Proposal summaries
B4752 - Genetic and environmental factors in child adjustment and mental health - 02/12/2024
Understanding the factors associated with adolescent psychosocial adjustment and mental health is crucially important as mental health challenges that arise during these years often have enduring consequences throughout adulthood. Research indicates that mental health disorders in adolescence can hinder social, educational, and occupational outcomes, resulting in significant long-term impairments (Kessler et al., 2005). Mental health problems and health-compromising behaviors can often be traced back to adolescence, with 50% of mental health difficulties being established by the age of 15 (Kessler et al., 2005; Sawyer et al., 2012). The economic burden of mental health problems in young populations is profound, with estimates indicating both direct healthcare expenses and substantial indirect costs associated with increased social service needs, and the economic impact on families (Gustavsson et al., 2011; Knapp et al., 2011).
Factors leading to maladjustment and mental health problems in children and adolescents are often multifaceted, typically arising from a combination of individual vulnerabilities and environmental stressors. The individual factors include increased genetic risk for externalizing behaviors and depression, difficult temperament (e.g., high neuroticism), or developmental delays. One of the most salient environmental stressors is childhood adversity (i.e., adverse childhood experiences), typically operationalized as various forms of abuse, neglect, and household disfunction experienced before age 18 (Felitti et al., 1998; Hughes et al., 2017). Adverse childhood experiences are strongly associated with a socioeconomic disadvantage (Lacey, et al., 2022) and are structured by socioeconomic factors at both the family (Walsh et al., 2019) and macro level (Lewer et al., 2019). Thus, poverty and socioeconomic inequality can be considered as drivers of adverse childhood experiences (ACE; Institute of Health Equity, 2020; Walsh et al., 2019).
Environmental effects not only complement genetic influences but also interact with them, embodying the gene-environment (GxE) concept—the idea that environments modify genetic effects. For example, the effects of genetic risk on problem behaviors was amplified in environments characterized by poverty or maladaptive parenting (Chubar et al., 2020; Jensen et al., 2017). The existing studies on GxE usually follow the diathesis-stress model, which suggests that individuals with pre-existing vulnerability (such as genetic risk) are more susceptible to negative outcomes when exposed to adverse environments (Colodro-Conde et al., 2018; Zuckerman, 1999).
Lastly, large-scale societal conditions, including economic downturns, socioeconomic transformations, and geopolitical conflicts have a profound influence on well-being and mental health (Deindl, 2013). As countries considerably differ in their socioeconomic conditions, the scale in which they are affected by crises and by their response to them (Cascini et al., 2022), country characteristics are an important factor contributing to variation in young people’s mental health.
The aim of this project is twofold: a) to test the environmental risk (defined as childhood adversity and socioeconomic disadvantage) and genetic risks for maladjustment and mental health difficulties in ALSPAC cohort, and b) to examine the association between socioeconomic inequality, childhood adversity and adolescent mental health across two sister cohorts (ALSPAC and ELSPAC-CZ) that represent different socioeconomic environments. Data collection of both cohorts took place during the 1990s; however, while this was a time of relative stability in the United Kingdom, Czechoslovakia (later Czech Republic) was undergoing a turbulent post-communist transformation. This project will be the first to harmonize and directly compare data from both cohorts.
References:
Colodro-Conde, L., Couvy-Duchesne, B., Zhu, G., Coventry, W. L., Byrne, E. M., Gordon, S., ... & Martin, N. G. (2018). A direct test of the diathesis–stress model for depression. Molecular psychiatry, 23(7), 1590-1596.
Deindl, C. (2013). The influence of living conditions in early life on life satisfaction in old age. Advances in Life Course Research, 18, 107-114.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
Gustavsson, A., et al. (2011). Cost of disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21(10), 718-779.
Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366. https://doi.org/10.1016/S2468-2667(17)30118-4
Institute of Health Equity. (2020). Health equity in England: The Marmot review 10 years on. https://www.health.org.uk/publications/reports/the-marmot-review-10-year...
Jensen, S. K., Berens, A. E., & Nelson, C. A. (2017). Effects of poverty on interacting biological systems underlying child development. The Lancet Child & Adolescent Health, 1(3), 225-239.
