Longitudinal study on maternal and child health celebrates 10 years

Most people have heard the saying, “You are what you eat.” But most don't know it came from French author Jean-Anthelme Brillat-Savarin, who wrote in his 1825 book, Physiologie Du Gout, “Tell me what you eat, I’ll tell you what you are.”

Brillat-Savarin was on to something. In the same spirit, in 2010, the Alberta Pregnancy Outcomes and Nutrition (APrON) study was started to understand more about pregnancy and nutrition, specifically how nutrition affects maternal and child mental and physical health. Since then, APrON has evolved to examine a wider array of predictors of maternal and child mental health — everything from genetics to environmental factors to neurotoxicants.

• Pictured above: More than 2,200 families have participated in APrON

Although many studies had shown that nutrients affect child development and the mental health of women, few studies had looked at broad nutrient intake and nutrient status. So the decision to start a longitudinal cohort study was groundbreaking.

Initial response was enthusiastic. “I come from a sociology background so I always found it interesting to study how people are changing and evolving," says participant Charlotte Berghofer. "After I learned I was pregnant with my second daughter, APrON was literally the third call I made.”

Berghofer says she wanted to better understand how her own children compared to others, but a decade later, her interest in the study remains. “I love that they're still following my daughter and hope they can continue doing it for a long time,” she says. "If nobody participates in these kinds of studies how are we ever going to get an idea of what is actually happening with our families or how our nutritional choices or stress really affect us?”

So far, 2,200 Alberta families have participated in APrON, which involves a pan-Alberta team with colleagues from UCalgary, the University of Alberta and the University of Lethbridge. From the initial $5 million invested by the Alberta Heritage Foundation for Medical Research (now Alberta Innovates), APrON has attracted more than $17 million in additional funding. Key findings from the study have generated more than 90 papers and over 400 presentations to local, national and international audiences.

Given the wide-ranging data on APrON parents and children, the study can help answer questions about predictors of child and adolescent mental health and intergenerational transmission of risk. APrON has collected data on epigenetics, genetics, inflammation, neuroendocrine activity, neurotoxicants, parenting/attachment, the microbiome, physical activity, social connections and nutrition.

Researchers are currently gathering data on coping and resiliency of families and children facing stress from COVID-19. This will allow the APrON team to identify predictors of child and adolescent mental health, suggest ways to help families, and figure out how risk is transmitted through the generations. And now, as APrON children grow up and start having children of their own, the goal is to transition into a prospective, multi-generational study over the next 10 years.

The APrON study is commemorating its 10-year anniversary with a free online birthday conference on Oct. 29 and 30.  Nearly 300 attendees have already registered. “We're delighted to share the amazing findings that are emerging from APrON data," says principal investigator Dr. Nicole Letourneau, RN, PhD. "We have so much to be proud of and are looking forward to another 10 years of success.

“Reflecting on the past as we look to the future, we realize that we've learned so much, but have so much yet to study and understand as APrON children grow. I hope trainees, researchers and members of the public will come and celebrate with us."

Attendees will also learn about other large studies, such as the Canadian Healthy Infant Longitudinal Development (CHILD) study, the largest multidisciplinary, longitudinal, population-based birth cohort study in Canada. Dr. Padmaja Subbarao, MD, director of the CHILD study, is a keynote speaker.

Celebrating Ten Years: APrON Achievements and Evolution is a free event and open to all. People are invited to register.

Nicole Letourneau is the Alberta Children’s Hospital Foundation Chair in Parent-Infant Mental Health, professor in the Faculty of Nursing, member of The Owerko Centre at the Cumming School of Medicine’s (CSM) Alberta Children’s Hospital Research Institute, and member of The Mathison Centre for Mental Health Research and Education in the Hotchkiss Brain Institute, CSM.

Mark Agius is a project manager at The Owerko Centre at the Alberta Children's Hospital Research Institute.