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Larger studies and projects at the NIPH using MoBa data

There are nearly 200 active research projects in MoBa. A number of research projects use existing data from the study. Some have entered into a partnership with MoBa so participants in MoBa are invited to participate in additional projects. Some projects couple anonymous data from MoBa to other health registries.

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Foto: Anne Lene Solbakken, FHI

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ABC study (autism)

The ABC study is a large research project carried out in collaboration between the NIPH and Columbia University, New York. The purpose is to identify the causes of autism, as well as studying how autism spectrum disorders develop in children. The study stems from MoBa.

ABC study uses MoBa’s 36-month questionnaire to identify children who may have autism spectrum disorders. This form contains elements from various psychological tests used in the diagnosis of developmental disorders and mental disorders in children. Children with symptoms and traits that may indicate autism are invited to participate in a comprehensive clinical examination over two days in Oslo.

The studies are carried out by child psychologists and psychiatrists at the Nic Waals Institute. A random selection of participants is selected for a control group, and these are also invited to participate in the studies.

The causes of autism are little known, but it is widely accepted that genes play a major role. Genetic mutations that are currently linked to autism are rare individually, but together they contribute to a significant proportion of cases. Many of these genetic mutations are new, meaning that they only exist in the child and not the parents. However, there are many who have these genes but do not have autism. Environmental factors such as infections and environmental toxins are therefore also a focus, both alone and in interaction with genes. Environmental factors may trigger autism in individuals with a genetic vulnerability, and that they may act via genetic mutations or changes in the transcription of genes.

The ABC study has blood samples from mother, father and child, which makes it possible to distinguish different genetic mutations. Using questionnaire data and environmental samples the interaction between genes and environmental factors is examined, which can lead to breakthroughs in the understanding of autism.

The ABC children will be followed over many years, to see how different types of autism spectrum disorders develop in children. The study is funded by the National Institutes of Health (NIH) in the USA.

ADHD study: Restless children; active or hyperactive?

Why do some children develop ADHD and how can we identify these at an early stage? It is important to find answers to these questions so that the children and families concerned can get help as early as possible. The ADHD study uses data from MoBa and recruits participants from there. Clinicians employed in the study examine children and identify their abilities and any difficulties they may have. In addition to its own research, the study has information about conditions in foetal and early infancy, and biological materials.

The ADHD study is a long-term follow-up study which started with clinical studies of three-year olds in 2007. By 2011, over 1,200 children were examined, and parents completed questionnaire and were interviewed about any difficulties in the child. In 2012, studies of eight year olds began, and all those who were examined as three year olds will be invited to participate again.

The ADHD study has many sub-projects and collaborative projects that look at different phases and different issues related to ADHD and other mental health problems among children. The projects are centred round three main areas: early characteristics, course, and risk and causal factors.

Early characteristics

The need is great to find out how to distinguish between naturally active children and children who have chronic problems when they are small. Most of the ADHD research is on children of school age, and we know very little about specific characteristics of ADHD in pre-school children.

Developmental pathways 

Children grow quickly and differently and it is quite normal to find that a child struggles at times. For many the problems are temporary, while others have enduring difficulties and need support. To look at different developmental pathways associated with symptoms of ADHD and other disabilities, children are followed over time.

Risk and causal factors

The reasons why some get ADHD are complex and may be different for each child. We expect that both the innate, genetic and environmental factors may influence the development of ADHD. By combining data from biological material and questionnaires in MoBa with data from studies of children in the ADHD study, both genetic and environmental factors can be studied.

The study is a collaboration between NIPH and Oslo University Hospital.

BraMat (NewGeneris)

Does the mother’s diet during pregnancy affect her child? This is a question to be examined in BraMat. The project is part of the EU-funded research project NewGeneris (Newborns and genotoxic exposure risks) and is a subproject of MoBa.

BraMat will follow 200 children from birth until they are 3-4 years old. In this period, we will examine the child's defences against allergies, infections and cancer. We hope that BraMat can contribute to safer food and better nutritional advice for pregnant women.

