2015

The MoBa cohort Aim: To find causes of disease and factors involved in health related issues in a lifespan A large population based pregnancy cohort A family cohort (mother + father + child) Long term follow-up

Hospitals with < 1000 births/year Hospitals with >1000 births/year Norway  60,000 births/year Inclusion period Collaboration with 50 hospitals Recruiting pregnant women and their partners midpregnancy

Based on informed consent Broad consent Can be withdrawn at any point Mother consented for herself and the child Father separate consent Child informed at 15 years Child own consent at 18 years

No Mothers95 000Pregnancies Fathers75 500Twins1950 Children Triplets 21 The MoBa cohort

Data collection Mother Father Child Cord blood Ultrasound 18 W 22, 30 WBirth ½, 1½, 3, 5 Y7Y 8 Y Blood Teeth 13, 14 Y

Data collection in MoBa Pregnancy Mother, father, screening, health, lifestyle 17, 22, 30 w environmental exposure, diet (week 22) Postnatal 6 m Mother and child: health and lifestyle Q 18 month Mother and child: health and lifestyle Q 36 month Focused on child health and behaviour, Autism and ADHD Q 5 years Focused on language skills Q 7 years Focused on respiratory health, allergy and diet Q 8 years Mother and child's mental health, child development and language skills

Planned data collection Fathers The fathers have only got a questionnaire at screening. Hopefully in 2015 a new questionnaire will be sent to all fathers. Main focus physical and mental health, relationship to child and mother of the child 13 year First questionnaire to the children. Main focus on mental health 14 yearQuestionnaire to the children regarded diet and nutrition School 8yQuestionnaire to the teachers of MoBa children

Biological samples MoBa: Top modern biobank – automated/manual 4.5 million samples stored EDTA whole blood and plasma (frozen -80 o C) DNA extracted from whole blood (frozen -20 o C) Urine (Mothers only)(frozen -20 o C ) RNA: from cord blood (Tempus-tubes)

Links with other registries Established MoBa - MBR record (a sample of the MBR variables) National registers and databases Prescription registery National Patient Registry (NPR) Cancer registry Statistics Norway Sysvac Social Security Registery Disease specific registers.

MoBa – strengths of the study The great number of participants The family structure is the father-mother-child trio, with the possibility of studying twins and siblings The wealth of information The biological specimens The unit of the datacollection is the pregnancy The potential for genetic studies and elucidating gene-environmental interactions

40 % of all invited accepted Socioeconomic gradient –Fewer <25 yrs, living alone, smokers, preterm deliveries, multiparous –More of supplement users, ”health-minded” Questionnaires only in Norwegian –fewer immigrants Decline in participation over time (<50 % for 8- year questionnaire) How representative is MoBa?

Activities Active research projects: 197 Completed research projects: projects have additional data collection (sub-cohorts) 321 publications 32 PhD projects completed

Research areas Infertility Diet in pregnancy Preeclampsia Preterm birth Hyperemesis Folic acid intake and consequences Eating disorders in pregnancy Medications in pregnancy Physical activity in pregnancy Pelvic girdle pain Urinary incontinence Smoking (maternal and paternal) Violence in pregnancy Childhood temperament Airway disease CHD and development Effect of early start in nursery ADHD Autism Pregnancy Child health

Access to questionnaire data and biological material Application –Application form –If required approval of formal bodies –Principal Investigator (PI) PI must have a PhD or equivalent PI must be affiliated with the sub-study institution PI must assure that data and biological material are stored securely

Application processing Evaluation at the MoBa SMG meeting. –Within the aim of MoBa –Scientific standard of the sub-study –Conflict of interest regarding ongoing studies

Charge for data access Data files and questionnaire data –3-5 publication (PhD/post Doc) NOK –1 publication NOK –Data file updates NOK Projects assistance –Senior /research assistance NOK 815 Cooperation fee –Long time projects, projects with separate data collection and extended access to data will be negotiated separately for each project Ongoing evaluation of price strategy

MoBa–funding Governmental direct funding National Institute of Public Health Project funding –National Institutes of Health USA –Norwegian Research Council –EU Research framework programmes

Questionnaire data Exposure data (and outcome data) Somatic and mental health medication infections toxins diet / vitamins occupation/socioeconomic status life style/alcohol/smoking

Information from blood and urine samples Genetic information environmental toxins infections dietary factors medication, drugs various other biomarkers

MoBa film short version with English subtitles