Language delay as an early marker in neurodevelopmental disorders. Nutritional influences

Transcription

1 Language delay as an early marker in neurodevelopmental disorders Nutritional influences

2 Background Folate is important for neurodevelopment Neural tube defects More subtle cognitive effects? Fatty acids are crucial for brain development Supplementation studies Breastfeeding

3 Background Language is a good measure of overall cognitive ability and IQ Language delay is an early symptom of neurodevelopmental disorders like autism, ADHD, schizophrenia 5 % of the children in MoBa is reported to be delayed at the age of three

4 MoBa - Data Collection Ultrasound week 17 week 30 Birth 6 months 18 months 3 years 7 years Child Mother Umbilical cord QI QII QIII QIV QV QVI QVII Father

5 MoBa - Recruitment April, pregnancies mothers live births fathers fathers some participate with more than one child

6 MoBa Sources of data Questionnaires Nutrition, smoking, alcohol, medication, health behaviour, psychological variables, social support etc Registries and hospital records Medical birth registry Prescription database Cause of death Cancer registry Vaccination registry, infectious disease registry Socioeconomic and demographic factors

7 Outcome Language competency, 36 months questionnaire Dorothy Bishop, language complexity Ages and Stages (ASQ), language skills Social Communication Questionnaire (SCQ)

8 Fatty acids: Exposures Food frequency questionnaire, week Analyses in plasma? FADS2, involved in genetic control of fatty acid pathways moderate breastfeeding effects?

9 Exposures Folate: Food frequency questionnaire, week Plasma, 600 mother-child pairs, week 17 Panel of B-vit, B-vit markers, related onecarbon metabolites DNA, 300 trios and 300 mother-child pairs 14 SNPs related to B-vit pathways

10 Folate and fatty acids 1. Estimate the relative risk of language delay according to maternal intake of Fatty acids Folate and other B-vitamin metabolites Food frequency questionnaire, week Plasma, 600 mother-child pairs, week 17 Panel of B-vit, B-vit markers, related one- carbon metabolites

11 Obstetric complications 2. Explore the independent effect of intake of fatty acids and folate on language delay controlling for complications during pregnancy and adverse pregnancy outcomes

12 Folate antagonists 3. Estimate the relative risk of language delay according to maternal use of folic acid antagonists during pregnancy

13 Biological material 4. Estimate the relative risk of Language Delay according to level of folate and metabolites in the folate pathway as measured in plasma sampled from the mother, father and child Related to presence of folate-relevant alleles (single nucleotide polymorphisms) using DNA from the mother, the father and the child Related to dietary intake contingent on the presence of specific folate-relevant alleles

14 Currently we are focusing on: Birth order Preeclampsia Fatty acids and vit D Folate Folate antagonists

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16 Potential explanations for an association with preeclampsia Fetal anoxia leading to brain damage? Indicator of maternal immune attack on the developing brain? Common yet unknown etiological factor? Fatty acids? Vit D?

17 Background Early environmental influence in neurodevelopment Obstetric complications Nutritional influences Folate Fatty acids