• Agreement between routine and research measurement of infant height and weight.

      Bryant, M.; Santorelli, G.; Fairley, L.; Petherick, E.S.; Bhopal, R.S.; Lawlor, D.A.; Tilling, K.; Howe, L.D.; Farrar, D.; Cameron, N.; et al. (2015)
      In many countries, routine data relating to growth of infants are collected as a means of tracking health and illness up to school age. These have potential to be used in research. For health monitoring and research, data should be accurate and reliable. This study aimed to determine the agreement between length/height and weight measurements from routine infant records and researcher-collected data. Methods Height/length and weight at ages 6, 12 and 24 months from the longitudinal UK birth cohort (born in Bradford; n=836–1280) were compared with routine data collected by health visitors within 2 months of the research data (n=104–573 for different comparisons). Data were age adjusted and compared using Bland Altman plots. Results There was agreement between data sources, albeit weaker for height than for weight. Routine data tended to underestimate length/height at 6 months (0.5 cm (95% CI −4.0 to 4.9)) and overestimate it at 12 (−0.3 cm (95% CI −0.5 to 4.0)) and 24 months (0.3 cm (95% CI −4.0 to 3.4)). Routine data slightly overestimated weight at all three ages (range −0.04 kg (95% CI −1.2 to 0.9) to −0.04 (95% CI −0.7 to 0.6)). Limits of agreement were wide, particularly for height. Differences were generally random, although routine data tended to underestimate length in taller infants and underestimate weight in lighter infants. Conclusions Routine data can provide an accurate and feasible method of data collection for research, though wide limits of agreement between data sources may be observed. Differences could be due to methodological issues; but may relate to variability in clinical practice. Continued provision of appropriate training and assessment is essential for health professionals responsible for collecting routine data.
    • Cohort Profile: the Born in Bradford multi-ethnic family cohort study

      Wright, J.; Small, Neil A.; Raynor, P.; Tuffnell, D.J.; Bhopal, R.S.; Cameron, N.; Fairley, L.; Lawlor, D.A.; Parslow, Roger C.; Petherick, E.S.; et al. (2013)
      The Born in Bradford cohort study was established in 2007 to examine how genetic, nutritional, environmental, behavioural and social factors impact on health and development during childhood, and subsequently adult life in a deprived multi-ethnic population. Between 2007 and 2011, detailed information on socio-economic characteristics, ethnicity and family trees, lifestyle factors, environmental risk factors and physical and mental health has been collected from 12 453 women with 13 776 pregnancies (recruited at ∼28 weeks) and 3448 of their partners. Mothers were weighed and measured at recruitment, and infants have had detailed anthropometric assessment at birth and post-natally up to 2 years of age. Results of an oral glucose tolerance test and lipid profiles were obtained on the mothers during pregnancy at ∼28 weeks gestation, and pregnancy serum, plasma and urine samples have been stored. Cord blood samples have been obtained and stored and Deoxyribonucleic acid (DNA) extraction on 10 000 mother–offspring pairs is nearly completed. The study has a biobank of over 250 000 samples of maternal blood, DNA and urine, cord blood and DNA and paternal saliva. Details of how scientists can access these data are provided in this cohort profile.
    • Design and characteristics of a new birth cohort, to study the early origins and ethnic variation of childhood obesity: the BiB1000 study

      Bryant, M.; Santorelli, G.; Fairley, L.; West, Jane; Lawlor, D.A.; Bhopal, R.S.; Petherick, E.S.; Sahota, P.; Hill, A.; Cameron, N.; et al. (2013)
      Epidemiological evidence indicates that early life factors are important for obesity development but there are gaps in knowledge regarding the impact of exposures during pregnancy and early life, especially in South Asian children. There is a corresponding lack of evidence to guide development of culturally-appropriate, obesity prevention programmes. This paper describes the methodology and characteristics of participants in Born in Bradford 1000 (BiB1000), a nested cohort of the Born in Bradford prospective birth cohort. BiB1000 aims to enable a deep and extensive understanding of the predictors and influences of health-related behaviours to develop a culturally-specific obesity prevention intervention. 1,735 mothers agreed to take part in detailed assessments focused on risk factors of obesity. Of these, 1,707 had singleton births. Data were collected from the families during pregnancy, at birth and when the infant was aged 6, 12, 18, 24 and 36 months. Approximately half of the mothers (n=933) are of South Asian ethnicity; of which, just under half were born in the UK. Prevalence of obesity in BiB1000 is similar to the full BiB cohort and to UK national averages. In addition to pre-specified hypothesised targets for obesity prevention, (e.g. parental feeding styles, diet and activity), BiB1000 is exploring qualitative determinants of behaviours andother exposures with a lesser evidence base (e.g. food environments, sleep, parenting practices). These data will enable a rich understanding of the behaviours and their determinants in order to inform the development of a culturally-relevant, childhood obesity prevention intervention.
    • Development and evaluation of an intervention for the prevention of obesity in a multiethnic population : the Born in Bradford applied research porgramme