The NewGeneris research project consists of a number of work packages (WP). Department of Environmental Immunology is involved in WP9: Biomarkers of immunotoxic risks. The goal is to develop biomarkers in umbilical cord blood that can predict immunotoxic effects of prenatal exposure to pollutants and other contaminants (such as acrylamide and alcohol).

BraMiljø (NewGeneris)

Does it matter how the child's mother lives and what she eats during pregnancy? These are the questions to be answered in BraMiljø. The project is part of the EU-funded research project NewGeneris (Newborns and genotoxic exposure risk), and is a subproject in MoBa.

The environment or the food we eat contains small amounts of substances that may be harmful to the body. Such substances may come from environmental pollution or they may be formed during cooking. During pregnancy, these substances could reach the unborn child, which is particularly vulnerable. At present, little is known about how these contaminants affect the child's health. The purpose of BraMiljø is to gain more knowledge about the impact of these contaminants on the unborn child. The knowledge gained from the project will help to make the environment safer and to provide better advice to pregnant women about diet and lifestyle.

Diabetes and Coeliac Disease

Each year, about 300 children in Norway develop type 1 diabetes, while more than 400 children develop coeliac disease. With the exception of some hereditary factors, we know little about the factors that affect the risk of these diseases. A study of MoBa (PAGE) will, in the next few years, investigate how genetic factors may interact with environmental factors on the risk of getting this disease.

Type 1 diabetes and coeliac disease have a lot in common and children with diabetes have a clearly increased risk of coeliac disease. These two diseases are the two most common autoimmune diseases in children, that is, diseases in which the immune system may react to the body's own cells. Genetic factors also overlap greatly between the two diseases - varieties of so-called HLA genes largely explain the genetic risk. But why do only a few develop the disease although the risk genes are found among many?

Studies from Norway and other countries suggest that low levels of vitamin D in pregnancy increases the risk of diabetes in the child. Much evidence also suggests that the way gluten is introduced in the child's food the first year of life is associated with a risk of coeliac disease. These are examples of factors in the environment which, together with genes, may influence the risk of developing these diseases.

In this project we will study the markers in the blood through pregnancy and birth to see if there is a difference in those who later received type 1 diabetes or coeliac disease and those who do not have these diseases. We will use blood samples from mother and child stored in the biobank to study possible connections. By coupling to disease registries (Children Diabetes Registry and the Norwegian Patient Register) we will find children in MoBa who have developed these two diseases.

In MoBa we will not look for new risk genes for these diseases. Results of the known genetic risk factors are important in the study to compare the effects of environmental factors in children with the same genetic markers.

Genetic testing is not considered to provide useful information to each participant, because tests can only inform about easily increased or decreased risk compared to the average - and because none of the conditions can be prevented on the basis of the knowledge we have today.

Genetic factors in child obesity 

Since 1980, the overweight proportion of the population has almost doubled. Why? We have more sedentary occupations, exercise less and often eat more unhealthy food. But is the explanation just poor diet and lack of exercise? What role do our genes play? This project seeks to find answers to these questions and to study the effects of genes and environmental factors on the development of obesity in children.

Today, around 22 million children under five years are overweight. These have a greater likelihood of still being overweight in adulthood. Overweight is associated with many serious diseases such as diabetes, cardiovascular disease and some cancers. Musculoskeletal disorders are also more common in overweight people.

Children with high birth weight and children who are growing especially quickly in the first two years of life are more likely to become obese as adults. This has been determined by studying growth curves of more than 44,000 children.
By mapping genes in the past few decades we have learned that there is less genetic variation between people than previously believed. People share about 99.9 per cent of the genetic material. But what is hidden in the last 0.1 per cent? It is therefore very important to compare the genetic code of individuals with and without special conditions. Half of the genes are inherited from the mother and the other half from the father. When we look for pathogenic areas in the genetic material of individuals with a disease or trait, we have help from the genetic material from the parents.

