4.6 Article

Prenatal exposure to trans fatty acids and head growth in fetal life and childhood: triangulating confounder-adjustment and instrumental variable approaches

Journal

EUROPEAN JOURNAL OF EPIDEMIOLOGY
Volume 37, Issue 11, Pages 1171-1180

Publisher

SPRINGER
DOI: 10.1007/s10654-022-00910-4

Keywords

Trans fatty acids; Pregnancy; Head; Regression analysis; Instrumental variable

Funding

  1. China Scholarship Council [201606100056]
  2. Stichting Volksbond Rotterdam
  3. Brain and Behavior Research Foundation NARSAD Young Investigator Grant [27853]
  4. Dutch Research Council (NWO) Aspasia Grant [015.016.056]
  5. Netherlands Organization for Health Research and Development ZonMw TOP project [91211921]
  6. Netherlands Organization for Health Research and Development ZonMw Vici Grant [016.VICI.170.200]
  7. European Union [733206 LifeCycle]
  8. Netherlands Organization for Scientific Research (Exacte Wetenschappen)
  9. SURFsara (Cartesius Computer Cluster)

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Dietary trans fatty acids (TFAs), primarily found in industrially produced processed food, have a negative impact on cardiometabolic health. Little is known about the association between TFA exposure during pregnancy and brain development. This study aimed to investigate the effect of maternal TFA concentration on offspring head growth. The findings showed an inverse relationship between maternal TFA concentration during pregnancy and fetal head circumference in the third trimester, as well as fetal head circumference growth from the second to the third trimester.
Dietary trans fatty acids (TFAs) are primarily industrially produced and remain abundant in processed food, particularly in low- and middle-income countries. Although TFAs are a cause of adverse cardiometabolic outcomes, little is known about exposure to TFAs in relation to brain development. We aimed to investigate the effect of maternal TFA concentration during pregnancy on offspring head growth in utero and during childhood. In a prospective population-based study in Rotterdam, the Netherlands, with 6900 mother-child dyads, maternal plasma TFA concentration was assessed using gas chromatography in mid-gestation. Offspring head circumference (HC) was measured in the second and third trimesters using ultrasonography; childhood brain morphology was assessed using magnetic resonance imaging at age 10 years. We performed regression analyses adjusting for sociodemographic and lifestyle confounders and instrumental variable (IV) analyses. Our IV analysis leveraged a national policy change that led to a substantial reduction in TFA and occurred mid-recruitment. After adjusting for covariates, maternal TFA concentration during pregnancy was inversely related to fetal HC in the third trimester (mean difference per 1% wt:wt increase: - 0.33, 95% CI - 0.51, - 0.15, cm) and to fetal HC growth from the second to the third trimester (- 0.04, 95% CI - 0.06, - 0.02, cm/week). Consistent findings were obtained with IV analyses, strengthening a causal interpretation. Association between prenatal TFA exposure and HC in the second trimester or global brain volume at age 10 years was inconclusive. Our findings are of important public health relevance as TFA levels in food remain high in many countries.

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