University of Oulu

Parmar P, Lowry E, Vehmeijer F, et al. Understanding the cumulative risk of maternal prenatal biopsychosocial factors on birth weight: a DynaHEALTH study on two birth cohorts, J Epidemiol Community Health 2020; 74: 933-941.

Understanding the cumulative risk of maternal prenatal biopsychosocial factors on birth weight : a DynaHEALTH study on two birth cohorts

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Author: Parmar, Priyanka1; Lowry, Estelle2; Vehmeijer, Florianne3,4,5;
Organizations: 1Center for Life Course Health Research, University of Oulu, Oulu, Finland
2School of Natural and Built Environment, Queen’s University Belfast, Belfast, UK
3Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
4The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands
5Department of Pediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands
6Department of Child and Adolescent Psychiatry, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
7Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
8Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
9Department of Epidemiology and Bio-statistics, School of Public Health, Imperial College London, London, UK
10Medical Research Center (MRC) Oulu, University of Oulu, Oulu, Finland
11Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
12Department of Clinical and Experimental Medicine, School of Biosciences and Medicine, University of Surrey, Guildford, UK
13Department of Metabolism, Digestion and Reproduction, Genomic Medicine, Faculty of Medicine, Imperial College London, London, UK
14Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
15MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
16Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
Format: article
Version: published version
Access: open
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Language: English
Published: BMJ, 2020
Publish Date: 2021-01-19


Background: There are various maternal prenatal biopsychosocial (BPS) predictors of birth weight, making it difficult to quantify their cumulative relationship.

Methods: We studied two birth cohorts: Northern Finland Birth Cohort 1986 (NFBC1986) born in 1985–1986 and the Generation R Study (from the Netherlands) born in 2002–2006. In NFBC1986, we selected variables depicting BPS exposure in association with birth weight and performed factor analysis to derive latent constructs representing the relationship between these variables. In Generation R, the same factors were generated weighted by loadings of NFBC1986. Factor scores from each factor were then allocated into tertiles and added together to calculate a cumulative BPS score. In all cases, we used regression analyses to explore the relationship with birth weight corrected for sex and gestational age and additionally adjusted for other factors.

Results: Factor analysis supported a four-factor structure, labelled closely to represent their characteristics as ‘Factor1-BMI’ (body mass index), ‘Factor2-DBP’ (diastolic blood pressure), ‘Factor3-Socioeconomic-Obstetric-Profile’ and ‘Factor4-Parental-Lifestyle’. In both cohorts, ‘Factor1-BMI’ was positively associated with birth weight, whereas other factors showed negative association. ‘Factor3-Socioeconomic-Obstetric-Profile’ and ‘Factor4-Parental-Lifestyle’ had the greatest effect size, explaining 30% of the variation in birth weight. Associations of the factors with birth weight were largely driven by ‘Factor1-BMI’. Graded decrease in birth weight was observed with increasing cumulative BPS score, jointly evaluating four factors in both cohorts.

Conclusion: Our study is a proof of concept for maternal prenatal BPS hypothesis, highlighting the components snowball effect on birth weight in two different European birth cohorts.

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Series: Journal of epidemiology and community health
ISSN: 0143-005X
ISSN-E: 1470-2738
ISSN-L: 0143-005X
Volume: 74
Issue: 11
Pages: 933 - 941
DOI: 10.1136/jech-2019-213154
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This work was supported by the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 633595 (DynaHEALTH), and grant agreement no. 733206 (LifeCycle) H2020–824989 EUCANCONNECT, H2020–873749 LongITools, H2020–848158 EarlyCause and the JPI HDHL, PREcisE project, ZonMw, the Netherlands no. P75416; the academy of Finland EGEA-project (285547). The Northern Finland Birth Cohort 1986 was supported by EU QLG1-CT-2000-01643 (EUROBLCS) Grant no. E51560, NorFA Grant no. 731, 20056, 30167, USA/NIHH 2000 G DF682 Grant no. 50945. The general design of the Generation R Study was made possible by financial support from the Erasmus Medical Centre, Rotterdam, the Erasmus University Rotterdam, the Netherlands Organization for Health Research and Development and the Ministry of Health, Welfare and Sport. VWVJ received agrant from the Netherlands Organization for Health Research and Development (VIDI 016.136.361) and a Consolidator Grant from the European Research Council (ERC-2014-CoG-648916). The funding bodies had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
(733206) LIFECYCLE - Early-life stressors and LifeCycle health
(824989) EUCAN-Connect - A federated FAIR platform enabling large-scale analysis of high-value cohort data connecting Europe and Canada in personalized health
Academy of Finland Grant Number: 285547
Detailed Information: 285547 (Academy of Finland Funding decision)
Copyright information: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.