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Leffelaar E.R.,VU University Amsterdam | Leffelaar E.R.,Documentation and Health Promotion | Van Eijsden M.,Documentation and Health Promotion
British Journal of Nutrition | Year: 2010

Low vitamin D levels during pregnancy may account for reduced fetal growth and for altered neonatal development. The present study explored the association between maternal vitamin D status measured early in pregnancy and birth weight, prevalence of small-for-gestational-age (SGA) infants and postnatal growth (weight and length), as well as the potential role of vitamin D status in explaining ethnic disparities in these outcomes. Data were derived from a large multi-ethnic cohort in The Netherlands (Amsterdam Born Children and their Development (ABCD) cohort), and included 3730 women with live-born singleton term deliveries. Maternal serum vitamin D was measured during early pregnancy (median 13 weeks, interquartile range: 12-14), and was labelled deficient (299nmol/l), insufficient (30-499nmol/l) or adequate (50nmol/l). Six ethnic groups were distinguished: Dutch, Surinamese, Turkish, Moroccan, other non-Western and other Western. Associations with neonatal outcomes were analysed using multivariate regression analyses. Results showed that compared with women with adequate vitamin D levels, women with deficient vitamin D levels had infants with lower birth weights (1144g, 95% CI 1512, 776) and a higher risk of SGA (OR 24, 95% CI 19, 32). Neonates born to mothers with a deficient vitamin D status showed accelerated growth in weight and length during the first year of life. Although a deficient vitamin D status influenced birth weight, SGA risk and neonatal growth, it played a limited role in explaining ethnic differences. Although vitamin D supplementation might be beneficial to those at risk of a deficient vitamin D status, more research is needed before a nationwide policy on the subject can be justified. © 2010 The Authors.


De Wit M.A.S.,Documentation and Health Promotion | Selten J.-P.,Mental Health Service
Social Psychiatry and Psychiatric Epidemiology | Year: 2012

Purpose Several European studies have shown that migrants from non-western countries are at increased risk of psychotic disorders. This study examines how this is reflected in the risk of acute compulsory admission (ACA). Methods Information on all patients with an ACA in Amsterdam from 1996 to 2005 was linked to the Amsterdam municipal register. Results The incidence of first ACA in Amsterdam was 4.5 per 10,000 person years. The incidence risk of ACA for any psychiatric disorders and for psychotic disorders in particular showed a 2- to 3-fold increase in almost all migrant groups from non-western countries, and especially for second-generation migrants. In addition, all non-western migrant groups were at increased risk of being assessed as posing a danger to others. Conclusions The relative risk of ACA for psychotic disorders was similar to that for the incidence of psychotic disorders in most ethnic groups from other studies, suggesting that the increased risk of ACA in non-western migrants can mainly be explained by the increased incidence of psychotic disorders in these groups. However, the relative risk of ACA for psychotic disorders among Moroccan migrants was lower than expected on the basis of incidence studies, which suggests that additional factors are relevant, such as illness-related expression and access to and quality of care. © Springer-Verlag 2010.


Van Eijsden M.,Documentation and Health Promotion | Van Eijsden M.,VU University Amsterdam | Roseboom T.J.,University of Amsterdam | Van Der Post J.A.M.,University of Amsterdam
Hypertension | Year: 2013

Adverse intrauterine conditions can program hypertension. Because one of the underlying mechanisms is thought to be cardiac autonomic balance, we investigated the association between prepregnancy body mass index (BMI) and blood pressure and indicators of the autonomic balance in the child at age 5 to 6 years. Also investigated was whether these associations were mediated by standardized birth weight and child BMI. Pregnant women (n=3074) participating in the Amsterdam Born Children and their Development study completed a questionnaire at gestational week 14. At age 5 to 6 years, offspring's sympathetic drive (pre-ejection period), parasympathetic drive (respiratory sinus arrhythmia), and heart rate were measured by electrocardiography and impedance cardiography at rest. Blood pressure was assessed simultaneously. After adjusting for possible maternal/offspring confounders, prepregnancy BMI was positively linearly associated with diastolic blood pressure (β=0.11 mm Hg; 95% confidence interval, 0.05-0.17), systolic blood pressure (β=0.14 mm Hg; 95% confidence interval, 0.07-0.21), but not with heart rate, sympathetic or parasympathetic drive. After adding birth weight and child BMI to the model, the independent effect size of prepregnancy body mass index on systolic blood pressure (β=0.07 mm Hg; 95% confidence interval, 0.00-0.14) and diastolic blood pressure (β=0.07 mm Hg; 95% confidence interval, 0.01-0.13) decreased by ≈50%. Birth weight did not mediate these relationships, but was independently and negatively associated with blood pressure. Child BMI was positively associated with blood pressure and partly mediated the association between prepregnancy BMI and blood pressure. In conclusion, higher prepregnancy BMI is associated with higher blood pressure in the child (aged 5-6 years) but does not seem to be attributable to early alterations in resting cardiac autonomic balance. Child BMI, but not birth weight, mediated the association between prepregnancy BMI and blood pressure. © 2013 American Heart Association, Inc.


