Municipal Institute of Medical Research

Barcelona, Spain

Municipal Institute of Medical Research

Barcelona, Spain
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Koutra K.,University of Crete | Chatzi L.,University of Crete | Bagkeris M.,University of Crete | Vassilaki M.,University of Crete | And 4 more authors.
Social Psychiatry and Psychiatric Epidemiology | Year: 2013

Purpose: A growing body of evidence links poor maternal mental health with negative outcomes on early child development. We examined the effect of antenatal and postnatal maternal mental health on infant neurodevelopment at age 18 months in a population-based mother-child cohort (Rhea Study) in Crete, Greece. Methods: Self-reported measures of maternal depression (EPDS), trait anxiety (STAI-Trait) and personality traits (EPQ-R) were assessed in a sample of women during pregnancy and at 8 weeks postpartum (n = 223). An additional sample of 247 mothers also completed the EPDS scale at 8 weeks postpartum (n = 470). Neurodevelopment at 18 months was assessed with the use of Bayley Scales of Infant and Toddler Development (3rd edition). Results: Multivariable linear regression models adjusted for confounders revealed that antenatal depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive development independently of postnatal depression. High trait anxiety and extraversion were associated with decrease and increase, respectively, in social-emotional development. Also, high trait anxiety and neuroticism had a positive effect on infants' expressive communication. Finally, postpartum depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive and fine motor development independently of antenatal depression. Conclusions: These findings suggest that antenatal and postnatal maternal psychological well-being has important consequences on early child neurodevelopment. © 2012 Springer-Verlag Berlin Heidelberg.


Chatzi L.,University of Crete | Garcia R.,Center for Research in Environmental Epidemiology | Garcia R.,CIBER ISCIII | Roumeliotaki T.,University of Crete | And 15 more authors.
British Journal of Nutrition | Year: 2013

Maternal diet during pregnancy might influence the development of childhood allergic disorders. The aim of the present study was to evaluate the impact of Mediterranean diet (MD) adherence during pregnancy on wheeze and eczema in the first year of life in two population-based mother-child cohorts in Spain and Greece. We studied 1771 mother-newborn pairs from the Spanish multi-centre 'INMA' (INfancia y Medio Ambiente) study (Gipuzkoa, Sabadell and Valencia) and 745 pairs from the 'RHEA' study in Crete, Greece. The symptoms of wheeze and eczema were based on the criteria of the International Study of Asthma and Allergies in Childhood. Maternal diet during pregnancy was assessed by FFQ and MD adherence was evaluated through an a priori score. Multivariate log-binomial regression models were used to adjust for several confounders in each cohort and summary estimates were obtained by a meta-analysis. MD adherence was not associated with the risk of wheeze and eczema in any cohort, and similar results were identified in the meta-analysis approach. High meat intake (relative risk (RR) 1·22, 95 % CI 1·00, 1·49) and 'processed' meat intake (RR 1·18, 95 % CI 1·02, 1·37) during pregnancy were associated with an increased risk of wheeze in the first year of life, while a high intake of dairy products was significantly associated with a decreased risk of infantile wheeze (RR 0·83, 95 % CI 0·72, 0·96). The results of the present study show that high meat intake during pregnancy may increase the risk of wheeze in the first year of life, while a high intake of dairy products may decrease it. © The Authors 2013.


Koutra K.,University of Crete | Vassilaki M.,University of Crete | Georgiou V.,University of Crete | Koutis A.,University of Crete | And 5 more authors.
Social Psychiatry and Psychiatric Epidemiology | Year: 2014