      West, Jane; Fairley, L.; McEachan, Rosemary; Bryant, M.; Petherick, E.S.; Sahota, P.; Santorelli, G.; Barber, Sally E.; Lawlor, D.A.; Taylor, N.; et al. (2016-05)
      Background: There is an absence of evidence about interventions to prevent or treat obesity in early childhood and in South Asian populations, in whom risk is higher. Objectives: To study patterns and the aetiology of childhood obesity in a multiethnic population and develop a prevention intervention. Design: A cohort of pregnant women and their infants was recruited. Measures to compare growth and identify targets for obesity prevention, sensitive to ethnic differences, were collected. A feasibility randomised controlled trial (RCT) was undertaken. Setting: Bradford, UK. Participants: A total of 1735 mothers, 933 of whom were of South Asian origin. Intervention: A feasibility trial of a group-based intervention aimed at overweight women, delivered ante- and postnatally, targeting key modifiable lifestyle behaviours to reduce infant obesity. Main outcome measures: The feasibility and acceptability of the pilot intervention. Data sources: Routine NHS data and additional bespoke research data. Review methods: A systematic review of diet and physical activity interventions to prevent or treat obesity in South Asian children and adults.
    • UK-born Pakistani-origin infants are relatively more adipose than white British infants: findings from 8704 mother-offspring pairs in the Born-in-Bradford prospective birth cohort

      West, Jane; Lawlor, D.A.; Fairley, L.; Bhopal, R.S.; Cameron, N.; McKinney, P.A.; Sattar, N.; Wright, J. (2013)
      BACKGROUND: Previous studies have shown markedly lower birth weight among infants of South Asian origin compared with those of White European origin. Whether such differences mask greater adiposity in South Asian infants and whether they persist across generations in contemporary UK populations is unclear. Our aim was to compare birth weight, skinfold thickness and cord leptin between Pakistani and White British infants and to investigate the explanatory factors, including parental and grandparental birthplace. METHODS: We examined the differences in birth weight and skinfold thickness between 4649 Pakistani and 4055 White British infants born at term in the same UK maternity unit and compared cord leptin in a subgroup of 775 Pakistani and 612 White British infants. RESULTS: Pakistani infants were lighter (adjusted mean difference -234 g 95% CI -258 to -210) and were smaller in both subscapular and triceps skinfold measurements. The differences for subscapular and triceps skinfold thickness (mean z-score difference -0.27 95% CI -0.34 to -0.20 and -0.23 95% CI -0.30 to -0.16, respectively) were smaller than the difference in birth weight (mean z-score difference -0.52 95% CI -0.58 to -0.47) and attenuated to the null with adjustment for birth weight (0.03 95% CI -0.03 to 0.09 and -0.01 95% CI -0.08 to 0.05, respectively). Cord leptin concentration (indicator of fat mass) was similar in Pakistani and White British infants without adjustment for birth weight, but with adjustment became 30% higher (95% CI 17% to 44%) among Pakistani infants compared with White British infants. The magnitudes of difference did not differ by generation. CONCLUSIONS: Despite being markedly lighter, Pakistani infants had similar skinfold thicknesses and greater total fat mass, as indicated by cord leptin, for a given birth weight than White British infants. Any efforts to reduce ethnic inequalities in birth weight need to consider differences in adiposity and the possibility that increasing birth weight in South Asian infants might inadvertently worsen health by increasing relative adiposity.