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Environments for Healthy Living

Environments for Healthy Living. Sinead Brophy College of Medicine, Swansea University. Data collected: Pregnancy:

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Environments for Healthy Living

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  1. Environments for Healthy Living Sinead Brophy College of Medicine, Swansea University

  2. Data collected: Pregnancy: Questionnaire (Socio-economic status (education, income, employment), mental health, family relationships, medications/vitamins, birth and feeding expectations, household cleanliness, partner information) Diet diary Weight, height, skin folds, blood pressure Fasting Glucose Physical activity & sedentary behaviour (accelerometer) Maternity record Birth: Medical notes for birth At 12 months Questionnaire (breast feeding, weaning, expectations for future) Skin folds, weight, height of child Diet diary of mother and child Medical notes for growth, vaccinations

  3. Linked with EHL in Australia • Very young study – pilot of 300 pregnant women compete • Planned contacts – pregnancy, 12 months, 3 years, 5 years • Collection of exposures using face to face contact • Collection of outcomes using routine data. • Exposures which will not be collected following findings from the pilot • Cord blood • Diffusion tube measures of pollution/Nitric Oxide • PROTOCOL BMC Public Health 2010, 10:150

  4. Datasets (incomplete coverage) Administrative Health: Population Inpatients Outpatients Emergency Department Child Health Database Wales NHS Direct Wales Administrative Non Health: Births Deaths Educational Attainment Social Services Housing Clinically rich data bases: Specialty specific Cancer Screening Congenital Anomalies Arthropathies Myocardial Infarction Diabetes Etc. General GP Data Laboratory systems Study specific Embedded trials and cohorts

  5. Questions: 1. Mental health in pregnancy and affect on health of child. Previous mental health diagnosis/treatment Current mental health problem (undiagnosed) Current mental health problem (diagnosed) Confounders and effect modifiers: diet, medication, co-morbidities Medical notes and routine data: Birth outcome (weight, gestation, apgar score, complications) Postnatal depression

  6. Questions 2. Sedentary behaviour and birth outcome. Accelerometer (Actigraph and GeneActiv) Sitting time, bouts of sitting. Confounders: Weight, co-morbidities, age Birth outcome (medical notes and routine data): Induced, C-section, length of labour, tears/stitches.

  7. Linkage with routine data: • Wales Electronic Children Cohort. • Links all birth in Wales, currently 794,398 children • Total population anonymised e-cohort, 8 datasets (1990+) • Funded • Vulnerable births: to inform service needs, development of interventions to improve health and reduce inequalities • Influence of the physical social and environment on childhood obesity

  8. WECC, n=123,633 (cell minimum of 100)

  9. All women consent to linkage (the cord blood may have improved consent for routine linkage) • Linked by NHS number • Focus group with teenagers found they feel it should be advertised that all data is being linked so that people are informed but consent should not be asked. (If you are treated within the NHS you consent).

  10. Embedding the EHL within WECC • Look in time at educational achievement, GP records for health (mother and baby). • EHL is a traditional birth cohort study embedded within a total population electronic cohort study • Low participant burden

  11. Thank you

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