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Biomedical subjects

Debbie A Lawlor

Publications and source records attributed to Debbie A Lawlor.

At least 73 records · Page 4Linked to original sources
PubMed2005

Early life predictors of adolescent smoking: findings from the Mater-University study of pregnancy and its outcomes.

In this study we have examined the early life predictors of smoking at age 14 in a birth cohort of individuals born in Brisbane, Australia between 1981 and 1984. In stratified and multivariable analyses maternal smoking throughout pregnancy and when the child was aged 14 were both associated with the child smoking: fully adjusted odds ratio [95% confidence interval] comparing maternal smoking throughout pregnancy with never smoking was 1.40 [1.25, 1.65] and that comparing maternal smoking when the child was aged 14 with not smoking was 1.57 [1.19, 2.06]. The association of maternal smoking throughout pregnancy was specific for adolescent smoking and was not associated with alcohol consumption, TV viewing or self-report of poor school performance at age 14. Maternal and paternal educational attainment were also associated with smoking at age 14, with these associations attenuating towards the null with adjustment for childhood behavioural problems and cognitive function. There was no association of family income with smoking at age 14 once other explanatory variables were taken into account.

Adolescent↗
PubMed2005

The association of ambient outdoor temperature throughout pregnancy and offspring birthweight: findings from the Aberdeen Children of the 1950s cohort.

BACKGROUND: We assessed the effect of mean ambient outdoor temperature during gestation on birthweight. OBJECTIVE: To assess the effect of mean ambient outdoor temperature during gestation on birth weight. DESIGN: Birth cohort study with record linkage to climate databases. SETTING: Aberdeen, Scotland. SAMPLE: A total of 12,150 individuals born in Aberdeen, Scotland between 1950 and 1956. METHODOLOGY/PRINCIPAL FINDINGS: Perinatal data from a cohort of 12,150 individuals born in Aberdeen, Scotland between 1950 and 1956 were linked to daily outdoor temperature data. Birthweight was seasonally patterned, with lowest birthweights among those born in the winter months (December-February) and highest birthweights among those born in the autumn months (September-November); P= 0.01 for joint sine-cosine functions. Mean ambient outdoor temperature during the first trimester of pregnancy was inversely associated with birthweight and mean ambient outdoor temperature during the third trimester of pregnancy was positively associated with birthweight. In fully adjusted (for sex, maternal age, birth year, birth order and social class) models a 1 degrees C increase in mean ambient outdoor temperature in the mid 10-day period of the first trimester was associated with a 5.4-g (95% confidence interval [CI] 2.9, 7.9 g) decrease in birthweight, whereas a 1 degrees C increase in the mid 10-day period of the third trimester was associated with a 1.3-g (95% CI 0.50, 2.1 g) increase in birthweight. Ambient outdoor temperature in the first trimester of pregnancy explained the seasonal patterning of birthweight. MAIN OUTCOME MEASURE: Birthweight. RESULTS: Birthweight was seasonally patterned, with lowest birthweights among those born in the winter months (December-February) and highest birthweights among those born in the autumn months (September-November); P= 0.01 for joint sine-cosine functions. Mean ambient outdoor temperature during the first trimester of pregnancy was inversely associated with birthweight and mean ambient outdoor temperature during the third trimester of pregnancy was positively associated with birthweight. In fully adjusted (for sex, maternal age, birth year, birth order and social class) models a 1 degrees C increase in mean ambient outdoor temperature in the mid 10-day period of the first trimester was associated with a 5.4 g (95% confidence interval 2.9, 7.9 g) decrease in birthweight, whereas a 1 degrees C increase in the mid 10-day period of the third trimester was associated with a 1.3 g (95% confidence interval 0.50, 2.1 g) increase in birthweight. Ambient outdoor temperature in the first trimester of pregnancy explained the seasonal patterning of birthweight. CONCLUSION: Higher ambient outdoor temperature in the first trimester of pregnancy and/or lower ambient outdoor temperature in the third trimester are associated with reduced offspring birthweight. With the increasing occurrence of temperature extremes, in particular, heat waves, these findings, if replicated in other studies, have important public health implications.

Adolescent↗
PubMed2005

Socio-economic position across the life course and hysterectomy in three British cohorts: a cross-cohort comparative study.