Purpose: Antenatal maternal mental health has been identified as an important determinant of postpartum depression (PPD). We investigated the occurrence of depression both antenatally and postnatally and examined whether maternal trait anxiety and depression during pregnancy were associated with PPD at 8 weeks postpartum in a prospective mother-child cohort (Rhea Study) in Crete, Greece. Methods: 438 women completed the Edinburgh Postnatal Depression Scale (EPDS) and the Trait subscale of the State-Trait Anxiety Inventory (STAI-Trait) questionnaires assessing antenatal depression and anxiety, respectively, during the third trimester of pregnancy as well as the EPDS at 8 weeks postpartum. Results: The prevalence of women with probable depression (EPDS score ≥13) was 16.7 % at 28-32 weeks of pregnancy and 13.0 % at 8 weeks postpartum. A per 5 unit increase in the STAI-Trait subscale increased the odds for PPD by 70 % (OR = 1.70, 95 % CI 1.41, 2.05), whereas a per unit increase in EPDS during pregnancy increased the odds for PPD by 27 % (OR = 1.27, 95 % CI 1.19, 1.36). Conclusions: Our findings suggest that antenatal maternal psychological well-being has a significant effect on PPD, which might have important implications for early detection during pregnancy of women at risk for postpartum depression. © 2013 Springer-Verlag Berlin Heidelberg.


van de Loock K.,Vrije Universiteit Brussel | Fthenou E.,University of Crete | Decordier I.,Vrije Universiteit Brussel | Chalkiadaki G.,University of Crete | And 10 more authors.
Environmental Health Perspectives | Year: 2011

Background: The use of cancer-related biomarkers in newborns has been very limited. Objective: We investigated the formation of micronuclei (MN) in full-term and preterm newborns and their mothers from the Rhea cohort (Crete), applying for the first time in cord blood a validated semiautomated analysis system, in both mono- and binucleated T lymphocytes. Methods: We assessed MN frequencies in peripheral blood samples from the mothers and in umbilical cord blood samples. We calculated MN in mononucleated (MNMONO) and binucleated (MNBN) T lymphocytes and the cytokinesis block proliferation index (CBPI) in 251 newborns (224 full term) and 223 mothers, including 182 mother-child pairs. Demographic and lifestyle characteristics were collected. Results: We observed significantly higher MNBN and CBPI levels in mothers than in newborns. In newborns, MNMONO and MNBN were correlated (r = 0.35, p < 0.001), and we found a moderate correlation between MNMONO in mothers and newborns (r = 0.26, p < 0.001). MNMONO frequencies in newborns were positively associated with the mother's body mass index and inversely associated with gestational age and mother's age, but we found no significant predictors of MNBN or CBPI in newborns. Conclusions: Although confirmation is needed by a larger study population, the results indicate the importance of taking into account both mono- and binucleated T lymphocytes for biomonitoring of newborns, because the first reflects damage expressed during in vivo cell division and accumulated in utero, and the latter includes additional damage expressed as MN during the in vitro culture step.


Costet N.,French Institute of Health and Medical Research | Costet N.,University of Rennes 1 | Villanueva C.M.,Center for Research in Environmental Epidemiology | Villanueva C.M.,Medica Hospital del Mar | And 12 more authors.
Occupational and Environmental Medicine | Year: 2011

Several epidemiological studies suggested an association between the risk of bladder cancer and the exposure to trihalomethanes (THMs), the main disinfection byproducts (DBPs) of chlorinated water. A previous pooled analysis of case-control studies from North America and Europe estimated a summarized dose-response relation. For policy guidance of drinking water disinfection in Europe and because major differences exist in water disinfection practices and DBPs occurrence between both continents, specific risk estimates for bladder cancer in relation to DBPs exposure for European populations were needed. We conducted a pooled and a two-stage random-effect meta-analyses of three European case-control studies from France, Finland, and Spain (5467 individuals: 2381 cases and 3086 controls). Individual exposure to THMs was calculated combining information on residential history, estimates of the average total THMs (TTHM) level in tap water at the successive residences and personal water consumption. A significant odds-ratio was observed for men exposed to an average residential TTHM level > 50 μg/l (OR=1.47 (1.05; 2.05)) when compared to men exposed to levels ≤ 5 μg/l. The linear trend of the exposure-risk association was significant (p=0.01). Risks increased significantly for exposure levels above 25 μg/l and with more than 30 years of exposure to chlorinated water, but were mainly driven by the level rather than the duration of exposure. No significant association was found among women or with cumulative exposure through ingestion. There was no evidence of a differential exposureresponse relation for TTHM and bladder cancer in Europe and North America. Consequently, a global exposure-risk relation based on 4351 cases and 7055 controls is now available.


