CHIPS-Child is a follow up study to the CHIPS (Control of Hypertension In Pregnancy Study) randomised controlled trial
There is now solid evidence that a reduced rate of growth before birth is associated with adult cardiovascular disease (like heart attack or stroke). The information comes from different populations around the world, and is true even when babies are born with normal birth weights. At present, the ‘Developmental Origins Hypothesis’ provides the best explanation. In response to decreased nutrition in the uterus, changes are made to the activity of fetal genes (the 'code' that determines our health and traits like height). These changes to gene activity are permanent, and after birth, set up the child’s metabolism in a way that may be harmful in the long-term (e.g., predispose to diabetes or high blood pressure).
The CHIPS-Child sub-study is designed to find out whether the way a mother’s blood pressure is managed during pregnancy may affect her baby’s(ies’) potential for growth before birth, and as a result, have long-lasting effects on the child such as diabetes or cardiovascular disease (such as high blood pressure or heart attack and stroke in adulthood).
We expect to follow up a total of 626 children in this sub-study.
What participation involves
Participation involves a Study Visit when the CHIPS mother's child is 12 months old (+/- 2 months). The visit involves the following**:
- Basic body measurements of the child (eg. weight, height, head and waist circumference).
- 4 painless swabs from inside the cheek to look at genes and gene activity.
- Hair sample from the back of the child’s head to measure a hormone called ‘cortisol’. Being born smaller than anticipated can cause stress, and increased production of cortisol (a stress hormone). It is thought that chronic production of cortisol may predispose us to medical conditions such as diabetes, high blood pressure and heart attacks.
- Completion of a maternal questionnaire about her background, emotional well-being and how her baby is fed. For example, she will be asked if her child feeds from her breast, a bottle, or a cup.
** In the event that the child is not able to attend the Study Visit or the basic body measurements are not obtained at the Study Visit and a repeat visit is not possible, the local CHIPS-Child Team will attempt to obtain the measurements from the child’s medical records (please see 'Limited Participation' below).
At (or after) the 12 month Study Visit, the local CHIPS-Child Team will give (or send) the child a birthday card, CHIPS-Child Measurement Postcard, CHIPS-Child Measuring Tape, and a CHIPS-Child wall growth chart. From the child’s second birthday (based on corrected post-gestational age), the child's height, weight and waist circumference will be recorded annually by the parents on a CHIPS-Child Measurement Postcard that will be mailed to them for this purpose; the parents will then send back the Postcard to the local CHIPS-Child Team which will also maintain contact with the family at two additional times during the year. Postcards will be mailed to families annually and contact will be maintained throughout years 3-5 (as in year 2) to confirm the family’s contact details.
What limited participation involves
For CHIPS mothers who either do not wish to attend, or are not able to attend the Study Visit, LIMITED PARTICIPATION Is a possibility. This includes consent to contact the child’s physician to obtain the basic body measurements taken in the doctor’s office as close as possible to 12m corrected post-gestational age. Parents will be sent the CHIPS-Child wall growth chart, Measuring tape, and Measurement Postcard on which they will records the child’s height, weight and waist circumference; they will then return the Postcard to the local CHIPS-Child Team which will also maintain contact with the family at two additional times during the year. Pre-stamped and addressed Measurement Postcards will be mailed to families annually and contact will be maintained throughout years 3-5 (as in year 2) to confirm the family’s contact details.