Cohort profile: project viva

Abstract

We established Project Viva to examine prenatal diet and other factors in relation to maternal and child health. We recruited pregnant women at their initial prenatal visit in eastern Massachusetts between 1999 and 2002. Exclusion criteria included multiple gestation, inability to answer questions in English, gestational age ≥22 weeks at recruitment and plans to move away before delivery. We completed in-person visits with mothers during pregnancy in the late first (median 9.9 weeks of gestation) and second (median 27.9 weeks) trimesters. We saw mothers and children in the hospital during the delivery admission and during infancy (median age 6.3 months), early childhood (median 3.2 years) and mid-childhood (median 7.7 years). We collected information from mothers via interviews and questionnaires, performed anthropometric and neurodevelopmental assessments and collected biosamples. We have collected additional information from medical records and from mailed questionnaires sent annually to mothers between in-person visits and to children beginning at age 9 years. From 2341 eligible women, there were 2128 live births; 1279 mother-child pairs provided data at the mid-childhood visit. Primary study outcomes include pregnancy outcomes, maternal mental and cardiometabolic health and child neurodevelopment, asthma/atopy and obesity/cardiometabolic health. Investigators interested in learning more about how to obtain Project Viva data can contact Project_Viva@hphc.org.

Keywords: Pregnancy; childhood; cohort; nutrition; obesity.

Figure 1.

Participant flow from recruitment through mid-childhood in the Project Viva cohort.

Figure 2.

Predicted probability of obesity at 7 to 10 years of age for 16 combinations of four modifiable prenatal and postnatal risk factors. Data are from 1110 mother–child pairs participating in Project Viva. Estimates are adjusted for the mother’s educational level and body-mass index (BMI), household income, and the child’s race or ethnic group. Obesity was defined as a BMI above the 95th percentile for age and sex. Excessive gestational weight gain was defined according to the 2009 recommendations of the Institute of Medicine. Plus signs indicate the presence of the risk factor, and minus signs the absence of the risk factor. I bars indicate 95% confidence intervals. From Gillman MW, Ludwig DS. How early should obesity prevention start? N Engl J Med 2013;369:2173–75. © 2013 Massachusetts Medical Society. Reprinted with permission.