1. The Mother and Child Cohort in Crete, Rhea Study Study design & key findings Leda Chatzi, MD, PhD Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece Brussels, October 2011

2. Study protocol: pregnancy- 2 years of age Mother Child Cord blood FFQQ2 +urine sample EPDS EPDS Q4(parents) Q5(parents) 12w – 24w Pregnancy Delivery 9 th month18 th month Q3 Q3 + blood sample Neurodevelo pment Q 1 Q 1 + blood + urine sample 25w – 36w Pregnancy EPDS EPDS STAI-T STAI-T EPQ EPQ S. Capital S. Capital 1 st month 4 th year The Mother & Child Cohort in Crete, Rhea Study

3. Study protocol: 4 years Questionnaires Clinical Exams FFQ Physical activity Q AD/HD Quest. Neurodevelo pment (McCarthy) Q6 (Clinical Questionnaire) Q6 (Clinical Questionnaire) 4 th year Urine & Blood samples Clinical Examination (+ spirometry) Strengths & Difficulties Quest. (SDQ) Parenting Stress Index (PSI-SF) The Mother & Child Cohort in Crete, Rhea Study

4. Diet assessment in pregnancy Dietary habits in mid pregnancy: FFQ on 250 items, completed by personal interview Dietary changes during pregnancy: FFQ in 3 rd trimester, 100 items, completed by personal interview Supplement use: specific questions in mid, late pregnancy for supplement use, brand names, dosages. Nutrient analysis: Based on the UK Nutrient Databank (McCance and Widdowson's, 6th edition 2002). The Mother & Child Cohort in Crete, Rhea Study

5. Diet assessment in childhood Breastfeeding practices: Questionnaire 9 th month Introduction of solid foods: Questionnaire 9 th month Dietary habits at 4 years: FFQ, 100 items, personal interview with the parents Nutrient analysis: Based on the UK Nutrient Databank (McCance and Widdowson's, 6th edition 2002). The Mother & Child Cohort in Crete, Rhea Study

6. Biological samples, Clinical Measurements related to Maternal Obesity in pregnancy Serum 10-14 th week of gestation: Fasting glucose, TG, LDL, HDL, Tchol, insulin Cord Blood at birth: Leptin Maternal anthropometry: BMI pre-pregnancy; BMI- first trimester, weight gain during pregnancy Blood pressure measurement: Standard protocol, 10- 14 th week of gestation Definition of Metabolic syndrome: NCEP III criteria with some adaptations to our study population of pregnant women The Greek Mother & Child Cohort Study The Mother & Child Cohort in Crete, Rhea Study

7. Coordination Leda Chatzi Maria Vassilaki Antonis Koutis RHEA STUDY Biobank Eleni Fthenou Georgia Chalkiadaki Polly Karakosta Maria Sarri Epidemiology Theano Roumeliotaki Katerina Sarri Vaggelis Georgiou Manolis Bagkeris Vicky Patelarou Constantinos Vardavas Vicky Lebentakou PIs Manolis Kogevinas Leda Chatzi Field Study S.Matalliotaki, D. Pagiataki, Μ. Karachaliou Κ. Koutra V.Lebentakou Chemistry Evripides Stephanou

8. The Greek Mother & Child Cohort Study to be continued …………… Thank you…