By identifying variations in genes of 21,000 individuals from MoBa, split by 7,000 nuclear families (mother, father and child), we examine the relationship between specific genetic variants and children with high birth weight, and children who show rapid growth in early childhood. Genetic variants that are more common in the obese can give us important information about where in the genetic material we need to look for these genes.

In 2011, the KG Jebsen Centre for Diabetes Research was awarded 17 million Norwegian kroner from the European Research Council to study obesity genes in MoBa.

Infections, infection burden and respiratory diseases

Acute and chronic respiratory diseases can adversely affect children's and families' everyday life due to frequent disease in early childhood. The purpose of this study is to investigate the risk factors for developing respiratory diseases in childhood.

The study is carried out on a small sample of 200 children in MoBa who have been admitted to Akershus University Hospital (AHUS). The project evaluates the risk factors for acute and chronic respiratory illness in children in the first 7-8 years of life. The data are collected from MoBa questionnaires at 3 and 7 years, where parental questionnaire data on hospital admissions for respiratory infections are compared with the recorded admissions to AHUS. The study is based at AHUS.

Inflammatory bowel disease (IBD)

Inflammatory bowel disease (IBD) is a common term for chronic intestinal disorders such as ulcerative colitis (UC) and Crohn's disease (CD). In this study we want to investigate the factors that may affect pregnancy outcomes such as gestational age and birth weight of children whose mother or father has these diseases.

We are interested in the effects that medication, diet, water quality and air quality may have on pregnancy. The reason we ask these questions is that these elements in different ways have been shown to be associated with the development of the disease itself. Through a sub-study we will contact women who responded that they have either ulcerative colitis or Crohn's disease and fathers who are being treated for these diseases. In addition to the information the participants provided in the questionnaire, we will use information on current diagnoses in the Norwegian Patient Register. We will use the data provided in the earliest questionnaires and about drinking water from the Waterworks Register. Project Manager is Professor Morten Vatn (Akershus University Hospital). May-Bente Bengtson and Geir Aamodt are also working on the project.

MoBaTann - Tooth bank

Milk teeth can provide invaluable information about the environmental impact on the foetus and in early childhood. The tooth bank, MoBaTann, is asking all parents to put one or more milk teeth into the "bank". Parents receive a postal invitation when the children are 6 years and 9 months.

MoBaTann is a subproject of the MoBa and is a collaboration between the NIPH and the Faculty of Medicine and Dentistry, University of Bergen.

What happens to the milk teeth?

After a milk tooth is lost, rinse it in clean water without detergent and leave it to dry overnight. Keep it in dry box until you get the invitation from MoBaTann to submit the tooth (teeth) to the tooth bank. A postage paid envelope is included with the invitation.

What can milk teeth tell us?

Children's milk teeth are formed in the womb and become fully developed during the first years of life. The substances built into the tooth tissue during formation remain there. Milk teeth therefore act as "flight data recorders" for exposures that your child has been exposed to as a foetus and in early childhood that can affect the child's health. This applies to substances such as lead, cadmium and zinc.

Contact:

Head of MoBaTann biobank Professor Kristin S. Klock
University of Bergen
E-mail: kristin.klock@iko.uib.no
Tel: +47 55 58 65 96

NewGeneris

NewGeneris (The Newborns and genotoxic Exposure Risks) is an international research project financed by the EU 6th framework programme for food quality and safety. Researchers from 25 institutions and 15 European countries are participating. The objective is to investigate whether exposure to contaminants in pregnancy plays a role in disease among children.

BraMat (‘Biomarkers of immunotoxic risk in newborns’) and BraMiljø ("Healthy environment and children's health"), both sub-projects in MoBa, are two of several contributions in this research collaboration from the NIPH.

The purpose of NewGeneris is to examine how the contaminants found in the food pregnant women eat or from environmental pollution affect the child's health.

Premature birth

Premature birth is a complex condition that can have many causes, and this happens spontaneously for about a quarter of premature births. In Norway, less than five per cent were born before week 37 of pregnancy. In many poor countries, over 15 per cent of children are born more than three weeks before their due date, and premature birth is the leading cause of death during the neonatal period worldwide.

