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Apeldoorn, Netherlands

Vrijkotte T.G.M.,University of Amsterdam | Algera S.J.,University of Amsterdam | Brouwer I.A.,VU University Amsterdam | Van Eijsden M.,VU University Amsterdam | Twickler M.B.,Public Health Service of Amsterdam
Journal of Pediatrics | Year: 2011

Objective: To investigate whether randomly sampled maternal total cholesterol (TC) and triglycerides (TG) levels during early pregnancy are associated with birth weight (BW) and postnatal growth. Study design: Data were derived from the prospective Amsterdam Born Children and their Development cohort study. Randomly sampled TC and TG levels were determined in early gestation (median, 13; IQR, 12-14 weeks). Outcome measures were BW SDS and weight-for-gestational age; postnatal outcome measures were SDS in weight, length, and body mass index during the first year of life (total n = 2502). Results: The highest TG level was associated with a higher BW SDS (differences 0.20 ± 0.06 between highest and middle quintile; P =.002) and with a higher prevalence (13%) of an infant large for gestational age compared with middle quintile (9%; P =.04). Infants from mothers in the lowest TG quintile had lower SDS in weight, length, and body mass index until age 3 months, and displayed accelerated postnatal growth patterns. Maternal TC was not associated with BW or postnatal growth. Conclusion: High maternal TG levels in the first term of pregnancy were associated with higher BWs and subsequently a higher occurrence of infants large for gestational age, whereas low TG levels were associated with accelerated postnatal growth. Copyright © 2011 Mosby Inc. All rights reserved.

Vrijkotte T.G.M.,University of Amsterdam | Krukziener N.,University of Amsterdam | Hutten B.A.,University of Amsterdam | Vollebregt K.C.,Flevo Hospital | And 3 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2012

Context: Elevated lipid levels during late pregnancy are associated with complications and adverse outcome for both mother and newborn. However, it is inconclusive whether a disturbed lipid profile during early pregnancy has similar negative associations. Objective: Our objective was to investigate whether nonfasting maternal total cholesterol and triglyceride levels during early pregnancy are associated with six major adverse pregnancy outcomes. Methods: Data were derived from the Amsterdam Born Children and Their Development (ABCD) cohort study. Random blood samples of nonfasting total cholesterol and triglyceride levels were determined during early gestation (median = 13, interquartile range = 12-14 wk). Outcome measures were pregnancy-induced hypertension (PIH), preeclampsia, preterm birth, small/large for gestational age (SGA/LGA), and child loss. Only nondiabetic women with singleton deliveries were included; the baseline sample consisted of 4008 women. Analysis for PIH and preeclampsia were performed in nulliparous women only (n = 2037). Results: Mean (SD) triglyceride and total cholesterol levels were 1.33 (0.55) and 4.98 (0.87) mmol/liter, respectively. The incidence of pregnancy complications and perinatal outcomes were as follows: PIH, 4.9%; preeclampsia, 3.7%; preterm birth, 5.3%; SGA, 9.3%; LGA, 9.3%; and child loss, 1.4%. After adjustments, every unit increase in triglycerides was linearly associated with an increased risk of PIH [odds ratio (OR) = 1.60, P = 0.021], preeclampsia (OR = 1.69, P = 0.018), LGA (OR = 1.48, P < 0.001), and induced preterm delivery (OR = 1.69, P = 0.006). No associations were found for SGA or child loss. Total cholesterol was not associated with any of the outcome measures. Conclusions: Elevated maternal triglyceride levels measured during early pregnancy are associated with pregnancy complications and adverse pregnancy outcomes. These results suggest that future lifestyle programs in women of reproductive age with a focus on lowering triglyceride levels (i.e. diet, weight reduction, and physical activity) may help to prevent hypertensive complications during pregnancy and adverse birth outcomes. Copyright © 2012 by The Endocrine Society.

Bom R.J.M.,Public Health Laboratory | Christerson L.,Uppsala University | Schim Van Der Loeff M.F.,Public Health Service of Amsterdam | Coutinho R.A.,National Institute of Public Health and the Environment | And 2 more authors.
Journal of Clinical Microbiology | Year: 2011