Brandenbarg J.,Documentation and Health Promotion | Vrijkotte T.G.M.,University of Amsterdam | Goedhart G.,University Utrecht | Van Eijsden M.,Documentation and Health Promotion | Van Eijsden M.,VU University Amsterdam
Psychosomatic Medicine | Year: 2012

OBJECTIVE: To examine low maternal vitamin D status as a potential risk factor for high levels of depressive symptoms in a pregnant population. METHODS: In the Amsterdam Born Children and Their Development cohort, maternal serum vitamin D (n = 4236) was measured during early pregnancy (median, 13 weeks) and labeled "deficient" (≤29.9 nM), "insufficient" (30-49.9 nM), "sufficient" (50-79.9 nM), and "normal" (≥80 nM). Maternal depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale at 16-week gestation. The association of vitamin D status with high levels of depressive symptoms (Center for Epidemiological Studies Depression score ≥16) was assessed by multivariate logistic regression (final sample, 4101). RESULTS: Overall, 23% of women had vitamin D deficiency, and 21% of women had vitamin D insufficiency. Women with high levels of depressive symptoms (28%) had lower vitamin D concentrations than women with low levels of depressive symptoms (p <.001). After adjustment for constitutional factors, life-style and psychosocial covariates, and sociodemographic factors, vitamin D deficiency (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.13-1.95) and insufficiency (OR, 1.44; 95% CI, 1.12-1.85) were significantly associated with high levels of depressive symptoms. Additional analyses revealed a linear trend, with an OR of 1.05 (95% CI, 1.02-1.08) for each 10-nM decrease in vitamin D status. CONCLUSIONS: In this study, low early-pregnancy vitamin D status was associated with elevated depressive symptoms in pregnancy. Further research, using a randomized controlled design, would be required to confirm the causality of this association and the potential benefits of higher vitamin D intake for psychosocial health. Copyright © 2012 by the American Psychosomatic Society.


Van Den Berg G.,EMGO Institute for Health and Care Research | Van Den Berg G.,Documentation and Health Promotion | Van Eijsden M.,Documentation and Health Promotion | Van Eijsden M.,VU University Amsterdam | And 3 more authors.
Hypertension | Year: 2013

Much remains to be understood about the socioeconomic inequalities in hypertension that continue to exist. We investigated the association of socioeconomic status with blood pressure and prehypertension in childhood. In a prospective cohort, 3024 five-to six-year-old children had blood pressure measurements and available information on potential explanatory factors, namely birth weight, gestational age, smoking during pregnancy, pregnancy-induced hypertension, familial hypertension, maternal body mass index, breastfeeding duration, domestic tobacco exposure, and body mass index. The systolic and diastolic blood pressures of children from mid-educated women were 1.0-mm Hg higher (95% CI, 0.4-1.7) and 0.9-mm Hg higher (95% CI, 0.3-1.4), and the blood pressures of children with low-educated women were 2.2-mm Hg higher (95% CI, 1.4-3.0) and 1.7-mm Hg higher (95% CI, 1.1-2.4) compared with children with high-educated women. Children with mid-(odds ratio, 1.50; 95% CI, 1.18-1.92) or low-educated mothers (odds ratio, 1.80; 95% CI, 1.35-2.42) were more likely to have prehypertension compared with children with high-educated mothers. Using path analyses, birth weight, breastfeeding duration, and body mass index were determined as having a role in the association of maternal education with offspring blood pressure and prehypertension. The socioeconomic gradient in hypertension appears to emerge from childhood as the results show a higher blood pressure and more prehypertension in children from lower socioeconomic status families. Socioeconomic disparities could be reduced by improving 3 factors in particular, namely birth weight, breastfeeding duration, and body mass index, but other factors might also play a role. © 2012 American Heart Association, Inc.