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication Archives of General Psychiatry, 62, 593-602.
Knapp, M., McDaid, D., & Parsonage, M. (Eds.). (2011). Mental health promotion and mental illness prevention: The economic case. London: Department of Health.
Lacey, R. E., Howe, L. D., Kelly-Irving, M., Bartley, M., & Kelly, Y. (2022). The Clustering of Adverse Childhood Experiences in the Avon Longitudinal Study of Parents and Children: Are Gender and Poverty Important? Journal of Interpersonal Violence, 37(5–6), 2218–2241. https://doi.org/10.1177/0886260520935096
Lewer D., King E., Bramley G., Fitzpatrick S., Treanor M. C., Maguire N., … Story A. (2019). The ACE Index: Mapping childhood adversity in England. Journal of Public Health. Advance online publication. 10.1093/pubmed/fdz158
Sawyer, S.M., Afifi, R.A., Bearinger, L.H., Blakemore, S.-J., Dick, B., Ezeh, A.C., et al. (2012). Adolescence: A foundation for future health. Lancet, 379, 1630-1640.
Walsh D., McCartney G., Smith M., Armour G. (2019). Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): A systematic review. Journal of Epidemiology & Community Health, 73(12), 1087–1093. [DOI] [PMC free article] [PubMed] [Google Scholar]
Zuckerman M. Diathesis-stress models. In: Vulnerability to Psychopathology: A Biosocial Model. American Psychological Association; 1999:3-23. doi:10.1037/10316-001
B4750 - Does physical activity moderate the relationship between genetic liability to depression and severity of depressive symptoms - 25/11/2024
Individuals with a higher genetic propensity for depression are more likely to experience later depression symptoms. Evidence suggests moderate effects of exercise on improving symptoms of depression and anxiety. In this project, we explore whether the effects of exercise on depression symptoms differ depending on the genetic liability of the individual.
B4751 - Early exposures and infectious outcomes in childhood - 16/12/2024
We want to study how a baby’s first months of life, including factors like their birth, family and living conditions might affect how they cope with common illnesses like coughs, colds and stomach bugs, or more serious infections.
This study will look back at the lives of a group of babies to understand how their early experiences might affect how their immune system develops and their ability to handle infections as children. We will analyse information collected about these babies, including details about the pregnancy and birth, their family lifestyle and living conditions as well as how often and what kind of illnesses they have during childhood.
The study aims to find out if any of these early factors influence how well children cope with infections. For example, the study might find that that certain living conditions, like their housing, spending time outdoors or having siblings or pets can make children more or less likely to get sick.
The goal is to identify patterns and factors that could help improve health outcomes for children by understanding what makes some babies more resilient to infections. This information could be used to guide parents and healthcare providers in making decisions that support better health during a child's early years.
B4749 - Smart Watch Face - Predicting Offspring Reproductive Development Using Maternal Placenta DNA Methylation Clock - 26/11/2024
This study focuses on the physiological behaviors of pregnant women and the health of their offspring. It leverages population information and biological samples from ALSPAC (Avon Longitudinal Study of Parents and Children), the Shanghai Minhang Birth Cohort, and the Millennium Cohort Study. By employing novel statistical modeling strategies and machine learning techniques, the research predicts the epigenetic age of pregnant women, a unique population, through DNA methylation data of maternal and child samples. Building upon this, the study further investigates the impact of actual age, epigenetic age, and accelerated epigenetic aging on the reproductive development outcomes of the offspring. This approach aims to provide new insights into the role of epigenetic mechanisms in the mother-child interaction and offspring development, offering potential epigenetic targets for interventions to improve maternal and child health.
B4745 - Exploring the link between autism spectrum disorder and an increased risk of postpartum depression - 25/11/2024
The aim of this project is to explore if having Autism Spectrum Disorder (ASD) increases the risk of Post-Partum Depression (PPD). PPD is the most common mental disorder experienced by women after pregnancy, affecting 10% to 20% of new mothers. Research suggests that individuals with ASD may face a higher risk of PPD due to challenges specific to autism, such as difficulties adjusting to change, lower self-esteem, and social stigma.
