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Journal of Epidemiology

Volume 32, Issue 9(September 2022)

Association of Pneumococcal and Influenza Vaccination With Patient–Physician Communication in Older Adults: A Nationwide Cross-sectional Study From the JAGES 2016
  • Older adults who have a family physician have around twice higher odds of pneumococcal and influenza vaccination.
  • Physicians’ listening attitude is associated with higher odds of pneumococcal and influenza vaccination.
  • Patients’ questioning attitude is positively associated with pneumococcal vaccination.
  • Shared decision-making is associated with higher odds of pneumococcal vaccination.
Reduced Road Injuries While Commuting Due to Heavy Snowfall and Ensuing Modal Shifts Among Junior High School Students in Japan
  • It is suggested that modal shifts in transport may reduce overall road injuries.
  • Road injury risk is high among cyclist junior high students while commuting in Japan.
  • Heavy snowfall reduced road deaths and serious injuries by 68 %.
  • The reduction was likely due to modal shifts from cycling to other, safer modes.
  • Inducing modal shifts can be an important tool for increasing road safety.
Association of the Time to First Cigarette and the Prevalence of Chronic Respiratory Diseases in Chinese Elderly Population
  • This is the first national study on the association between the time to first cigarette after waking (TTFC) and the prevalence of chronic respiratory diseases in China.
  • Significant differences in the association between shorter or longer TTFC and the prevalence of chronic respiratory diseases have been detected among elderly Chinese smokers, contrary to previous studies.
  • Compared with TTFC >30 min, TTFC ≤30 min is associated with higher prevalences of chronic respiratory diseases in females, those aged ≥90 years old, urban residents, and ex-smokers.
  • Tobacco control efforts to delay the time interval from waking to the first cigarette might be beneficial to specific sub-populations.
  • The threshold for TTFC predicting the prevalence of chronic respiratory diseases should be set differently for various races.
Association Between Trajectory of Severe Hypoglycemia and Dementia in Patients With Type 2 Diabetes: A Population-based Study
  • We explored the associations between exposure to various intensity and timing trajectories of severe hypoglycemic events and risk of dementia in patients with type 2 diabetes.
  • We used a novel group-based trajectory model to better illustrate the role of severe hypoglycemia on the relationship between type 2 diabetes.
  • We found that early manifestation and uninterrupted clusters of severe hypoglycemia within a 3-year period after new diagnosis of type 2 diabetes posed a greater influence on the increased risk of dementia.
  • Patients with type 2 diabetes experiencing early or persistently recurrent severe hypoglycemia can be used as a measure for risk stratification of subsequent dementia.
Diagnosis-specific Cumulative Incidence of Return-to-work, Resignation, and Death Among Long-term Sick-listed Employees: Findings From the Japan Epidemiology Collaboration on Occupational Health Study
  • Return-to-work and resignations commonly occurred within 1 year of sick leave among long-term sickness absentees in the Japanese private sector.
  • As previously reported among European workers, the cumulative return-to-work rate differs between diagnostic groups among Japanese workers.
  • The cumulative incidence of death was visible among long-term absentees with neoplasms.
  • A paid sick-leave system, which ensures 1 year of leave, would enable most long-term sickness absentees to return to work.
  • Reduction of death rates through early cancer detection would enhance work continuity among long-term absentees with neoplasms in Japan.

Volume 32, Issue 8(August 2022)

Perceptions of Heated Tobacco Products (HTPs) and Intention to Quit Among Adult Tobacco Users in Korea
  • Heated tobacco product (HTP) use has spread dramatically in Korea since its introduction in 2017, and it may potentially be attributed to the positive perception of HTPs.
  • Contrary to the tobacco companies’ claims, HTPs could not be considered substitutes for conventional cigarettes to aid in the cessation of tobacco use, as a substantial portion of poly-product users of HTPs reported a lower intention to quit.
  • Ambiguous naming of HTPs as “conventional cigarette like e-cigarettes” in Korea could affect market response with the products confusion and make difficulties in exact monitoring of product use.
Association Between Nutrient Patterns and Fatty Liver Index: Baseline Survey of the Japan Multi-Institutional Collaborative Cohort Study in Tokushima, Japan
  • We examined the association between nutrient patterns and fatty liver index (FLI) and its components.
  • A nutrient pattern rich in vitamins, dietary fiber, iron and potassium was inversely associated with high FLI (P for trend <0.001), after adjusting for potential confounders.
  • Analysis of each component of FLI suggested that obesity and abdominal obesity were intermediate variables for the association between this nutrient pattern and FLI.
Economic Recession and the Risk of Cancer: A Cohort Study From Eastern Finland
  • Studies on the impact of financial crises on cancer have not yielded consistent findings.
  • Most of the earlier studies have used only unemployment to measure the recession impact, and only cancer mortality as an outcome.
  • Finland’s economic recession in early 1990s seemed to pose cancer risks to men, but not to women according to our study of 20-years follow-up.
  • Various health and social policy tools are needed to protect population health during and after future macroeconomic downturns.
Study Profile
Data Resource Profile of Shizuoka Kokuho Database (SKDB) Using Integrated Health- and Care-insurance Claims and Health Checkups: The Shizuoka Study
  • The Shizuoka Kokuho Database (SKDB) is an individual-level, population-based longitudinal cohort of Shizuoka Prefecture residents.
  • The SKDB comprises data of all insured individuals with National Health Insurance and Latter Stage Elderly Medical Care System.
  • From April 2012 to September 2018, the SKDB included 2,230,848 individuals; the median individual subscription period was 4.36 years.
  • The SKDB included health checkup data of 2,469,648 records from 654,035 individuals and care-service recipient data for 283,537 individuals.
  • The SKDB may be better for addressing health-care issues of an older population and unclarified epidemiological issues than conventional cohorts.

