oa Qatar Birth Cohort: Prevention Program of Risk Factors for Reproductive Health, Pregnancy and Child Health- A “Crossomics” Study

Background

Qatar demonstrated high incidence of low birth weight (8.8%), preterm deliveries (8.5%), and stillbirths rate (6.85) (Rahman et all, 2013). In addition, Qatari pregnant women are 1.2 times more likely to have a low birth weight newborn compared to other Arab women, where Gestational Diabetes (13.4%–20.8%) and Gestational Hypertension (15.2%–21.6%) were the leading maternal complications observed.). The WHO Qatar STEPS survey (2012) on chronic disease risk factors reported that 42.5% of the women in reproductive age have high risk factor for developing chronic diseases, while 68% are overweight with high blood pressure, elevated total cholesterol levels and fasting glucose. In addition to these data, the International Association of the study of Obesity has ranked Qatar sixth globally for prevalence of obesity.

Methods/Design

This is a prospective five year cohort study developed by SCH. Pregnant women (n = 2500) and offspring will be, respectively, recruited during certain critical periods of fetal development and the first years of life. The genetic, environmental exposures and potential human health risks (including cancer, immune, metabolic and cardiovascular diseases, neurodevelopmental abnormalities, asthma, and birth outcomes) will be investigated via specific questionnaires and collection of biological samples. The study comprises an extensive range of “omics” analyses for the in-depth investigation of the impact of the genome-exposome synergy in the establishment of adverse birth outcomes and early childhood diseases. This is a multidisciplinary study where SCH is collaborating with various research institutions such as PHCC, QU, WCMC-Q, QBRI, QBB, QEERI, TAMU-Q, Sidra, and HMC.

Discussion

Human epidemiological studies and animal research data propose a concept of fetal developmental programming whereby intrauterine environment is believed to trigger adaptations preparing the fetus in a particular range of environments. In this context intrauterine exposures have been referred to as the “fourth factor” in the causation of human disease. Consequently, the design of birth-cohort study is crucial for investigating the complex multidimensional molecular mechanisms associated with genetic, environmental and socioeconomic determinants, and their contribution to the development of chronic diseases and birth defects. This first birth-cohort in the state of Qatar has been launched by SCH with the main objective of evaluating the association of these exposures with the fetal development, reproductive outcomes, endocrine related outcomes, neurodevelopment, and obesity and with the occurrence of chronic diseases including asthma and allergies, metabolic syndrome and endocrine disorders that appear first in childhood but may perpetuate to future health problems. The main outcome of this multi-disciplinary project is to address the national concern of low reproductive health. The identification and quantification of the gene-environmental interaction affecting fetal growth and child health, shall provide evidence-based data to assist policy makers at SCH to develop better primary prevention programs and evidence based healthcare policies concerning Maternal Health, Reproductive Health, Pregnancy and Child Health in Qatar.