Work Package 2

Cohort studies

General aim

To collect data on – and analyze associations between microbial, behavioral and sociocultural factors in relation to oral and metabolic health of children during the first 1000 days of life, particularly in those from families (to be) in vulnerable conditions.

Objectives related to the oral and gut microbiome

• To establish the foundation for microbiome analysis within MetaHealth, by compiling a database of taxonomic and functional profiles and a genomic inventory of the developing oral and gut microbiome in the first 1000 days of life.
• To elucidate the temporal dynamics of the infant oral and gut microbiome and the role of microbial strain transmissions within families on these dynamics in the first 1000 days of life; and to identify and quantify networks of interactions among different species and their functions.
• To assess the association between behavioral and sociodemographic factors on the development of the oral and gut microbiome, in the first 1000 days of life.
• To assess the influence of different maternal cardiometabolic backgrounds (obesity, arterial hypertension and diabetes mellitus) on the development of the gut and oral microbiome of children in the first 1000 days of life.

Objectives related to oral and metabolic health outcomes

To collect information on oral and metabolic health in children in the first 1000 days, to assess if / how they are related, and how microbial, behavioral and sociodemographic factors are associated with both oral and metabolic health outcomes.

Objectives related to sociocultural factors and practices

• To qualitatively identify social and cultural parenting and health practices connecting macro, meso and micro system components 1) within households and 2) between households and healthcare professionals, and their mediating contributions to oral and metabolic health outcomes.
• To quantify the effects of abovementioned practices for oral and metabolic health outcomes.
• To identify obstacles and opportunities for healthy practices in collaboration with stakeholders (families, professionals, local community workers).

Active period

Year 1-8

Members of WP2

Applicants

ACTA, AUMC, UvA-FMG, VU, Inholland, UPorto, TNO Microbiology & Systems Biology, TNO Child Health.

Cooperation partners/co-funders

GGD, Sarphati Amsterdam, NVvK, JTV Amsterdam, Bètapartners, PANEL, NCJ, Food4Smiles, PHAROS, Gezonde en Kansrijke start, NIBI, BaseClear.

Progress

Research in WP 2 focused on three components: 1) the inclusion of participants and collection of data in the three cohort studies: the Amsterdam Infant Microbiome Study (AIMS), the OralBioBorn study and the Sarphati Ethnography study, 2) first analysis of the oral and gut microbiome from samples of mother-child pairs from AIMS, and 3) collection and analysis of qualitative data on health practices within Sarphati Ethnography.

Data collection

AIMS is a prospective birth cohort study, following 500 children from Amsterdam and their family members from pregnancy until three years of age, to study the development of the microbiome and its effect on child development and growth. The first period of the MetaHealth project focused on inclusion of families and the collection of biological samples, questionnaire data and anthropometric and oral health measurements in partnership with the GGD, ACTA and JTV Amsterdam. Currently, over 300 families have been included by using multiple recruitment approaches i.a. via pregnancy centering groups and the vaccination walk-in-hour at the baby-well clinics (OKT-teams). Methods to increase participation and retainment have been explored (together with WP1) with MSc students and during the World Café interactive session of the consortium meeting.

OralBioBorn is a prospective cohort study in Porto (following a similar protocol as AIMS) in which 200 healthy, obese, hypertensive and diabetic pregnant women have been recruited and were followed until one year after birth. Currently, more families, particularly families that include mothers with metabolic disease, are being recruited. The 200 initially included families in the cohort are being invited for a follow-up oral examination to collect data on the oral and systemic health of the children and mothers 2-3 years after inclusion. PhD student Inês Magalhães and assistant Marta Sousa are conducting this work.

Data analysis of oral and gut samples

Using pilot data from 25 first AIMS mother-child pairs, PhD student Nicholas Pucci explored microbial communities in the gut of the child and mother. A manuscript on this work has been submitted. Currently, Pucci is analyzing the data from the oral samples from the same pilot dataset.

Research on health practices

PhD student Yosheng Liu and Postdoc Carla Rodrgues are currently conducting research on care practices of young families that influence the microbiome. The interview item list has been adjusted to incorporate microbiome-related questions and the observation guide is under revision. In conjunction with WP1 and following several reading and discussion sessions focused on health research participation, inclusion and diversity, the social science team is now working on a theoretically guided sampling strategy to recruit new families for the Sarphati Ethnography Cohort. Efforts have also been made to collaborate between the Sarphati Ethnography and the AIMS cohort team.