OBJECTIVE: To examine the association between indicators of lifetime socio-economic position and rates of hysterectomy in three British cohorts. DESIGN: Cross-cohort comparative study. SETTING: Two cohorts: England, Scotland and Wales. Third cohort: Aberdeen, Scotland. POPULATION: Three thousand two hundred and eight women born between 1919 and 1940, participating in the British Women's Heart and Health Study (BWHHS); 1394 women from the MRC National Survey of Health and Development (NSHD), followed up since birth in 1946; 3208 women born between 1950 and 1955, participating in the Aberdeen Children of the 1950s study, all with complete information on lifetime socio-economic position and hysterectomy status. METHODS: Relative indices of inequality were derived for markers of socio-economic position in childhood and adulthood. Cox's regression models were used to test the association between these markers and hysterectomy. MAIN OUTCOME MEASURE: Self-reported hysterectomy with or without oophorectomy. RESULTS: Adverse socio-economic position in childhood and as indicated by educational status was associated with reduced rates of hysterectomy in the oldest of the three cohorts (BWHHS), whereas conversely in the NSHD and Aberdeen cohorts it was associated with increased rates of hysterectomy. The unadjusted hazards ratios for hysterectomy comparing worst to best socio-economic position for father's social class were 0.73 (0.56, 0.96) for women from the BWHHS, 1.77 (1.19, 2.65) for those from the NSHD and 2.06 (1.46, 2.89) for those from the Aberdeen cohort. Associations between markers of adult socio-economic position and hysterectomy tended to be weaker in all three cohorts and often did not reach conventional levels of statistical significance. CONCLUSIONS: Our results show that hysterectomy rates are influenced by childhood socio-economic position and educational attainment, but that the nature of this association varies across these three British cohorts born in different decades of the 20th century. That there were no consistent or strong associations between adult SEP and hysterectomy rates suggest that social factors influencing rates of hysterectomy are likely to be those experienced or which develop in early life rather than those which develop later.

Adult↗
PubMed2005

Association between childhood and adulthood socioeconomic position and pregnancy induced hypertension: results from the Aberdeen children of the 1950s cohort study.

BACKGROUND: Pregnancy induced hypertension may indicate a tendency towards endothelial and metabolic abnormalities leading to future cardiovascular disease. Childhood socioeconomic adversity is associated with increased cardiovascular disease risk but the association with pregnancy induced hypertension is unknown. AIM: To examine the association of childhood and adulthood socioeconomic position with pregnancy induced hypertension. DESIGN: Historical cohort study with record linkage to obstetric data. SUBJECTS: 3485 women who were born in Aberdeen between 1950 and 1956 and delivered 7080 viable singleton offspring in the period up until to 1999. MAIN OUTCOME MEASURE: Pregnancy induced hypertension (pre-eclampsia and gestational hypertension) in these women's pregnancies. RESULTS: Neither childhood nor adulthood socioeconomic position were associated with either pre-eclampsia or gestational hypertension. The fully adjusted odds ratio (95% confidence interval) comparing those born in manual social classes to those born in non-manual social classes for pre-eclampsia was 1.10 (0.72 to 1.73) and for gestational hypertension was 1.02 (0.83 to 1.32). Similar results comparing women in manual with non-manual social classes classified at the time of each pregnancy were 1.09 (0.73 to 1.67) for pre-eclampsia and 0.99 (0.81 to 1.30) for gestational hypertension. CONCLUSION: Although imprecise these results suggest that neither childhood nor adulthood socioeconomic adversity is associated with pregnancy induced hypertension.

Adult↗
PubMed2005

Intrauterine growth and intelligence within sibling pairs: findings from the Mater-University study of pregnancy and its outcomes.

OBJECTIVE: To examine the association between intrauterine growth and intelligence. DESIGN: Population based birth cohort study of sibling pairs born within a maximum of three years of each other. SETTING: Mater-University women and children's hospital, Brisbane, Australia. PARTICIPANTS: 235 (470 children) sibling pairs. RESULTS: Among one randomly selected sibling from each pair verbal comprehension at age 5, general intelligence at age 14, and reading ability at age 14 increased linearly with increasing gestational age and sex standardised birth weight z scores. With adjustment for maternal age, race, and smoking during pregnancy, birth order, family income, and parental education the associations with verbal comprehension at age 5 and general intelligence at age 14 remained, whereas the association with reading ability at age 14 was attenuated to the null. Within sibling pairs, differences in intrauterine growth were positively associated with differences in verbal comprehension at age 5 (test score difference per one unit difference in birth weight z score = 1.52 (0.11 to 3.26)) and general intelligence at age 14 (1.09 (0.01 to 2.18)), but not with reading ability at age 14. CONCLUSIONS: Socioeconomic position or other fixed maternal characteristics do not seem to explain the positive association between intrauterine growth and childhood intelligence.

