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

Background Maternal 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 findings We 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 lifestylerelated 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. Conclusions In 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.Peer reviewe

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

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

L'exposition maternelle aux pesticides

National audienceLes voies d’exposition aux pesticides sont multiples : par ingestion, inhalation ou contact cutané. On estime à un million, le nombre de femmes susceptibles d’être exposées (5% des femmes actives), directement ou indirectement, à ces substances dans leur environnement professionnel. Un nombre croissant d’études épidémiologiques suggère un impact de l’exposition aux pesticides pendant la grossesse sur la santé des enfants à la naissance ainsi que sur leur développement. Or, la connaissance des déterminants des niveaux d’imprégnation de pesticides de la population générale est aujourd’hui encore inégale en France

Characterization of environmental multi-exposure to pesticides in pregnant women

extended abstractInternational audienceThe objective was to develop a multi-residue approach to quantify different pesticides in urine from pregnant women and to assess their determinants of exposure. 244 urine samples from a mother-child cohort were analyzed by UHPLC/QTOFMS after a sample preparation step to look for 42 different molecules. Bayesian statistical analyses were used to study the determinants of exposure to >10% detected pesticides. Methylated organophosphorous (OP) were the most concentrated (600 µg/L). Determinants of exposure were: location in rural zone and proximity / presence of crops, diet, and smoking status. Surprisingly, an inverse association between the presence of potatoes or peas crops in the town of residence and urinary metabolites of pyrethroids was found

Deciphering the prenatal chemical exposome using placenta and metabolomics

International audienc

Organophosphate flame retardants: a review of indoor contamination and human exposure in Europe, and human health effects.

International audienc

Potential input from metabolomics for exploring and understanding the links between environment and health.

International audienceHumans may be exposed via their environment to multiple chemicals as a consequence of human activities and use of synthetic products. Little knowledge is routinely generated on the hazards of these chemical mixtures. The metabolomic approach is widely used to identify metabolic pathways modified by diseases, drugs, or exposures to toxicants. This review, based on the state of the art of the current applications of metabolomics in environmental health, attempts to determine whether metabolomics might constitute an original approach to the study of associations between multiple, low-dose environmental exposures in humans. Studying the biochemical consequences of complex environmental exposures is a challenge demanding the development of careful experimental and epidemiological designs, in order to take into account possible confounders associated with the high level of interindividual variability induced by different lifestyles. The choices of populations studied, sampling and storage procedures, statistical tools used, and system biology need to be considered. Suggestions for improved experimental and epidemiological designs are described. Evidence indicates that metabolomics may be a powerful tool in environmental health in the identification of both complex exposure biomarkers directly in human populations and modified metabolic pathways, in an attempt to improve understanding the underlying environmental causes of diseases. Nevertheless, the validity of biomarkers and relevancy of animal-to-human extrapolation remain key challenges that need to be properly explored

Évaluation des effets sur le neurodéveloppement de l’exposition prénatale et postnatale aux produits phytopharmaceutiques. Présentation du projet NEUROPHYTO

International audiencePrenatal and neonatal periods are windows of vulnerability to environmental chemical contaminants. A growing number of epidemiological and toxicological studies suggest that exposure to pesticides during these periods may impact the health of children at birth as well as their development, with potential delayed adverse effects.The NEUROPHYTO project is a new research project that aims to evaluate the exposure to pesticides of French children from prenatal period to early childhood and to study the possible effects of these exposures on their motor and neuropsychological development. New exposure data will be generated: levels of 140 pesticides and metabolites will be measured in biological samples (urine and hair) of 200 children from the national cohort Elfe (French longitudinal study of children). The levels of active substance(s) in the brain will be estimated using a mathematical model and then related to early neurodevelopmental effects. Two approaches will be used to better identify and characterize these links. The first strategy will rely on epidemiological methods and the second will be based on the understanding of the neurotoxicity mechanisms of the substances. Finally, a child-specific risk analysis will provide support to public policies by targeted evidence during pre- and post-natal windows of vulnerability.Les périodes prénatale et néonatale constituent des fenêtres de sensibilité vis-à-vis des contaminants chimiques de l’environnement. Un nombre croissant d’études épidémiologiques et toxicologiques suggère que l’exposition aux pesticides pendant ces périodes pourrait impacter la santé des enfants à la naissance ainsi que leur développement, avec des retentissements possibles tout au long de la vie.Le projet NEUROPHYTO est un nouveau projet de recherche qui vise à évaluer les expositions aux produits phytosanitaires d’enfants français lors de la période prénatale à la petite enfance et à étudier les effets possibles de ces expositions sur leur développement moteur et neuropsychologique. De nouvelles données d’exposition seront produites : les concentrations de 140 pesticides et métabolites seront mesurés dans les échantillons biologiques (urine et cheveux) de 200 enfants de la cohorte nationale Elfe (Etude longitudinale française depuis l’enfance). Les concentrations de substance(s) active(s) dans le cerveau seront estimées par modélisation puis mis en relation avec des effets neurodéveloppementaux précoces. Deux approches seront mises en œuvre afin de mieux identifier et caractériser ces liens : l’une épidémiologique et l’autre basée sur la compréhension des mécanismes de neurotoxicité des substances. Enfin, une analyse spécifique des risques pour les enfants permettra d’appuyer les politiques publiques en apportant des éléments ciblés sur les fenêtres de sensibilité pré et postnatales