Language delay as an early marker in neurodevelopmental disorders Nutritional influences
Background Folate is important for neurodevelopment Neural tube defects More subtle cognitive effects? Fatty acids are crucial for brain development Supplementation studies Breastfeeding
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
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
MoBa - Recruitment April, 2008 100 349 pregnancies 86 007 mothers 93 668 live births 67 384 fathers 76 795 fathers some participate with more than one child
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
Outcome Language competency, 36 months questionnaire Dorothy Bishop, language complexity Ages and Stages (ASQ), language skills Social Communication Questionnaire (SCQ)
Fatty acids: Exposures Food frequency questionnaire, week 17-22 Analyses in plasma? FADS2, involved in genetic control of fatty acid pathways moderate breastfeeding effects?
Exposures Folate: Food frequency questionnaire, week 17-22 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
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 17-22 Plasma, 600 mother-child pairs, week 17 Panel of B-vit, B-vit markers, related one- carbon metabolites
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
Folate antagonists 3. Estimate the relative risk of language delay according to maternal use of folic acid antagonists during pregnancy
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
Currently we are focusing on: Birth order Preeclampsia Fatty acids and vit D Folate Folate antagonists
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?
Background Early environmental influence in neurodevelopment Obstetric complications Nutritional influences Folate Fatty acids