Perinatal, Obstetric & Paediatric Epidemiology (POPE) – University of Copenhagen

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Perinatal, Obstetric & Paediatric Epidemiology (POPE)

The research group is conducting epidemiologic research on maternal health and child health. Additionally, the research group examines how conditions during pregnancy and early life influence the health for mother and child later in life.
The group holds special interest in the fetal and child effects of maternal working conditions, social conditions, maternal and paternal age, infections and health behavior during pregnancy, reproductive immunology, and reproductive conditions among ethnic minorities in Denmark. Furthermore, the group takes interest in developing epidemiologic methods.

The specific projects within the research group

The Danish National Birth Cohort: 11 years follow-up

The Danish National Birth Cohort (DNBC) is a valuable resource to provide new insights in causes of disease. The study includes almost 100,000 children born between 1996 and 2003 who have been followed since birth. The mothers were interviewed twice during pregnancy about their health and lifestyle and again when the children were ½ and 1½ years of age. When the children were 7 years, a questionnaire about the life and development of the child was mailed to the parents.
In pre-puberty, the body is particularly sensitive to external exposures, partly because the children are still relatively small and partly because the body is particularly sensitive in periods of accelerated growth. This is also a life stage during which attitudes, habits, and behaviors are formed. For these reasons an additional data collection at the age of 11 years is initiated.
In the 11-years follow-up, information on the children's life, well-being, and health is collected, and both parents and children are asked to contribute by means of web-based questionnaires. The project focuses on why and when obesity and metabolic disorders develop, on causes and consequences of frequent infections in childhood, and development of asthma and allergy. Additionally, focus is put on causes and consequences of behavioral disorders in childhood, and on early markers of severe psychiatric disorders. Also conditions in childhood, which can influence muscle and skeleton disorders, will be examined.
Contact: Principal Investigator Professor Anne-Marie Nybo Andersen

The DanCHASE project (Danish Child Health And Social Equity project)

In this project we examine how health conditions during pregnancy and childhood vary according to social conditions. The aims are to describe social inequalities in children's health and to apply the knowledge of how health conditions vary with different aspects of social conditions (parents' education, income, work, age, and ethnicity) in aetiologic studies of these health phenomena. The project utilizes linked register data of all children born during the last three decades in Denmark.

Contact: Professor Anne-Marie Nybo Andersen  or Post Doc Laust H. Mortensen

Health effects of physical exercise during pregnancy

Many women wish - in keeping with the official recommendations - to continue to exercise while being pregnant. However, the advisable activity level is uncertain. At the same time, pregnancy will restrain level of the physical activity for most of the women, and many women never return to their previous level of exercise after the delivery. The aim of this project is to fill in some of the gaps, which still exist as regards knowledge about physical exercise and reproductive health. It is the intention to examine specific periods during pregnancy, specific conditions (e.g. pregnancy diabetes and pelvic pain), and the course of the delivery.
Contact: Post doc Mette Juhl

Is birth weight and length of gestation important? Using family-based designs to strengthen causal inference on the causes and consequences of birth weight and gestational age

Low birth weight and preterm birth are associated with increased risk of ill health later in life but it is an open question whether the relationship is causal or if it can be explained by unobserved factors. The aim of this project is to examine if factors shared between siblings can explain the associations.
Contact: Post doc Laust H. Mortensen

Alcohol during pregnancy

It remains unsettled whether it is safe to drink small amounts of alcohol while being pregnant or whether binge drinking before recognition of pregnancy can inflict damage on the fetus. Several studies have shown that women who drink small amounts of alcohol during pregnancy have reduced risk of e.g. preterm birth, low birth weight, and behavioral problems at the age of 3 and 5 years. In an attempt to explore if these observed associations can be attributed to bias or confounding alternative study designs are applied e.g. designs using siblings and cousins, and designs with restriction to women with no awareness of their reproductive abilities. It is examined if consumption of five or more drinks during pregnancy is associated with, respectively, preterm birth, the size of the child's body, and behavioral development.
Contact: Associate professor Katrine Strandberg-Larsen