By studying gene variants and protein markers of spontaneous preterm birth, we can better understand the reasons why this happens. The risk appears to be influenced by genes from the mother, the father and the foetus, by the interaction between these genes and the interplay between genes and environment.

The research group in MoBa has examined 3,000 blood samples from participants. Through testing large portions of genetic material (GWAS) researchers examine how maternal and foetal genetic variants affect gestational age. Researchers are also studying interactions between genes and environment, such as whether the use of caffeine, alcohol, nicotine, folic acid or probiotics has different effects depending on genetic background.

The study is based on 983 mother / child pairs and 958 unrelated individuals (146 children and 812 mothers). The group of spontaneous preterm births consists of 963 pregnancies, while 978 normal pregnancies are in the control group. In addition to gestational length and spontaneous preterm birth, the child's weight in relation to gestational length is also studied.

The research group collaborates with other major research groups, where childhood eczema, growth and obesity are examined.

The project is funded by the Norwegian Research Council.

Relationships and health

What happens to relationships when partners become parents for the first time? We will study changes in relationships from early pregnancy until the child is 18 months.

The project has made two additional studies on a sub-sample of 1000 couples from MoBa who are first-time parents. Here we ask other questions regarding relationships than those included in the MoBa study. This concerns communication and conflict management, emotional connection and commitment to family life, and we ask about attitudes to and experiences of participating in the family life course "Good relationships". Mother and father filled out their own questionnaire at 2-4 months and 14-16 months after birth, as well as the standard MoBa questionnaires.

Eating disorders project

The research project Eating Disorders and Pregnancy Outcome in 100,000 Births wants to identify women in MoBa who have an eating disorder when they become pregnant. The goal is to find out how this affects pregnancy and childbirth, as well as the progress of mother and child in the first three years after birth.

Language and Learning Study

The Language and Learning Study (SOL) is a large research project linked to MoBa. The purpose of the project is to increase knowledge about children's language development, to find early signs of delayed language development, to examine who develops language difficulties and the additional difficulties that are often found in those who are struggling to learn the language. It provides the possibility to detect early signs of delayed or abnormal development in children and increase knowledge about the effects of initiating early treatment and targeted preventive measures.
The project is run by the NIPH and is supported by the Ministry of Education and it is hoped that the results of the project can form the basis for a proper focus on preventive measures and treatments for children who struggle to learn language.

As part of the collaboration we investigate how childcare influences language development, learning and well-being. In addition, we investigate the relationship between experiences in childcare and what happens to children in school at eight years old. Some of the participants in MoBa can be invited to participate in a study related to SOL, which specifically deals with children's language development and childcare. 

Pre-eclampsia

Pre-eclampsia is a pregnancy complication that affects three to five per cent of all pregnant women. The condition is characterised by high blood pressure and protein in the urine, and can arise from the second half of pregnancy until birth. Pre-eclampsia is often difficult to predict, and the cause is unknown. Pre-eclampsia occurs frequently in families whichmay mean that genes play a role in the development of the condition.

In the study InterPregGen we want to understand which genetic variants of the woman and her unborn child pose a greater risk of developing pre-eclampsia.

Blood tests and associated health data from women with and without pre-eclampsia in pregnancy are available from national studies in participating countries, including MoBa. By analysing samples from mother-child pairs and family triads (mother, father and child) with and without disease, research can study the relationship between genetic factors and how they interact in the development of pre-eclampsia.

The study is the largest ever of its kind, and provides the opportunity to identify gene variants in women who are vulnerable to developing pre-eclampsia, and confirm the importance of gene variants that have been made in previous studies. This may form the basis for new hypotheses about causal relationships.

InterPregGen is an international collaborative project, funded by the EU. The research groups are from the UK, Norway, Finland and Iceland, with two participating countries in Central Asia (Uzbekistan and Kazakhstan).