Also, there is evidence that mental health outcomes differ based on when individuals with ASD are diagnosed. Those diagnosed later in life often experience more loneliness, lower self-esteem, and use less effective coping strategies, which are known risk factors for PPD. This project will investigate whether the risk of PPD is amplified in late-diagnosed autistic individuals, who may face added emotional challenges during the postpartum period. To date, no existing longitudinal studies have explored these potential mechanisms.
Currently, significant gaps remain in understanding how autism impacts the transition to motherhood, as research in this area often reflects a neurotypical perspective. This study seeks to address this gap by examining the long-term outcomes for individuals with ASD as they become mothers, using a longitudinal approach to provide new insights into the link between ASD and PPD.
B4747 - The impact of childhood emotional abuse on peer relationships The role of anxiety and emotional support - 25/11/2024
This research investigates how emotional abuse experienced during childhood (ages 0–17) might impact relationships later in life, particularly the ability to make and maintain friendships. We’re exploring whether anxiety plays a role in explaining this connection and whether having strong emotional support as an adult can help reduce these difficulties. Our study draws on attachment theory, which explains how early caregiving experiences shape our ability to form secure and trusting relationships. Emotional abuse can disrupt the development of secure attachment, potentially leading to struggles with trust, fear of rejection, or emotional withdrawal, which may persist into adulthood and affect friendships.
Healthy relationships are vital for well-being, mental health, and social support. However, individuals who experience emotional abuse in childhood are at higher risk of developing anxiety and difficulties in building meaningful connections later in life. By understanding how anxiety and emotional support influence this relationship, we aim to uncover pathways that can help people recover from early trauma. Attachment theory helps explain these effects, offering insights into how early experiences shape our emotional and relational patterns. This research could inform interventions that promote emotional support and help individuals overcome the lasting impacts of childhood trauma, improving their social and emotional outcomes.
B4746 - Association of serum Interleukin 6 levels with negativity bias in early adulthood a prospective birth cohort study - 25/11/2024
Around two thirds of adults do not respond to the first trial of antidepressants meaning depression often goes untreated leading to severe complications. This may be due to antidepressants targeting the wrong mechanisms underlying depression, meaning alternative anti-depressive pathways must be targeted. Alternative routes include inflammatory pathways which have been associated with the development and pathogenesis of depression, demonstrated in a prospective study linking cytokine Interleukin 6 (IL-6) in childhood to depression later in life. The ways in which IL-6 contribute to depression remain unclear, and this study aims to investigate this relationship.
This study will investigate the role of cognitive biases, specifically negative biases, in the association between inflammation and depression. Cognitive biases are systematic deviations from normality when processing information; negativity bias refers to a negative shift in emotional processing. The neurocognitive model of depression suggests that negative biases have an important role in the development and maintenance of depressed mood. While there is a significant amount of research mapping neurotransmitter pathways of these cognitive mechanisms, the role of inflammatory pathways is largely unknown. This study aims to bridge this knowledge gap investigating the causal relationship between IL-6 serum levels with emotional processing, specifically negativity bias. This may highlight a new neurocognitive pathway between inflammation and depression, suggesting that IL-6 levels may cause changes in emotional processing subsequently maintaining depressed mood.
There is a small amount of research already suggesting an association, however there are significant experimental issues meaning a causal relationship cannot be drawn. Most research uses small samples of specific populations e.g. breast cancer patients in cross sectional designs. The extant research is at risk of inflated effect sizes due to moderation of chronic inflammatory disease, meaning the relationship between inflammation and negativity bias may be larger than in healthy populations. Additionally, there is a risk of depression mediating this relationship. Current research lacks a large sample prospective study, adjusted for moderation of chronic inflammatory illness, mediating effect of depression and several confounding variables.
This study will use ALSPAC data to investigate the relationship between IL-6 serum levels in childhood through to early adulthood and negativity bias in early adulthood. Using a large longitudinal data set allows for a temporal, directional relationship to be determined. Adjusting for confounders, testing for moderation of disease and mediation of depression means a valid, causal association can be investigated between IL-6 and negativity bias.
B4743 - Genome-Wide Association Study of lipids and the influence of education - 25/11/2024
The Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium is an international organization founded to facilitate large-scale genetic studies among multiple large and well-characterised groups of participants.