Fetal microchimerism and mother's health

During pregnancy, mother and fetus are exchanging cells. After pregnancy, most of the fetal cells in the mother die out but in the majority of women small amounts of fetal cells continue to circulate in the mother's blood, even several decades after pregnancy. This phenomenon is called fetal microchimerism. It is unknown whether the circulating fetal cells influence the mother's health, and if so, whether the effect is beneficial or harmful. To get more knowledge of the possible mechanisms we are studying diseases related to parity e.g. breast cancer and allergy.
Contact: Associate professor Mads Kamper-Jørgensen

Minerva

The research program MINERVA puts the work environment's influence on reproductive outcomes on the agenda in Danish research. In the project we use data from the Danish National Birth Cohort and the Danish Registers. A subproject about ergonomic strains at work and risk of miscarriage, stillbirth, restricted fetal growth, and preterm birth as well as pregnancy disorders in the mother to be is carried out by the POPE-group. Other subprojects about stress at work, occupational exposure to hormone disturbing substances and other exposures in the mother's and father's work environment, which play a part in the incidence of reproductive damages, allergic disorders, and fertility among Danish children, are managed by the Department of Environmental and Occupational Medicine, Aarhus and the National Research Centre for the Working Environment (NRCWE). Link to minervanet.dk
Contact: Professor Anne-Marie Nybo Andersen

CHICOS

The aim of the project is to improve research into children's health in Europe through a more effective utilization of the many existing European birth cohorts. The POPE research group is responsible for the project's work package 1, which includes mapping and a searchable inventory of existing birth cohorts and the possibilities of using register data in connection with the birth cohorts. Moreover, the research group has initiated two case studies about fetal health effects of maternal alcohol consumption and socio-economic disparities in preterm birth in order to identify strengths and limitations of examining a research question using data from several different birth cohorts within the CHICOS framework.
Link to www.chicosproject.eu
Contact: Professor Anne-Marie Nybo Andersen

Reproductive Outcomes Among Migrants in Denmark

Recently published population-based studies have demonstrated significant ethnic disparities in fetal, infant, and child mortality in Denmark. In these papers, we demonstrated that offspring of immigrant from certain countries (Turkey, Pakistan and Somalia) had around a doubled mortality risk in the first years of life, while this did not apply to other immigrant groups despite these being socially disadvantaged. The mechanisms adding to these dissimilarities are not sufficiently established. The excess mortality risk in early life is mainly attributed to congenital malformations and the risk of having a child with a congenital malformation is over twice as high for consanguine parents as compared to non-consanguine. Also factors related to use of the health care system and antenatal care could be explanations for the excess perinatal mortality. Failure to account for this excess risk of early life mortality in some ethnic groups highlights the need for further research to disentangle some of the important and changeable causal mechanisms for the observed ethnic inequalities in early child health and to establish knowledge about the potential beneficial effect of initiatives in the Danish health care system on the ethnic early life disparity. Within the framework of SULIM we 1) investigate ethnic differences in utilization of antenatal and perinatal health care, 2) address the issue of consanguinity and 3) to develop a model for improved preconceptional and antenatal care for migrants in Denmark. In the project, we utilize a mixed methods approach, taking advantage of epidemiologic methods and of qualitative methods.
Link to SULIM (findes endnu ikke, men etableres i januar)
Contact: Professor Anne-Marie Nybo Andersen 

Other projects

Several master and PhD. students affiliated with the group are working with the following projects:
Early life indicators of childhood obesity (Cand. Scient. San. Publ. Camilla Schmidt Morgen)
A European comparative study of social determinants of preterm birth (Cand. Scient. Gry Poulsen)
Maternal alcohol consumption and behavioral disorders in 7-years old children (Cand.Psych. Janne Niclasen)
Reproduction and child health among ethnic minorities in Denmark (Cand. Scient. San. Publ. Grete Skøtt Petersen)
EUROmediCAT: Social conditions, use of medicine during pregnancy and congenital malformations (Medical Doctor Anne-Sofie Birkelund)
Fever in pregnancy and reproductive damages (Medical Doctor Jesper Kjærgaard)
Birth weight and later risk of PCOS (Medical Doctor Hanne Mumm)
Risk factors for miscarriage (Stud. Scient. San. Publ. Sandra Feodor)
Work strains and pelvic pain (Cand. Scient. San. Publ. Pernille Stemann Larsen)

Updated January 19th. 2012