de Nazelle A.,Center for Research in Environmental Epidemiology | de Nazelle A.,Municipal Institute of Medical Research | de Nazelle A.,CIBER ISCIII | Morton B.J.,University of North Carolina at Chapel Hill | And 2 more authors.
Transportation Research Part D: Transport and Environment | Year: 2010

This paper examines how conversion of automobile trips of less than 3. miles to other transportation modes reduces emissions. Short trips contribute disproportionately to emissions because of cold starts. An analysis is conducted of short-trip behavior across the US using the 1995 Nationwide Personal Transportation Survey. The data is used to develop likely scenarios of mode conversions for short trips, which are then applied to estimate emission savings using MOBILE6 cold start and running emission factors for volatile organic compounds, nitrogen oxides, carbon monoxide, and carbon dioxide. The results suggest that reducing short auto trips would modestly reduce mobile source air pollution, but emission reductions are high compared to most federally-funded surface transportation interventions aimed at improving air quality. Enhanced the community pedestrian environment to encourage short trip mode conversion also produces co-benefits such as increased physical activity and subsequent reductions in chronic diseases. © 2010 Elsevier Ltd.


Leynaert B.,French Institute of Health and Medical Research | Leynaert B.,University Paris Diderot | Leynaert B.,Center dInvestigation Clinique | Sunyer J.,Center for Research on Environmental Epidemiology | And 33 more authors.
Thorax | Year: 2012

Background: Although women with severe non-allergic asthma may represent a substantial proportion of adults with asthma in clinical practice, gender differences in the incidence of allergic and non-allergic asthma have been little investigated in the general population. Methods: Gender differences in asthma prevalence, reported diagnosis and incidence were investigated in 9091 men and women randomly selected from the general population and followed up after 8-10 years as part of the European Community Respiratory Health Survey. The protocol included assessment of bronchial responsiveness, IgE specific to four common allergens and skin tests to nine allergens. Results: Asthma was 20% more frequent in women than in men over the age of 35 years. Possible under-diagnosis of asthma appeared to be particularly frequent among non-atopic individuals, but was as frequent in women as in men. The follow-up of subjects without asthma at baseline showed a higher incidence of asthma in women than in men (HR 1.94; 95% CI 1.40 to 2.68), which was not explained by differences in smoking, obesity or lung function. More than 60% of women and 30% of men with new-onset asthma were non-atopic. The incidence of non-allergic asthma was higher in women than in men throughout all the reproductive years (HR 3.51; 95% CI 2.21 to 5.58), whereas no gender difference was observed for the incidence of allergic asthma. Conclusions: This study shows that female sex is an independent risk factor for non-allergic asthma, and stresses the need for more careful assessment of possible non-allergic asthma in clinical practice, in men and women.


Roman-Vinas B.,University of Barcelona | Ortiz-Andrellucchi A.,University of Las Palmas de Gran Canaria | Mendez M.,Municipal Institute of Medical Research | Sanchez-Villegas A.,University of Las Palmas de Gran Canaria | And 4 more authors.
Maternal and Child Nutrition | Year: 2010

The objective of this study was to review how accurately micronutrient intakes in infants, children, and adolescents were assessed with validated food frequency questionnaires (FFQs) to which study quality criteria had been applied. The methodology and the analysis presented were based on several research activities carried out within the European Micronutrient Recommendation Aligned Network of Excellence. The analysis was limited to vitamin D, vitamin C, vitamin B 12, folate, selenium, iron, zinc, iodine, calcium, and copper. A search strategy was defined in MEDLINE and EMBASE literature for studies validating FFQs that estimated intakes of micronutrients being evaluated. Identification of at least three validation studies per micronutrient was required to be included in the analysis. A total score for each nutrient was calculated from the mean of the correlation coefficients weighted by the quality of the study, which included a quality score that was based on sample size, statistics used, data collection procedure, consideration of seasonality and supplement use, an adjustment/weighting of the correlation coefficient according to the quality score, and a rating of the adjusted/weighted correlation. When the mean weighted correlation coefficient was equal to or higher than 0.5, micronutrient intake was considered as adequately estimated. Sufficient validation studies were identified for vitamin C, vitamin D, vitamin B 12, iron, zinc, and calcium for infants and pre-school children, and vitamin C, calcium, and iron for older children and adolescents. Results showed that the FFQ was a good instrument for estimating intake of vitamin C, vitamin D, calcium, zinc and iron in infants and pre-school children, and for estimating calcium and vitamin C in children and adolescents. © 2010 Blackwell Publishing Ltd.


