Adolescent follow-up in the Health Outcomes and Measures of the Environment (HOME) Study: cohort profile

Joseph M Braun, Jessie P Buckley, Kim M Cecil, Aimin Chen, Heidi J Kalkwarf, Bruce P Lanphear, Yingying Xu, Anastasia Woeste, Kimberly Yolton, Joseph M Braun, Jessie P Buckley, Kim M Cecil, Aimin Chen, Heidi J Kalkwarf, Bruce P Lanphear, Yingying Xu, Anastasia Woeste, Kimberly Yolton

Abstract

Purpose: Environmental chemical exposures may adversely affect an array of adolescent health outcomes. Thus, we used the Health Outcomes and Measures of the Environment (HOME) study, a prospective cohort that recruited pregnant women and conducted longitudinal follow-up on children over the first 12 years of life, to determine if and when chemical exposures affect adolescent health.

Participants: We recruited 468 pregnant women (age range: 18-45 years) from the Cincinnati, Ohio region to participate in a cohort study between March 2003 and January 2006. Follow-up included two clinic and one home visits during pregnancy, a delivery hospital visit, and four home and six clinic visits when children were aged 4 weeks and 1, 2, 3, 4, 5 and 8 years. Of 441 children available for follow-up, 396 (90%) completed at least one follow-up and 256 (58%) completed the most recent follow-up at 12 years of age (range: 11-14).

Findings to date: Our new measures include maternal/child report of internalising symptoms, neuroimaging, dual-energy X-ray absorptiometry-derived estimates of lean/adipose tissue and bone mineral density, and cardiometabolic risk biomarkers. We assessed adolescent exposure to perfluoroalkyl substances, phenols, phthalates and flame retardants. Participants completing follow-up at 12 years of age were similar to the original cohort in terms of baseline factors. Most children had typical and expected values for this age on measures of internalising symptoms, body composition, bone density and cardiometabolic risk markers. Notably, 36% and 11% of children had scores indicative of potential anxiety and depressive disorders, respectively. Approximately 35% of children were overweight or obese, with higher prevalence among girls. Thirty-three per cent of children had borderline or high triglyceride concentrations (>90 mg/dL).

Future plans: We will examine associations of early life environmental chemical exposures with adolescent health measures while considering potential periods of heightened susceptibility and mixture effects.

Trial registration number: NCT00129324.

Keywords: epidemiology; paediatrics; toxicology.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Illustrations of the multimodal neuroimaging protocol acquired from a HOME Study participant. Top left, a representation of white matter fibre tracks emerging from the cingulum determined using diffusion tensor imaging. Top centre, a spectral plot of relative concentrations of select neurochemicals within the perigenual anterior cingulate cortex acquired with MRS). Top right, a calculated activation MAP from a single slice of the brain during a continuous performance task that was measured with functional MRI. Bottom, anatomical images acquired with MRI; slices are oriented in the sagittal, coronal and axial planes. The yellow box denotes the location and volume (8 cm3) where the MRS sampling was acquired. The anatomical images are acquired at high resolution, on the order of 1 mm3, to enable volumetric and morphometric analyses. All images courtesy of Travis Beckwith, PhD and Kim M Cecil, PhD. HOME, Health Outcomes and Measures of the Environment; MAP, mean apparent propagator; MRS, magnetic resonance spectroscopy.

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