De Beer M.,VU University Amsterdam | Vrijkotte T.G.M.,University of Amsterdam | Fall C.H.D.,University of Southampton | Van Eijsden M.,Documentation and Health Promotion | And 2 more authors.
International Journal of Obesity | Year: 2015

Background:Growth and feeding during infancy have been associated with later life body mass index. However, the associations of infant feeding, linear growth and weight gain relative to linear growth with separate components of body composition remain unclear.Methods:Of 5551 children with collected growth and infant-feeding data in a prospective cohort study (Amsterdam Born Children and their Development), body composition measured using bioelectrical impedance analysis at the age of 5-6 years was available for 2227 children. We assessed how feeding (duration of full breastfeeding and timing of introduction of complementary feeding) and conditional variables representing linear growth and relative weight gain were associated with childhood fat-free mass (FFM) and fat mass (FM).Results:Birth weight was positively associated with both FFM and FM in childhood, and more strongly with FFM than FM. Faster linear growth and faster relative weight gain at all ages in infancy were positively associated with childhood FFM and FM. The associations with FM were stronger for relative weight gain than for linear growth (FM z score: β coefficient 0.23 (95% con 0.19 to 0.26), P<0.001 and 0.14 (0.11 to 0.17), P<0.001 per s.d. change in relative weight gain and linear growth between 1 and 3 months, respectively). Compared with full breastfeeding <1 month, full breastfeeding >6 months was associated with lower FM (FM z score: -0.17 (-0.28 to -0.05), P=0.005) and lower FFM (FFM z score: -0.13 (-0.23 to -0.03), P=0.015), as was the introduction of complementary feeding >6 months (FM z score: -0.22 (-0.38 to -0.07), P=0.004), compared with <4 months.Conclusions:Faster infant weight gain is associated with a healthier childhood body composition when it is caused by faster linear growth. Full breastfeeding >6 months and introduction of complementary feeding >6 months are associated with lower childhood FM.


Van Dijk T.K.,Documentation and Health Promotion | Agyemang C.,University of Amsterdam | De Wit M.,Documentation and Health Promotion | Hosper K.,Documentation and Health Promotion | Hosper K.,University of Amsterdam
European Journal of Public Health | Year: 2011

Background: This study examines the associations between perceived discrimination and depressive symptoms among Turkish-Dutch and Moroccan-Dutch adolescents and young adults living in the Netherlands. Methods: We analysed cross-sectional data from a sample of 199 Turkish-Dutch and 153 Moroccan-Dutch respondents, aged 15-24 years, using multiple logistic regression analyses. Discrimination was measured on group level and personal level. Depression was measured by the Centre for Epidemiologic Studies-Depression Scale (CES-D). Results: Respondents that experienced perceived discrimination on a personal level were more likely than those that experienced no perceived discrimination to have depression (OR=3.21, 95 CI=1.59-6.47). This association was larger for the Moroccan-Dutch (OR=5.32, 95 CI=1.75-16.16) compared with the Turkish-Dutch (OR=2.76, 95 CI=1.03-7.40). Analysis of separate group level discrimination items, measuring different domains, revealed an association between discrimination on school and depression for the Moroccan-Dutch (OR=2.80, 95 CI=1.16-6.78). Conclusion: Personal level perceived discrimination is associated with depressive symptoms among young minority group members with a Turkish or Moroccan cultural background. This indicates that discrimination is an important factor that should be taken into account in developing public health policies. © The Author 2010. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.


Dorn T.,Documentation and Health Promotion | Ceelen M.,Documentation and Health Promotion | Buster M.,Documentation and Health Promotion | Das K.,Public Health Service Amsterdam
Psychiatric Services | Year: 2013

Objective: Research on the mental health of police detainees is scarce. This study aimed to identify the proportion of persons detained by the Police Service Amsterdam- Amstelland who screened positive for a serious mental condition. Methods: A survey conducted in 2009 among 264 randomly selected detainees assessed demographic characteristics and general medical andmental health and included use of the Brief Jail Mental Health Screen (BJMHS) (N5248). Results: Almost 40% of survey respondents screened positive on the BJMHS, indicating a need for further evaluation. This rate was lower than the rate reported for police detainees in Australia but substantially higher than the rates reported for persons incarcerated in U.S. jails. Conclusions: More systematic research is needed to examine reasons for reports of different rates of mental illness among detainees in different countries.


