Person:

Alseaidan, Mohammad M.S.

Background: Lifestyle changed in Kuwait with the rapid development and economic expansion and the Americanization of the Kuwaiti market. Fast food and sedentary lifestyle became very prevalent. Environmental exposures such as passive tobacco smoke and extreme temperatures are common in Kuwait where the prevalence of chronic conditions is increasing. We describe a Kuwait based pregnancy-birth cohort and examine the associations between perinatal exposures and the risk of chronic disease.

Methods: We recruited women from antenatal clinics in Kuwait and administered baseline questionnaires then followed the women postnatally. We examined maternal and lifestyle risk factors of gestational diabetes mellitus (GDM). We examined the association between passive tobacco smoke exposure and gestational diabetes, and finally we examined the association between preterm delivery with heat and humidity in Kuwait

Results: We successfully enrolled 2,478 women and followed 2,254 to delivery. Overall, frequencies of stillbirth, preterm birth, and small for gestational age were comparable to other developed countries. The incidence of self-reported gestational diabetes was within the expected range worldwide. After past GDM history, pre-pregnancy obesity was the strongest maternal risk factor associated with GDM. We observed patterns suggestive of a positive association between home passive tobacco smoke exposure and GDM among primiparous women. Finally, high relative humidity but not temperature was associated with an increased risk of preterm delivery.

Conclusions: We successfully established a large pregnancy birth cohort in Kuwait. There are several social and environmental challenges in Kuwait that may increase the risk of chronic disease such as diabetes, which is already very prevalent in Kuwait. Our results should be replicated and the results used to inform interventions to reduce the rates of chronic disease in Kuwait.

Background—Rapid development and westernisation in Kuwait and other Gulf states have been accompanied by rising rates of obesity, diabetes, asthma, and other chronic conditions. Prenatal experiences and exposures may be important targets for intervention. We undertook a prospective pregnancy–birth cohort study in Kuwait, the TRansgenerational Assessment of Children’s Environmental Risk (TRACER) Study, to examine prenatal risk factors for early childhood obesity. This article describes the methodology and results of follow-up through birth. Methods—Women were recruited at antenatal clinical visits. Interviewers administered questionnaires during the pregnancy and collected and banked biological samples. Children are being followed up with quarterly maternal interviews, annual anthropometric measurements, and periodic collection of biosamples. Frequencies of birth outcomes (i.e. stillbirth, preterm birth, small and large for gestational age, and macrosomia) were calculated as a function of maternal characteristics and behaviours. Results—Two thousand four hundred seventy-eight women were enrolled, and 2254 women were followed to delivery. Overall, frequencies of stillbirth (0.6%), preterm birth (9.3%), and small for gestational age (7.4%) were comparable to other developed countries, but not strongly associated with maternal characteristics or behaviours. Macrosomia (6.1%) and large for gestational age (23.0%) were higher than expected and positively associated with pre-pregnancy maternal overweight/obesity. Conclusions—A large birth cohort has been established in Kuwait. The collected risk factors and banked biosamples will allow examination of the effects of prenatal exposures on the development of chronic disease in children. Initial results suggest that maternal overweight/obesity before pregnancy should be targeted to prevent macrosomia and its associated sequelae of childhood overweight/obesity.