Adolescent↗
PubMed2005

Adverse socioeconomic position across the lifecourse increases coronary heart disease risk cumulatively: findings from the British women's heart and health study.

OBJECTIVE: To examine the associations of childhood and adult measurements of socioeconomic position with coronary heart disease (CHD) risk. METHODS: Cross sectional and prospective analysis of a cohort of 4286 British women who were aged 60-79 years at baseline. Among these women there were 694 prevalent cases of CHD and 182 new incident cases among 13 217 person years of follow up of women who were free of CHD at baseline. RESULTS: All measurements of socioeconomic position were associated with increased prevalent and incident CHD in simple age adjusted models. There was a cumulative effect, on prevalent and incident CHD, of socioeconomic position across the lifecourse. This effect was not fully explained by adult CHD risk factors. The adjusted odds ratio of prevalent CHD for each additional adverse (out of 10) lifecourse socioeconomic indicator was 1.11 (95% confidence interval: 1.06, 1.16). The magnitude of the effect of lifecourse socioeconomic position was the same in women who were lifelong non-smokers as in those who had been or were smokers. CONCLUSION: Adverse socioeconomic position across the lifecourse increases CHD risk cumulatively and this effect is not fully explained by adult risk factors. Specifically in this cohort of women cigarette smoking does not seem to explain the association between adverse lifecourse socioeconomic position and CHD risk.

Aged↗
PubMed2005

Early life predictors of childhood intelligence: evidence from the Aberdeen children of the 1950s study.

OBJECTIVE: To identify the early life predictors of childhood intelligence. DESIGN: Cohort study of 10 424 children who were born in Aberdeen (Scotland) between 1950 and 1956. RESULTS: Social class of father around the time of birth, gravidity, maternal age, maternal physical condition, whether the child was born outside of marriage, prematurity, intrauterine growth, and childhood height were all independently associated with childhood intelligence at ages 7, 9, and 11. The effect of social class at birth was particularly pronounced, with a graded linear association across the distribution even with adjustment for all other covariates (p<0.001 for linear trend). Those from the lowest social class (V) had intelligence scores that were on average 0.9-1.0 of a standard deviation lower than those from the higher groups (I and II) at each of the three ages of intelligence testing. Collectively, the early life predictors that were examined explained 16% of the variation in intelligence at each age. CONCLUSIONS: Father's social class around the time of birth was an important predictor of childhood intelligence, even after adjustment for maternal characteristics and perinatal and childhood factors. Studies of the association of childhood intelligence with future adult disease need to ensure that the association is not fully explained by socioeconomic position.

Adult↗
PubMed2005

Accuracy of adults' recall of childhood social class: findings from the Aberdeen children of the 1950s study.

BACKGROUND: Although adult reported childhood socioeconomic position has been related to health outcomes in many studies, little is known about the validity of such distantly recalled information. This study evaluated the validity of adults' reports of childhood paternal social class. METHODS: Data are drawn from the Aberdeen children of the 1950s study, a cohort of 12 150 people born in Aberdeen (Scotland) who took part in a school based survey in 1962. In this survey, two indices of early life socioeconomic position were collected: occupational social class at birth (abstracted from maternity records) and occupational social class in childhood (reported during the 1962 survey by the study participants). Between 2000 and 2003, a questionnaire was mailed to traced middle aged cohort members in which inquiries were made about their fathers' occupation when they were aged 12 years. The level of agreement between these reports and prospectively collected data on occupational social class was assessed. RESULTS: In total, 7183 (63.7%) persons responded to the mid-life questionnaire. Agreement was moderate between social class of father recalled in adulthood and that measured in early life (kappa statistics were 0.47 for social class measured at birth, and 0.56 for social class reported by the child). The relation of occupational social class to birth weight and childhood intelligence was in the expected directions, although weaker for adults' reports in comparison with prospectively gathered data. CONCLUSIONS: In studies of adult disease aetiology, associations between childhood social class based on adult recall of parental occupation and health outcomes are likely to underestimate real effects.