The goal of the CHARGE studies is to identify susceptibility genes involved in diseases of the heart, lung, and blood and their risk factors.
In our study, we will analyse the association of gene variants with serum lipids, considering the effect of the educational level in ALSPAC participants. The results will be combined with results from other groups of participants around the world to be able to identify new gene variants that help understand the biology of serum lipids.
B4748 - Depression cardiovascular risk factors and inflammatory biomarkers - 25/11/2024
Cardiovascular diseases (CVDs) and depression are globally prevalent health concerns with substantial impacts. CVDs, including ischemic heart disease and stroke, rank among the leading global health burdens (WTO, 2023). Research indicates a high rate of comorbidity between CVD and depression (Karami et al., 2023; Rafiei et al., 2023), with the onset of CVD significantly increasing the risk of depression (Whooley & Wong, 2013). Conversely, depression elevates CVD risk by 1.5 times and doubles to triples the incidence of cardiac events in individuals with coronary artery disease (Frasure-Smith & Lesperance, 2009; Goldston & Baillie, 2008; Rudisch & Nemeroff, 2003; Van der Kooy et al., 2007). However, it remains unclear how adolescent depression contributes to heightened cardiovascular risk in adulthood, as defined by indicators such as BMI, HDL (high-density lipoprotein cholesterol), total cholesterol and systolic blood pressure (SBP).
Emerging evidence suggests that inflammation may be a common biological mechanism underlying the comorbidity of depression and CVD (Chen et al., 2018; Shao et al., 2020). Recent research has identified 185 genes significantly associated with both depression and coronary artery disease (CAD), many of which are linked to inflammatory and cardiomyopathic phenotypes (Singh et al., 2024). Our current research (in progress, 2024) has identified several inflammatory biomarkers—such as CRP/hs-CRP, IL-6, and TNF-α—that are shared between depression and CVD.
This study aims to (1) test the hypothesis that adolescent depression predicts an elevated cardiovascular risk in adulthood, (2) map the trajectory of cardiovascular risk factors from adolescence to adulthood, and (3) investigate how changes in inflammation, as indicated by inflammatory biomarkers and DNA methylation, influence the progression of cardiovascular risk factors in both depressed and non-depressed groups.
B4744 - Investigating the association between subclinical post-partum depression and offspring oppositional defiant disorder - 25/11/2024
We aim to explore if subclinical post-natal depression (PND) causes offspring oppositional defiant disorder (ODD), a disruptive behavioural disorder.
The historical focus on participants presenting severe cases in psychological research has long distorted our view of mental disorders, ostracising subsyndromal mental health and reducing the scope of care within clinical practice. Therefore, it is crucial to include subclinical PND when looking at its association with child ODD, due to its possible important public health implications in representing the need for reform within the scope of care.
Additionally, PND has been associated with predisposing an individual to reduced maternal bonding, thus, investigating whether subclinical PND also holds such effects is crucial as significant results could indicate the need for greater intervention strengthening early parent-infant interaction. Furthermore, whilst many studies investigating PND and its association to child psychopathology mention the need for greater maternal education as a means of reducing its effect, investigating knowledge, specifically pregnancy-related knowledge as a moderator remains unknown. Therefore, it is necessary to clarify whether the effects of PND on child psychopathology is conditioned to pregnancy-related knowledge, or whether such effects only exist when analysing education more generally.
Although understanding the effects of PND on ODD has important public health implications, due to the nature of the question, it would be unethical and infeasible to use randomisation. As such, observational data is required.
This study aims to contribute to the body of research regarding PND and its generational effect on child psychopathology, specifically ODD, directed at filling the gap within the current literature that often disregards subclinical PND.
B4741 - Whole-exome sequencing as a tool to reveal genetic architecture of cleft palate - 18/11/2024
Cleft palate is a congenital condition that occurs when the tissues of the roof of the mouth do not join together properly during foetal development. Although the exact cause is unknown, it's believed to result from a combination of genetic and environmental factors. Cleft palate repair involves a complex surgical procedure aimed at reconstructing the palate to improve speech, feeding, and overall quality of life. The healing process following cleft palate surgery is crucial and can be influenced by several factors, including those derived from the surgical process itself but also from the individual healing process (genetics, excessive tissue tension, infection, inflammation, etc).
