from 2 to 6 years of age were explored, with associated physical and psychological symptoms among the children and their parents. RESULTS: In a population cohort of 13971 children, RAP was reported for 11.8% of 6-year-old children. It was less common at ages 2 years (3.8%) and 3 years (6.9%). There was a striking degree of continuity of RAP between the ages of 2 and 6 years. RAP was associated with headaches and limb pains among children and with higher rates of anxiety among both children (adjusted odds ratio: 2.12; 95% confidence interval: 1.70-2.65) and their mothers (odds ratio: 1.75; 95% confidence interval: 1.30-2.36). CONCLUSIONS: In a large, population-based, cohort study, RAP was found to be increasingly common up to the age of 6 years. Children with RAP at a young age have a high risk of RAP later in childhood. RAP is associated with other somatic pain symptoms among children and with symptoms of anxiety among children and their mothers. These findings highlight the high prevalence and continuity of RAP through early childhood and the importance of considering psychological symptoms for these children and their families.

Abdominal Pain↗

Association of insulin-like growth factor I and insulin-like growth factor-binding protein-3 with intelligence quotient among 8- to 9-year-old children in the Avon Longitudinal Study of Parents and Children.

BACKGROUND: Insulin-like growth factor I (IGF-I) is a hormone that mediates the effects of growth hormone and plays a critical role in somatic growth regulation and organ development. It is hypothesized that it also plays a key role in human brain development. Previous studies have investigated the association of low IGF-I levels attributable to growth hormone receptor deficiency with intelligence but produced mixed results. We are aware of no studies that investigated the association of IGF-I levels with IQ in population samples of normal children. OBJECTIVES: To investigate the association of circulating levels of IGF-I and its principle binding protein, IGF-binding protein-3 (IGFBP-3), in childhood with subsequent measures of IQ. METHODS: The cohort study was based on data for 547 white singleton boys and girls, members of the Avon Longitudinal Study of Parents and Children, with IGF-I and IGFBP-3 measurements (obtained at a mean age of 8.0 years) and IQ measured with the Wechsler Intelligence Scale for Children (at a mean age of 8.7 years). We also investigated associations with measures of speech and language based on the Wechsler Objective Reading Dimensions test (measured at an age of 7.5 years) and the Wechsler Objective Language Dimensions test (listening comprehension subtest only, measured at an age of 8.7 years). For some children (n = 407), IGF-I (but not IGFBP-3) levels had been measured at approximately 5 years of age in a previous study. Linear regression models were used to investigate associations of the IGF-I system with the measures of cognitive function. RESULTS: Three hundred one boys and 246 girls were included in the sample. IGF-I levels (mean +/- SD) were 142.6 +/- 53.9 ng/mL for boys and 154.4 +/- 51.6 ng/mL for girls. IQ scores (mean +/- SD) were 106.05 +/- 16.6 and 105.27 +/- 15.6 for boys and girls, respectively. IGF-I levels were associated positively with intelligence. For every 100 ng/mL increase in IGF-I, IQ increased by 3.18 points (95% confidence interval [CI]: 0.52 to 5.84 points). These positive associations were seen in relation to the verbal component (coefficient: 4.27; 95% CI: 1.62 to 6.92), rather than the performance component (coefficient: 1.06; 95% CI: -1.67 to 3.78), of IQ. There was no evidence that associations with overall IQ differed between boys and girls. In a data set with complete information on confounders (n = 484), controlling for birth weight (adjusted for gestation), breastfeeding, and BMI slightly strengthened the associations of IGF-I levels with IQ. Additionally controlling for maternal education and IGFBP-3 levels attenuated the associations (change in IQ for every 100 ng/mL increase in IGF-I levels: 2.51 points; 95% CI: -0.42 to 5.44 points). The weakening of associations in models controlling for markers of parental socioeconomic position and education could reflect shared influences of parental IGF levels on parents' own educational attainment and their offspring's IGF-I levels. In unadjusted models examining associations of Wechsler Objective Reading Dimensions and Wechsler Objective Language Dimensions test scores with IGF-I levels, there was no strong evidence that performance on either of these tests was associated with circulating IGF-I levels, although positive associations were seen with both measures. Associations between IGF-I levels measured at age 5 and Wechsler Intelligence Scale for Children scores (n = 407) were similar to those for IGF-I levels measured at age 7 to 8. For every 100 ng/mL increase in IGF-I levels at 5 years of age, IQ increased by 2.3 points (95% CI: -0.21 to 4.89 points). CONCLUSIONS: This study provides some preliminary evidence that IGF-I is associated with brain development in childhood. Additional longitudinal research is required to clarify the role of IGF-I in neurodevelopment. Because IGF-I levels are modifiable through diet and other environmental exposures, this may be one pathway through which the childhood environment may influence neurodevelopment.