Birth Weight↗
PubMed2005

Associations of fibrinogen and C-reactive protein with prevalent and incident coronary heart disease are attenuated by adjustment for confounding factors. British Women's Heart and Health Study.

A cross sectional and prospective analysis of 3,745 British women aged 60-79 years at baseline was undertaken. Among these women there were 570 prevalent cases of coronary heart disease (CHD) and 151 new cases among 12,641 person-years of follow up of women who were free of CHD at baseline. Both fibrinogen and CRP were associated with indicators of socioeconomic position in childhood and adulthood and there was a cumulative effect of socioeconomic position from across the life course. The age-adjusted odds ratio (95% confidence interval) of prevalent CHD for a 1 unit (1 g/L) increase in fibrinogen was 1.29 (1.12, 1.49); with full adjustment for all potential confounding factors this attenuated to 1.09 (0.93, 1.28). The hazards ratio for incident CHD among those free of disease at baseline was 1.28 (1.00, 1.64); with full adjustment for all potential confounding factors this attenuated to 1.09 (0.84, 1.44). Similar effects of adjustment for confounding factors were seen for the associations between CRP and both prevalent and incident CHD. By contrast, the strong positive association between smoking (an established causal risk factor for CHD) and CHD was not attenuated by adjustment for life course socioeconomic position or other risk factors. We conclude that fibrinogen and CRP predict CHD but may not be causally related to it.

Age Factors↗
PubMed2005

Life-course socioeconomic position, area deprivation, and coronary heart disease: findings from the British Women's Heart and Health Study.

OBJECTIVES: We sought to determine whether residential area deprivation, over and above the effect of life-course socioeconomic status or position (SEP), is associated with coronary heart disease. METHODS: We conducted a cross-sectional analysis of 4286 women aged 60 to 79 years from 457 British electoral wards. RESULTS: After adjustment for age and 10 indicators of individual life-course SEP, the odds of coronary heart disease was 27% greater among those living in wards with a deprivation score above the median compared with those living in a ward with a deprivation score equal to or below the median (odds ratio=1.27; 95% confidence interval=1.02, 1.57). CONCLUSIONS: Adverse area-level socioeconomic characteristics, over and above individual life-course SEP, are associated with increased coronary heart disease.

Aged↗
PubMed2005

Childhood socioeconomic position, educational attainment, and adult cardiovascular risk factors: the Aberdeen children of the 1950s cohort study.

OBJECTIVES: We assessed the associations of childhood socioeconomic position with cardiovascular disease risk factors (smoking, binge alcohol drinking, and being overweight) and examined the roles of educational attainment and cognitive functioning in these associations. METHODS: Data were derived from a cohort study involving 7184 individuals who were born in Aberdeen, Scotland, between 1950 and 1956; had detailed records on perinatal characteristics, childhood anthropometry, and cognitive functioning; and responded to a mailed questionnaire when they were aged 45 to 52 years. RESULTS: Strong graded associations existed between social class at birth and smoking, binge drinking, and being overweight. Adjustment for educational attainment completely attenuated these associations. However, after control for adult social class, adult income and other potential confounding or mediating factors, some association remained. CONCLUSIONS: Educational attainment is an important mediating factor in the relation between socioeconomic adversity in childhood and smoking, binge drinking, and being overweight in adulthood.

Cardiovascular Diseases↗
PubMed2004

Associations of parental, birth, and early life characteristics with systolic blood pressure at 5 years of age: findings from the Mater-University study of pregnancy and its outcomes.

BACKGROUND: We examined the associations of a range of parental and early life characteristics with systolic blood pressure at 5 years of age. METHODS AND RESULTS: Information from 3864 children who were followed up prospectively from their mother's first antenatal clinic assessment was used. Maternal age, body mass index, and smoking during pregnancy were all positively associated with offspring systolic blood pressure at 5 years of age. The systolic blood pressure of children whose mothers had smoked throughout pregnancy was on average 0.92 mm Hg (95% CI 0.17 to 1.68) greater than that of children whose mothers had never smoked, after full adjustment. Children who had been breast fed until at least 6 months had lower systolic blood pressure than those who were breast fed for a shorter duration. Paternal body mass index and child's weight, height, and body mass index were all positively associated with blood pressure at age 5. CONCLUSIONS: Because childhood blood pressure tracks into adulthood, interventions aimed at early life risk factors, such as quitting smoking during pregnancy, breast feeding, and prevention of obesity in all family members, may be important for reducing the population distribution of blood pressure and thus cardiovascular disease risk.