We aimed to compare conventional ompA typing of Chlamydia trachomatis with multilocus sequence typing (MLST) and multilocus variable-number tandem-repeat (VNTR) analysis (MLVA). Previously used MLST and MLVA systems were compared to modified versions that used shorter target regions and nested PCR. Heterosexual couples were selected from among persons with urogenital C. trachomatis infections visiting the sexually transmitted infection outpatient clinic in Amsterdam, The Netherlands. We identified 30 couples with a total of 65 C. trachomatis-positive samples on which MLST and MLVA for eight target regions were performed. All regions were successfully sequenced in 52 samples, resulting in a complete profile for 18 couples and 12 individuals. Nine ompA genovars from D to K, with two variants of genovar G, were found. The numbers of sequence type and MLVA type profiles were 20 for MLST and 21 for MLVA, and a combination of MLST and MLVA yielded 28 profiles, with discriminatory indexes (D) ranging from 0.95 to 0.99. Partners in 17 couples shared identical profiles, while partners in 1 couple had completely different profiles. Three persons had infections at multiple anatomical locations, and within each of these three individuals, all profiles were identical. The discriminatory capacity of all MLST and MLVA methods is much higher than that of ompA genotyping (D = 0.78). No genotype variation was found within the samples of the same person or from heterosexual couples with a putative single transmission. This shows that the chlamydial genome in clinical specimens has an appropriate polymorphism to enable epidemiological cluster analysis using MLST and MLVA. Copyright © 2011, American Society for Microbiology. All Rights Reserved.

Stronks K.,University of Amsterdam | Snijder M.B.,University of Amsterdam | Peters R.J.,University of Amsterdam | Prins M.,Public Health Service of Amsterdam | And 3 more authors.
BMC Public Health | Year: 2013

Background: Populations in Europe are becoming increasingly ethnically diverse, and health risks differ between ethnic groups. The aim of the HELIUS (HEalthy LIfe in an Urban Setting) study is to unravel the mechanisms underlying the impact of ethnicity on communicable and non-communicable diseases. Methods/design. HELIUS is a large-scale prospective cohort study being carried out in Amsterdam, the Netherlands. The sample is made up of Amsterdam residents of Surinamese (with Afro-Caribbean Surinamese and South Asian-Surinamese as the main ethnic groups), Turkish, Moroccan, Ghanaian, and ethnic Dutch origin. HELIUS focuses on three disease categories: cardiovascular disease (including diabetes), mental health (depressive disorders and substance use disorders), and infectious diseases. The explanatory mechanisms being studied include genetic profile, culture, migration history, ethnic identity, socio-economic factors and discrimination. These might affect disease risks through specific risk factors including health-related behaviour and living and working conditions. Every five years, participants complete a standardized questionnaire and undergo a medical examination. Biological samples are obtained for diagnostic tests and storage. Participants' data are linked to morbidity and mortality registries. The aim is to recruit a minimum of 5,000 respondents per ethnic group, to a total of 30,000 participants. Discussion. This paper describes the rationale, conceptual framework, and design and methods of the HELIUS study. HELIUS will contribute to an understanding of inequalities in health between ethnic groups and the mechanisms that link ethnicity to health in Europe. © 2013 Stronks et al.; licensee BioMed Central Ltd.

Prince P.D.,Public Health Service of Amsterdam | Matser A.,Public Health Service of Amsterdam | Matser A.,University Utrecht | Van Tienen C.,Erasmus Medical Center | And 3 more authors.
AIDS | Year: 2014

OBJECTIVE:: As compared to HIV-1 infection, HIV-2 is less transmissible, disease progression is slower, and the mortality risk is lower. It has been suggested that HIV-2 infection inhibits the progression of HIV-1 in individuals dually infected by HIV-1 and HIV-2 (HIV-D). We examined whether the mortality rates in dually infected individuals differ from those in persons infected with either HIV-1 or HIV-2. DESIGN:: We conducted a systematic review and meta-analysis. METHODS:: Medline and Embase databases were searched for studies that reported the number of deaths and person-years of observation (PY) for at least two of the three HIV groups (i.e. HIV-1, HIV-2, and HIV-D). Meta-analyses were then performed with random-effects models, estimating combined mortality rate ratios (MRRs). RESULTS:: Of the 631 identified titles, six articles were included in the meta-analysis of HIV-D-infected individuals versus HIV-mono-infected persons, and seven were included in the analysis of HIV-1-mono-infected versus HIV-2-mono-infected individuals. The overall MRR of those infected with HIV-D versus HIV-1 was 1.11 [95% confidence interval (CI) 0.95-1.30]. The overall MRR of those infected with HIV-D versus HIV-2 was 1.81 (95% CI 1.43-2.30) and the MRR of those infected with HIV-1 versus HIV-2 was 1.86 (95% CI 1.44-2.39). CONCLUSION:: HIV-2-mono-infected persons have a lower mortality rate than those mono-infected with HIV-1 and those with HIV-D. There is no evidence that HIV-2 delays progression to death in HIV-D-infected individuals. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

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