Psychosocial and educational outcomes of weight faltering in infancy in ALSPAC

OBJECTIVES: To investigate whether infants with weight faltering have impaired psychosocial and educational outcomes in later childhood. DESIGN: Follow-up of infants with weight faltering in a large UK cohort study. SETTING: The Avon Longitudinal Study of Parents and Children (ALSPAC). PARTICIPANTS: 11 534 term infants from ALSPAC with complete weight records. Weight gain (conditional on initial weight) was calculated for three periods: from birth to 8 weeks, 8 weeks to 9 months, and birth to 9 months. Cases of weight faltering were defined as those infants with a conditional weight gain below the 5th centile, and these were compared with the rest of the cohort as the control group. OUTCOMES: Between 6 and 11 years, social, emotional and behavioural development was measured by direct assessment of the children and parental and teacher report. Educational outcomes included Standardised Assessment Test results at 7 and 11 years and Special Educational Needs status at age 11. RESULTS: Differences seen on univariate analysis in attention, non-verbal accuracy, educational attainment and special educational needs became non-significant after adjustment for confounding. Children with weight faltering in infancy did not differ from controls on any measures of self-esteem, peer relationships, experience of bullying, social cognition, antisocial activities, anxiety, depression or behavioural problems. CONCLUSIONS: Weight faltering in early infancy was associated with poorer educational outcomes in later childhood, but these associations were explained by confounding. The subsequent psychosocial development of infants with slow weight gain was not different from that of their peers

Girl or boy? Prenatal lead, cadmium and mercury exposure and the secondary sex ratio in the ALSPAC study

AbstractThe aim of this study was to evaluate the effect of prenatal exposure to lead, cadmium and mercury levels on the secondary sex ratio. Whole blood samples were collected from pregnant women enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) study at a median gestational age of 11 weeks and were analyzed for lead, cadmium and mercury. Regression analysis was used to identify associations between maternal lead, cadmium and mercury levels and the secondary sex ratio with adjustment for confounders. There was no evidence for associations between maternal lead, cadmium or mercury levels and the secondary sex ratio in this sample. It appears unlikely that alterations in the secondary sex ratio are influenced by exposure to heavy metals, but further work should be done in large cohorts in other countries to confirm these findings

Intake of game birds in the UK:assessment of the contribution to the dietary intake of lead by women of childbearing age and children

AbstractObjectiveConcern has recently been expressed about Pb levels in Pb-shot game meat. Our aim was to determine the consumption of game birds in a representative sample population in the UK, and in children and women of childbearing age in particular.DesignPopulation-based cross-sectional cohort study. Data from 4 d diet diaries from the UK National Diet and Nutrition Survey (NDNS; 2008–2010) were extracted to analyse data on game bird consumption in the sample population, in women of childbearing age (15–45 years old) and in children ≤6 years old.SettingHome-based study in representative areas of the UK.SubjectsParticipants in the NDNS (2008–2010; n 2126, age 1·5 to &gt;65 years).ResultsFifty-eight participants (2·7 %) reported eating game birds. The mean intake was 19·5 (sd 18·1) g/d (median 15·6, range 1·3–92·9 g/d). In women of childbearing age (15–45 years), 11/383 (2·9 %) reported eating game birds, with a mean intake of 22·4 (sd 25·8) g/d (median 15·6, range 2·0–92·9 g/d). In children aged ≤6 years old, 3/342 (0·9 %) were reported as eating game birds, with a mean intake of 6·8 (sd 9·7) g/d (median 2·4, range 1·3–23·2 g/d).ConclusionsThe prevalence of consumption of game birds by women of childbearing age and children ≤6 years old was relatively low and intakes were small. However, any exposure to Pb in these two groups is undesirable. As are uncertainties about the ability of the diet diary method to capture the consumption of food items that are infrequently consumed, alternative methods of capturing these data should be used in future studies.</jats:sec

Moderate prenatal cadmium exposure and adverse birth outcomes:a role for sex-specific differences?

BACKGROUND/AIM: Studies on the effects of moderate prenatal exposure to cadmium (Cd) on birth outcomes have been contradictory and it has been suggested that effects may be partly masked by sex‐specific effects. Our aim was to examine the association of Cd exposure in a large group of pregnant women with birth outcomes in the whole group of participants and by sex. METHODS: Pregnant women were enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples for singleton pregnancies with a live birth were analysed for Cd (n = 4191). Data collected on the infants included anthropometric variables and gestational age at delivery. Data were analysed using SPSS v18. RESULTS: There were adverse associations of maternal blood Cd level with birthweight (unstandardized B coefficient −62.7 g, 95% CI −107.0, −18.4) and crown–heel length (−0.28 cm, 95% CI −0.48, −0.07) in adjusted regression models. On stratification by sex, maternal blood Cd level was adversely associated with birthweight (−87.1 g, 95% CI −144.8, −29.4), head circumference (−0.22 cm, 95% CI −0.39, −0.04), and crown–heel length (−0.44 cm, 95% CI −0.71, −0.18) in girls but not in boys in adjusted regression models. CONCLUSION: In these pregnant women with moderate prenatal Cd exposure there evidence of adverse associations with birth anthropometry variables in the whole group. However, there was evidence of associations with anthropometric variables in girls that were not evident in boys. Sex‐specific effects require further investigation in large cohorts as a possible contributor to the lack of associations generally found in mixed‐sex studies