Adult↗
PubMed2004

The association of the PON1 Q192R polymorphism with coronary heart disease: findings from the British Women's Heart and Health cohort study and a meta-analysis.

BACKGROUND: There have been inconsistent results from case-control studies assessing the association of the PON1 Q192R polymorphism with coronary heart disease (CHD). Most studies have included predominantly men and the association in women is unclear. Since lipid levels vary between the sexes the antioxidant effect of PON1 and any genes associated with it may also vary by sex. We have examined the association of the PON1 Q192R polymorphism with CHD in a large cohort of British women and combined the results from our cohort study with those from all other published studies. RESULTS: The distribution of genotypes was the same among women with CHD and those without disease. The odds ratio (95% confidence interval) of having CHD comparing those with either the QR or RR genotype to those with QQ genotype (dominant model of association) was 1.03 (0.89, 1.21) and the per allele odds ratio was 0.98 (0.95, 1.01). In a meta-analysis of this and 38 other published studies (10,738 cases and 17,068 controls) the pooled odds ratio for the dominant effect was 1.14 (1.08, 1.20) and for the per allele effect was 1.10 (1.06, 1.13). There was evidence of small study bias in the meta-analyses and the dominant effect among those studies with 500 or more cases was 1.05 (0.96, 1.15). Ethnicity and reporting of whether the genotyping was done blind to the participants clinical status also contributed to heterogeneity between studies, but there was no difference in effect between studies with 50% or more women compared to those with fewer women and no difference between studies of healthy populations compared to those at high risk (with diabetes, renal disease of familial hypercholesterolaemia). CONCLUSION: There is no robust evidence that the PON1 Q192R polymorphism is associated with CHD risk in Caucasian women or men.

Aged↗
PubMed2004

(Mis)use of factor analysis in the study of insulin resistance syndrome.

Over the last decade, factor analysis has been used increasingly to describe patterns of simultaneous occurrence of the central components of the insulin resistance syndrome. In this paper, the authors describe factor analysis, review studies that have used factor analysis to examine the insulin resistance syndrome, and explore how factor analysis might be used to increase our understanding of this syndrome. Most studies that they reviewed gave vague reasons for using factor analysis and did not demonstrate an understanding of the use and limitations of this statistical method. Confirmatory factor analysis based on sound theoretical concepts and a clear understanding of the statistical methods may provide some insights into the pathophysiology of the syndrome. However, to date none of the studies has adopted this approach, and other statistical approaches and study designs are likely to provide greater understanding of the syndrome.

Factor Analysis, Statistical↗
PubMed2004

Clustering of risk factors and social class in childhood and adulthood in British women's heart and health study: cross sectional analysis.

OBJECTIVE: To examine co-occurrence and clustering of risk factors used in the Framingham equation by social class in childhood and adult life. DESIGN: Cross sectional study. SETTING: 23 towns across England, Wales, and Scotland. PARTICIPANTS: 2936 women aged 60-79 years. MAIN OUTCOME MEASURES: Prevalence of risk factors (hypertension, obesity, smoking, left ventricular hypertrophy on electrocardiography, diabetes, and low concentration of high density cholesterol); ratios of observed to expected frequencies of clusters of risk factors. RESULTS: Risk factors were more common in women from manual social classes in either childhood or adult life, and the co-occurrence of three or four of these risk factors was greater among more disadvantaged groups. Within the four socioeconomic groups, these risk factors occurred together more than would be expected from their individual frequency distributions, indicating that they were clustered. The extent of this clustering was similar in all four social class groups. CONCLUSIONS: Clustering of risk factors included in the Framingham risk function occurs in all social class groups, but the lack of social patterning makes it unlikely that clustering is an explanation of socioeconomic inequalities in cardiovascular disease. As the proportion of women with co-occurrence of risk factors is greatest in those from manual social class in childhood, this measure of socioeconomic position might prove useful in risk prediction.

Aged↗