De Hoog M.L.A.,University of Amsterdam | De Hoog M.L.A.,Documentation and Health Promotion | Stronks K.,University of Amsterdam | Van Eijsden M.,Documentation and Health Promotion | And 2 more authors.
International Journal of Obesity | Year: 2012

Objective: To determine the ethnic variation in maternal underestimation of their child's weight status and the explanatory role of socio-economic status (SES), acculturation and parental body mass index (BMI).METHOD:A multi-ethnic sample of 2769 normal or overweightobese children (underweight children excluded) aged 5-7 years was examined (The Amsterdam Born Child and their Development study), comprising five ethnic subgroups: Dutch (n1744), African descent (n184), Turkish (n86), Moroccan (n161) and other non-Dutch (n592). Data on mothers perception of their child's weight status (5-point scale from too low to too high), SES, acculturation, parental BMI and the children's height and weight were collected. Underestimation was defined by comparing maternal perception with the actual weight status of her child (International Obesity Task Force guidelines). Ethnic differences in underestimation were calculated in the normal weight and overweightobese categories. Results: Underestimation ranged from 3.6 (Dutch) to 15.7 (Moroccan) in normal-weight children, and from 73.0 (Dutch) to 92.3 (Turkish) in overweightobese children. After correction for ethnic differences in child's BMI, higher odds ratios (ORs) for underestimation were found in the Turkish (normal weight: OR 6.83; 95 confidence interval (CI) 2.33-20.05 and overweight: OR 2.80; 95 CI 1.12-6.98) and Moroccan (normal weight: OR 11.55; 95 CI 5.28-25.26) groups (reference is the Dutch group). Maternal educational level and immigrant generation largely explained the ethnic differences, with a minor contribution of maternal age. After correction, ORs remained higher in the Moroccan group (OR 4.37; 95 CI 1.79-10.62) among the normal-weight children.CONCLUSION:Mothers frequently underestimate the actual weight status of their child, especially mothers from Turkish or Moroccan origin. Having a lower SES, being first-generation immigrant and a young mother are important determinants in explaining these differences. As weight perceptions may affect weight gain and almost all mothers of overweightobese children underestimate their child's weight, health professionals should help mothers (particularly those from ethnic minority groups) to acquire a realistic perception of their children's weight status. © 2012 Macmillan Publishers Limited All rights reserved.


van den Berg G.,VU University Amsterdam | van den Berg G.,Documentation and Health Promotion | van Eijsden M.,Documentation and Health Promotion | van Eijsden M.,VU University Amsterdam | And 2 more authors.
PLoS ONE | Year: 2012

Objective: Socioeconomic status (SES) is adversely associated with perinatal outcomes. This association is likely to be mediated by tobacco exposure. However, previous studies were limited to single perinatal outcomes and devoted no attention to environmental tobacco exposure. Therefore, this study aimed firstly to explain the role of maternal smoking in the association between maternal education and preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA), and secondly to explain whether environmental tobacco smoke mediates these associations further. Study Design: This study was nested in a population-based cohort study in the Netherlands, the Amsterdam Born Children and their Development (ABCD) study. Analyses were done in a sample of 3821 pregnant women of Dutch origin, using logistic regression analysis. Results: Least educated women, who were more often smoking and exposed to environmental tobacco smoke, had a significantly higher risk of PTB (OR 1.95 [95% CI: 1.19-3.20]), LBW (OR 2.41 [95% CI: 1.36-4.27]) and SGA (OR 1.90 [95% CI 1.32-2.74]) than highly educated women. The mediating effect of smoking in the least educated women was 43% for PTB, 55% for LBW and 66% for SGA. Environmental tobacco smoke did not explain these associations further. After adjustment for maternal smoking, the association between lower maternal education and pregnancy outcomes was no longer significant. Conclusions: Smoking explains to a considerable extent the association between lower maternal education and adverse perinatal outcomes. Therefore, tobacco-interventions in lower educated women should be primarily focussed on maternal smoking to reduce PTB, LBW, and SGA. Additional attention to environmental tobacco exposure does not seem to reduce educational inequalities in perinatal outcomes. © 2012 van den Berg et al.

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