Developmental Origins of Health and Disease

The Helsinki Birth Cohort Study

The Helsinki Birth Cohort Study (HBCS) has primarily been focusing on the importance of factors active in early life and their effect on later health in two study cohorts including 20,431 people born 1924–44. Our main study cohort consists of 13345 people born 1934–44 in Helsinki. The cohort is a longitudinal study cohort with data throughout the life span including prenatal life, early childhood and later life. Besides extensive epidemiological data over 2000 subjects have been randomly selected for a clinical part. The subjects have been followed up clinically for over two decades with extensive phenotypic data available including metabolic data, dietary information as well as other lifestyle data. Psychological factors including personality, depression and anxiety has been focused upon. A GWAS has been performed on the HBCS. One primary aim of HBCS is to assess how growth and environmental factors acting during early life are related to health in adult life. Besides taking into account early life factors, socioeconomic and adult lifestyle factors are also considered, as well as genetic factors. In other words, health and disease are focused upon from a life course perspective. Our particular focus has been to study the early life origins of cardiovascular disease and its risk factors, cognitive function, psychological and behavioral outcomes as well as aging-related processes. As the study cohort is aging our more recent focus has been on healthy aging and healthy longevity from a life course perspective.

To summarise, we have shown that early growth patterns are associated with several health outcomes including coronary heart disease and type 2 diabetes as well as mental health outcomes. The long-term health impact of maternal adiposity during pregnancy has also been studied. We have been assessing potential underlying factors explaining the described associations and these include genetic and epigenetic factors. Several non-communicable diseases have their origins in early life therefore optimizing the health of women of reproductive age will have positive consequences for their offspring. One overview of findings in HBCS over the past 20 years has been published in Annals of Medicine 2016 Sep;48(6):456-467. There are over 200 peer-reviewed scientific publications based on findings from HBCS and the study is still ongoing. Our findings have attracted great global interest from agencies including WHO and NIH and been including in several recommendations.

DeMoD

Maternal type 1 diabetes (T1D) increases the risk for pregnancy and birth complications and offspring risk for adverse health outcomes. In pregnancies complicated with T1D, high erythropoietin concentrations in amniotic fluid and fetal plasma reflecting fetal oxygen deficiency may explain adverse health outcomes among the offspring. In 2017, we initiated the study: Developmental origins of adult health in offspring of mothers with type 1 diabetes (DeMoD).

Our aim is to investigate:

1. Whether high erythropoietin concentrations in amniotic fluid and fetal plasma among the offspring of women with T1D are associated with offspring health 18-23 years later. The study cohort consists of the offspring born to women with T1D and with measured erythropoietin concentration (n=273) and their matched controls (n=273). The study subjects will be studied clinically (physical examination, health questionnaires, blood and urinary samples, ECG, pulse wave velocity, measurements of advanced glycation end products, actigraphy, and cognitive tests). 
2. Whether there are differences in health outcomes, based on national healthcare registry data, between the offspring of women with T1D (n=1762) compared with matched offspring of women without T1D (n=8810) during a 16-year follow-up.