Multiple genetic studies in individuals affected by cleft palate have identified several susceptibility genes, including IRF6, MSX1, SATB2, TBX22, COL2A1, FBN1, PCGF2, KMT2D, MYC, PTCH1, VAX1, SPRY2, NOG, MAFB and TAF1B, among others.
To facilitate the understanding of the genetic architecture and gain a better understanding of the genetic basis underlying cleft palate, we will look into the DNA of ALSPAC participants that codes the proteins, to identify variants in genes associated with cleft palate disorders. Then we will investigate if those variants have an impact on the manifestation of traits related with wound healing, such as levels of markers involved in the immune system and inflammatory processes.
B4374 - Parental-related risk factors for central nervous system disorder - 18/11/2024
Both functional and organic disorders of the central nervous system (CNS) can cause serious physical harm and emotional distress to patients. Previous research suggests that parent-related factors may be associated with CNS disorders in the population, and in this project we have focused on the genetic factors of both parents, the physical condition of the pregnant woman before and after pregnancy, and the level of health care she receives. Using the ALSPAC data, we hope to further identify specific factors and quantify the strength of their influence.
B4738 - Changes in cognitive ability and architecture as a function of developmental priorities form early childhood to adolescence - 09/11/2024
This project is based on our earlier research theory, which integrates psychometric, cognitive, and developmental models of the human mind. The theory postulates that the profile of cognitive abilities changes with development, according to the processes that need to be mastered at successive age periods. Control of episodic interactions with persons and objects, control of representation-based executive processes, inferential control, and truth and cognitive cohesion control dominate in infancy, early childhood, middle and late childhood, and adolescence, respectively. So far, the theory is based on many cross-sectional studies and some longitudinal studies conducted in our laboratory. The main aim of this project is to test theory on an independent sample that has been longitudinally examined, to test if the patterns obtained so far replicate here.
B4739 - Re-imagining how universities respond to self-harm a social-ecological approach - 09/11/2024
Despite high and increasing rates of self-harm amongst university students, there is a lack of research exploring how they can best be supported. Interventions for self-harm amongst students have been developed and positively evaluated, but 80% of students who self-harm never receive support. I propose a creative, ambitious and comprehensive approach to discover how self-harm is experienced and responded to within universities to improve the experience for students and the response to their self-harm. This will be achieved via four related work packages informed by a social ecological model. Firstly, on a university level, university policy and student-facing messaging around self-harm will be collated and triangulated with first-hand experiences of university wellbeing and pastoral staff to identify best practice and challenges. Secondly, on a community level, discourses around self-harm within university communities will be explored to gauge perceptions and possible sources of stigma. Thirdly, on an inter-personal level, experiences of friends and/or family who support students who self-harm will be investigated to understand any unmet needs they have. Finally, on an individual level, secondary data regarding self-harm and university attendance will be analysed to uncover who the largely unknown population is of students who self-harm. Additionally, students’ needs and priorities for wellbeing and self-harm support will be creatively explored to elevate voices that may typically be excluded from traditional methods. Findings will be brought together during a series of workshops with key stakeholders to co-produce resources aiming to better equip universities, staff and students to respond to self-harm.
B4737 - Investigating Food Insecurity and Eating Disorder Symptoms Among Adults in the UK An analysis of Epidemiological Data - 08/11/2024
Not having enough money to buy food—known as food insecurity—is a serious issue, affecting over one in ten households in the UK during 2022/23. This struggle impacts both physical and mental health. New findings suggest that food insecurity is also linked to eating disorders. Adults who experience food insecurity are more likely to show symptoms of disordered eating, including behaviors like binge eating, restrictive eating, and compensatory behaviours (e.g., meal skipin, dieting). These patterns have been observed across various groups, including adults, teenagers, students, and people in treatment for eating disorders. This evidence highlights the need to consider food insecurity as a critical risk and/or maintenance factor for eating disorders. Yet, most research has focused on the USA despite the similar prevalence of food insecurity households in the UK. However, findings from the USA may not directly translate to the UK due to cultural and welfare differences (e.g., the US offers monthly food benefits, while UK food bank access varies regionally and by policy). Our study will use data from the UK to explore how food insecurity and eating disorders are associated among adults in the general population.