Birth Weight↗

Medication use during pregnancy: data from the Avon Longitudinal Study of Parents and Children.

OBJECTIVE: To present data on the self-reported use of all types of medicinal products collected during pregnancy in a large cohort in southwest England. METHODS: Pregnant women with a delivery date during 1991-1992 and forming part of the prospective, population-based Avon Longitudinal Study of Parents and Children (ALSPAC) were sent up to four self-completion postal questionnaires during pregnancy. Text data collected from the questions on drug usage were coded using an ALSPAC drug dictionary based on the World Health Organization Drug Dictionary. RESULTS: At least one antenatal self-completion questionnaire was completed for 14,119 pregnancies, and 11,545 women completed all four. The data included prescription, over-the-counter, herbal and homeopathic products as well as iron, vitamins and other supplements. Only 7.6% did not report use of any medicinal product throughout their entire pregnancy. The remaining 92.4% used at least one product at some stage. After exclusion of iron, folate, vitamins, supplements, herbal and homeopathic products and skin emollients, 83% of those completing all questionnaires had used conventional therapeutic drugs. Analgesics were reported by approximately one-third of women at each stage during pregnancy, and paracetamol was the most frequently reported substance. Iron preparations were reported by 33% of the full cohort, at some stage, and folate by 21.9%. Use of anti-anaemic products increased during pregnancy with the greatest incidence at 32 weeks. Other vitamins and supplements were taken by 17.4% at some stage. Use of vitamins decreased throughout pregnancy from 9.6% in early pregnancy to 5% at 32 weeks. Antacids were reported by 23% at 32 weeks. The reported incidence of antibiotic use decreased slightly during pregnancy from 8% early on to 5.8% at 32 weeks; amoxicillin was the most frequently reported antibacterial. CONCLUSION: Use of medicinal products was high during pregnancy in the ALSPAC cohort. This finding is consistent with data from recent publications.

Adolescent↗

Does breast-feeding in infancy lower blood pressure in childhood? The Avon Longitudinal Study of Parents and Children (ALSPAC).

BACKGROUND: Breast-feeding in infancy has been associated with decreased coronary heart disease mortality, but the underlying mechanisms are unclear. We investigated the association of breast-feeding with blood pressure in a contemporary cohort. METHODS AND RESULTS: In a prospective cohort study (ALSPAC, United Kingdom), a total of 7276 singleton, term infants born in 1991 and 1992 were examined at 7.5 years. Complete data were available for 4763 children. The systolic and diastolic blood pressures of breast-fed children were 1.2 mm Hg lower (95% CI, 0.5 to 1.9) and 0.9 mm Hg lower (0.3 to 1.4), respectively, compared with children who were never breast-fed (models controlled for age, sex, room temperature, and field observer). Blood pressure differences were attenuated but remained statistically significant in fully adjusted models controlling for social, economic, maternal, and anthropometric variables (reduction in systolic blood pressure: 0.8 mm Hg [0.1 to 1.5]; reduction in diastolic blood pressure: 0.6 mm Hg [0.1 to 1.0]). Blood pressure differences were similar whether breast-feeding was partial or exclusive. We examined the effect of breast-feeding duration. In fully adjusted models, there was a 0.2-mm Hg reduction (0.0 to 0.3) in systolic pressure for each 3 months of breast-feeding. CONCLUSIONS: Breast-feeding is associated with a lowering of later blood pressure in children born at term. If the association is causal, the wider promotion of breast-feeding is a potential component of the public health strategy to reduce population levels of blood pressure.

Adult↗