Dezetter A.,EHESP School of Public Health | Dezetter A.,University of Paris Descartes | Briffault X.,Municipal Institute of Medical Research | Alonso J.,Municipal Institute of Medical Research | And 7 more authors.
Psychiatric Services | Year: 2011

Objective: This study analyzed use of services from psychiatrists and other mental health professionals (psychologists, psychotherapists, counselors, and social workers) in six European countries. Methods: Data were from respondents (N=8,796) to the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross-sectional survey (2001-2003) of a representative sample of noninstitutionalized adults in Belgium, France, Germany, Italy, the Netherlands, and Spain that was conducted via computer-assisted interviews with the Composite International Diagnostic Interview, version 3.0. Results: Twenty-three percent of respondents reported lifetime use of any professional for mental health problems, and 60% consulted a mental health provider. Among these, 56% used a psychiatrist and 68% used a nonpsychiatrist provider. Factors associated with use of psychiatrists only were being retired or unemployed, having 12 or fewer years of education, living in France or Spain, having a severe disorder, and using psychotropic medication. Factors associated with use of nonpsychiatrist providers only were living in the Netherlands or Germany, never being married, and having an anxiety disorder. Conclusions: The findings suggest that there is no simple model of associations between mental health care system and patterns of service use. System characteristics, such as practitioner-population ratios, levels of practitioner availability, and gatekeeping and reimbursement policies, affect patterns of use of mental health providers. Recent British and Australian plans could be used as models for better allocation of services in some ESEMeD countries.


Dolk H.,University of Ulster | Armstrong B.,London School of Hygiene and Tropical Medicine | Lachowycz K.,London School of Hygiene and Tropical Medicine | Vrijheid M.,London School of Hygiene and Tropical Medicine | And 5 more authors.
Occupational and Environmental Medicine | Year: 2010

Objectives To investigate whether there is an association between risk of congenital anomaly and annual ward level exposure to air pollution in England during the 1990s. Methods A geographical study was conducted across four regions of England using population-based congenital anomaly registers, 1991-1999. Exposure was measured as 1996 annual mean background sulphur dioxide (SO 2), nitrogen dioxide (NO2) and particulate matter (PM 10) concentrations at census ward level (n=1474). Poisson regression, controlling for maternal age, area socioeconomic deprivation and hospital catchment area, was used to estimate relative risk for an increase in pollution from the 10th to the 90th centile. Results For non-chromosomal anomalies combined, relative risks were 0.99 (95% CI 0.93 to 1.05) for SO2, 0.97 (95% CI 0.84 to 1.11) for NO2 and 0.89 (95% CI 0.75to 1.07) for PM10. For chromosomal anomalies, relative risks were 1.06 (95% CI 0.98 to 1.15) for SO2, 1.11 (95% CI 0.95 to 1.30) for NO2 and 1.18 (95% CI 0.97 to 1.42) for PM10. Raised risks were found for tetralogy of Fallot and SO2 (RR=1.38, 95% CI 1.07 to 1.79), NO 2 (RR=1.44, 95% CI 0.71 to 2.93) and PM10 (RR=1.48, 95% CI 0.57 to 3.84), which is of interest in light of previously reported associations between this cardiac anomaly and other air pollutants. Conclusions While air pollution in the 1990s did not lead to sustained geographical differences in the overall congenital anomaly rate in England, further research regarding specific anomalies is indicated.

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