Blood mercury levels and fish consumption in pregnancy:Risks and benefits for birth outcomes in a prospective observational birth cohort

AbstractBackgroundTo avoid exposure to mercury, government advice on fish consumption during pregnancy includes information on fish species to avoid and to limit, while encouraging consumption of least two portions of fish per week. Some women may, however, chose to avoid fish completely during pregnancy despite potential benefits to the fetus.ObjectivesOur aims were to evaluate the effects of blood mercury levels in pregnant women on birth outcomes in the UK, and to compare outcomes in those who ate fish with those who did not.MethodsPregnant women were enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples for singleton pregnancies with a live birth were analysed for Hg by inductively coupled plasma dynamic reaction cell mass spectrometry (n=4044). Fish intake was determined by a food frequency questionnaire during pregnancy. Data collected on the infants included anthropometric variables and gestational age at delivery. Regression models were adjusted for covariates using SPSS v23.ResultsThere were no significant associations of maternal blood Hg level with birthweight, head circumference or crown–heel length in adjusted linear regression models. Similarly, there were no increased odds of low birthweight or preterm delivery in adjusted logistic regression models. When the models were repeated after stratification into fish-eaters and there were no associations except for a negative association with birthweight in non-fish-eaters (unstandardised B coefficient −58.4 (95% confidence interval −113.8, −3.0) g, p=0.039).ConclusionModerate mercury levels in pregnancy were not associated with anthropometric variables, or on the odds of low birthweight or preterm birth. Fish consumption may have a protective effect on birthweight. Consumption of fish in line with government guidelines during pregnancy should be encouraged

Impact of co-occurring hearing and visual difficulties in childhood on educational outcomes:a longitudinal cohort study

Background: Mild hearing and visual difficulties are common in childhood, and both may have implications for educational achievement. However, the impact of co-occurring common hearing and visual difficulties in childhood is not known. Objective: To determine the prevalence and impact of co-occurring common hearing and visual difficulties of childhood on educational outcomes in primary and secondary school. Methods: The sample was drawn from the Avon Longitudinal Study of Parents and Children, a longitudinal birth cohort study in England. The exposures were hearing and visual difficulties at age 7 (defined as conductive hearing loss or otitis media with effusion, and amblyopia, strabismus or reduced visual acuity, respectively). The outcomes measured were achievement of level 4 or above at Key Stage 2 (KS2) in English, Maths and Science, respectively, at age 11, and attainment of five or more General Certificate of Secondary Education (GCSEs) at grades A*-C at age 16. Multiple logistic regression models assessed the relationship between hearing and visual difficulties and educational outcomes, adjusting for potential confounding factors. Results: 2909 children were included in the study; 261 had hearing difficulties, 189 had visual difficulties and 14 children had co-occurring hearing and visual difficulties. Children with co-occurring hearing and visual difficulties were less likely to achieve the national target at KS2 compared with children with normal hearing and vision, even after adjustment for confounding factors (OR 0.30, CI 0.15 to 0.61 for KS2 English). Differences in IQ, behaviour, attention and social cognition did not account for this relationship. The impact of co-occurring hearing and visual difficulties on GCSE results was explained largely by poor performance at KS2. Conclusions: Co-occurring hearing and visual difficulties in childhood have an enduring negative impact on educational outcomes. Identification of affected children and early intervention in primary school is essential

Prevention of sports injuries in children at school: A systematic review of policies

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. Background Participation in sports as a child improves physical and psychological health. Schools need to promote sport while protecting against injury. It is not clear whether increasing evidence on injury prevention generated from professional sport is influencing school sports practices. This study reviewed policies promoting sport safety in schools to determine whether exposure to injury risk is recognised and whether evidence based prevention and management are included. Methods A search strategy to identify policies for children aged 4-18 years was applied to electronic databases and grey literature sources. Safeguarding policies were excluded. Included policies were critically appraised and synthesised using modified framework analysis. Results Twenty-six policies were analysed. Most (57.7%) were from the USA. Ten (38.5%) focused solely on concussion. Synthesis identified primary, secondary and tertiary injury prevention measures relating to people (staff, students and parents), systems, school physical environment and national-level factors. Conclusions Robust, evidence-based policies for reducing injury risk in school sports are limited. Guidelines with the largest evidence base were focused on concussion, with other school sport guidelines showing limited inclusion of evidence. Where included, evidence focused on injury management rather than prevention and frequently applied evidence from adult to children. Guidance was not specific to the child's age, gender or developmental stage