This is part of an EU proposal which will be led by Olle Bygren at the Karolinska Institute in Stockholm. The over-arching aim of the study is to determine transgenerational effects of smoking, stress and famine on subsequent generations. We propose to undertake the following two work-packages using ALSPAC:

1. Transgenerational smoking studies:

Detailed information was collected from the parents during pregnancy concerning their own backgrounds, including their childhood. The details included the age at which the parents started to smoke, the maximum amount they had smoked in their lifetime, the duration in years that they had smoked,and the amounts they were smoking at three stages of the study pregnancy. There was also information on the preceding generation [including whether the parents' own parents were smokers, and whether the grandmother smoked when expecting the study parent]. Information on the study 'child' is now available concerning the age at which he/she started smoking, and the amount smoked in adolescence and will be available for the early 20s.

The data currently available allow detailed time-related data on active and passive smoke exposure of the grandparents, the parents and the child. Although we have carried out research projects on: (a) the association between paternal onset of regular smoking in the pre-puberty [slow growth] period, and (b) exploration of the effects of parental prenatal smoke exposure on the anthropometry of the study children, there is much still to be done.

The long-term effects across the generations of active and passive smoke exposure will be assessed for the first time in a human population. This work-package will determine whether there are other outcomes [we have already shown associations with height, fat and lean mass in the next generation to age 17; these observations will be extended in this work-package to age 24]. Candidate outcomes will include factors that have been linked with smoking in a single generation or with prenatal exposure, but not across generations. Possibilities include: markers of the metabolic syndrome such as insulin resistance, reproductive outcomes such as miscarriage and subfertility; myopia; hyperactivity; conduct disorder and criminal behaviour; neurocognitive and motor development.

2. Transgenerational stress studies:

Detailed information was collected from the parents during pregnancy concerning their own backgrounds, including their childhood. Information included traumatic events, such as separation, divorce or death of a parent, physical or emotional abuse and neglect, with a childhood traumatic life event scale of over 40 items. The parents also completed life event scales to cover the first half of pregnancy, and subsequent approximately annual periods for the first 10 years after delivery. In parallel a series of similar questions elicited traumatic events experienced by the study child at approximately annual periods.

The data currently available allow detailed time-related data on traumatic events to the parents and to the child. Ideally, the study would benefit from knowledge of traumas to the generation before. This work package will be used to make detailed enquiries of the parents in regard to the childhood of their own parents. This would particularly enquire about their experience of World War II - where were they, were they evacuated, were they bombed, did they lose family members as a consequence, etc.

Outcome variables that will be considered include neurocognitive development and motor abilities [we have already shown a strong association between maternal stress in mid-childhood and developmental coordination disorder in the child], as well as growth. We will look in particular at differences between the study offspring according to whether the maternal or paternal parents experienced the trauma, the ages at which it occurred, and the sex of the offspring.