B4736 - Fish intakes in childhood and neurodevelopmental outcomes 2 - 08/11/2024
Seafood is a major source of essential nutrients such as long chain fatty acids, selenium, iodine and vitamin D. There is debate over whether these essential nutrients offset the potential adverse effects of mercury - a widespread environmental toxin which can accumulate in seafood. Current NHS guidance for pregnancy advises eating no more than 2 portions (approximately 280g) oily fish a week. Previous studies have utilised ALSPAC data to assess the possible benefits and harms of different levels of maternal seafood intake during pregnancy on a child's development, e.g., Hibbeln et al. (2007) modelled the association between maternal fish intake during pregnancy and cognitive development in offspring.
However, there is no current modelling of the relationship between childhood intake of fish and neurodevelopmental outcomes. This project aims to use existing data from ALSPAC, to examine the possibility of a connection between childhood fish intake and cognitive development. We will look at ALSPAC data collected from food frequency questionnaires on fish intake during childhood, as well as later data on neurodevelopmental indicators (DDS - ALSPAC Developmental Score and WPPSI IQ). This may subsequently assist with informing nutrition guidance on fish intake in childhood.
B4735 - Internalized weight stigma causes and consequences in young adulthood - 06/11/2024
Increasing evidence suggests that social processes including weight-related stigma are key to explaining many consequences of overweight and obesity. For instance, people carrying genetic variants linked to obesity are at higher risk of depression, even where those variants have no known metabolic consequences. This strongly implicates social, not just biological, processes by which body weight affects mental health. Among the different facets of stigma is internalized weight stigma (self-attribution of negative obesity-related stereotypes) which may have especially negative consequences.
Despite strong theoretical work in this area, our empirical understanding of weight stigma’s causes and consequences is limited. This includes how social, psychological, and familial factors across the lifecourse influence weight stigma internalization, and the consequences for mental health and social functioning. This is because research has been almost entirely based on small, non-representative samples. This PhD project will use the data on internalized weight stigma at age 31, completed by ALSPAC participants of all weight statuses, to investigate causes and consequences of weight stigma internalization in a large sample of young people.
B4733 - Exercise in adolescence as a protective factor against negative neurodevelopmental effects of bullying - 05/11/2024
Healthy socialization plays a crucial role in adolescent maturation. Social stress is known to hamper proper development of the prefrontal cortex and its dopamine dynamics. The dopamine system is tightly linked to brain processes underlying impulse control, social behavior and cognition. Social adversity commonly occurs during adolescence. We can aim to reduce bullying, but this stressor cannot be avoided entirely, so it is necessary that we understand how to protect against its long-term negative effects on the brain. There is some evidence that physical exercise can prevent, reduce, or reverse negative effects of adverse experiences on brain function and behavior.
B4727 - Rare variants in PKIG in a UK Birth Cohort - 05/11/2024
We have found that rare changes in DNA are associated with a diagnosis of heart failure in a large study called UK biobank. In general, these mutations are exceptionally rare in UK Biobank, but we know that the design of UK Biobank can lead to inadvertent exclusion of groups of people which can lead to inaccurate estimates of how common mutations in some genes are. This study, ALSPAC, included the majority of people born during a certain time period in the Avon region. As such, it is less susceptible to some of these problems. As such, we want to use it to refine our estimates of how common these mutations are.
B4734 - Reproductive factors and the risk of pregnancy complications a student project by Zhuohui Chen linked to B4306 - 05/11/2024
This is a student project linked to my current project B4306. The reproductive factors including lifestyle, disease status, infection, medication use, nutrient supplements, physical activity, and mental health are associated with pregnancy complications. The adverse outcomes of pregnancy confront the world as a major challenge, with extensive impact on individuals, families, and societies at large. This study will take advantage of the data provided by the Avon Longitudinal Study of Parents and Children to quantify the risk of possible adverse outcomes of pregnancy, and present opportunities to reduce the burden associated with congenital disorders at a population level.