Volume 32, Issue 7(July 2022)

Relationship Between Non-fasting Triglycerides and Cardiovascular Disease Mortality in a 20-year Follow-up Study of a Japanese General Population: NIPPON DATA90
  • The present study demonstrated a U-shaped association between non-fasting TG and CVD mortality in a Japanese general population.
  • In the analysis stratified by age, lower levels of non-fasting TG had a stronger impact on increased risk for CVD mortality among individuals with age ≧65 years, on the contrary, higher levels of non-fasting TG had a stronger impact among those with age <65 years.
  • Our findings suggest that the desirable management of non-fasting TG might differ according to age.
Body Fat Distribution, Glucose Metabolism, and Diabetes Status Among Older Adults: The Multiethnic Cohort Adiposity Phenotype Study
  • The incidence of type 2 diabetes differs considerably across ethnic groups.
  • Obesity confers a higher type 2 diabetes risk in persons of Asian ancestry.
  • The ratio of visceral to subcutaneous fat is strongly associated with type 2 diabetes.
  • The ratio of visceral to subcutaneous fat appeared most important among Japanese Americans.
  • Early detection efforts can be focused on persons with abdominal adiposity.
Stages of a Transtheoretical Model as Predictors of the Decline in Estimated Glomerular Filtration Rate: A Retrospective Cohort Study
  • Chronic kidney disease (CKD) progression can be caused by various pathophysiological factors, including diabetes, hypertension, and systemic immune disorders, but whether consciousness of healthy behaviors is also associated with CKD progression has not been fully examined.
  • The transtheoretical model (TTM), also called the stages of change model, has been used to assess an individual’s readiness to adopt a new, healthier behavior, and we investigated connections between TTM-based stages and a decrease of 30% or more in estimated glomerular filtration rate (eGFR) in the future.
  • Compared with the risk associated with the precontemplation stage (stage 1), the preparation, action, and maintenance stages (stages 3, 4, and 5), were associated with a lower risk of eGFR decline.
  • Changing the TTM stages and their healthy behaviors might reduce the progression of eGFR reduction.
Maternal Height-standardized Prevalence of Stunting in 67 Low- and Middle-income Countries
  • Stunting prevalence is commonly used for assessing undernutrition in children under five years at the population level.
  • Short parental stature (especially maternal), a non-modifiable risk factor, is one of the strongest determinants of child stunting.
  • The component of the prevalence of stunting explained by maternal height varies widely between countries.
  • We find that maternal height-standardized prevalence of stunting correlates substantially better than the traditional measure of stunting with other measures of child health.

Volume 32, Issue 6(June 2022)

Prospective Study of Engagement in Leisure Activities and All-Cause Mortality Among Older Japanese Adults
  • In Cox proportional hazards model, we found a linear relation between the total number of leisure activities and mortality hazard (adjusted hazard ratio = 0.93, 95% confidence interval: 0.92, 0.95) in a cohort of older Japanese adults.
  • Engagement in leisure activities involving physical activity, as well as group-based interactions, showed the strongest associations with lowered mortality.
  • Engagement in cultural leisure activities and solitary leisure activities were not associated with all-cause mortality.
Lower Respiratory Tract Infections and Orofacial Clefts: A Prospective Cohort Study From the Japan Environment and Children’s Study
  • Infants with cleft lip and palate as well as those with cleft lip only were significantly associated with an increased risk of lower respiratory tract infections, whereas those with cleft palate only were not.
  • When accumulated breastfeeding duration was added to the model, the risk of lower respiratory tract infections in infants with cleft lip and palate was decreased.
  • The sample size of infants with orofacial clefts was relatively small. A high degree of uncertainty of the current results should be noted.
Overtime Work and the Incidence of Long-term Sickness Absence Due to Mental Disorders: A Prospective Cohort Study
  • Previous studies have linked working long hours and negative health outcomes.
  • We focused on long-term sickness absence (LTSA) due to mental health problems.
  • Results showed a U-shaped association between overtime working hours and LTSA.
  • Engaging in excessive overtime work was linked with a higher risk of LTSA.
  • Individuals working 45-79 hours/month of overtime work were at a lower risk of LTSA.
Relationship Between Neighborhood Food Environment and Diet Variety in Japanese Rural Community-dwelling Elderly: A Cross-sectional Study
  • We examined the relationship between diet variety and neighborhood food environments among elderly people living in rural Japan.
  • The results of multivariate regression analysis showed a significant trend toward greater distance from home to the nearest food store and low diet variety.
  • There were significant trends between the greater distance to each supermarkets and convenience stores and low diet variety but was not significant in small food store.
  • In sub-analyses by the food groups, distance to food store was significantly associated with less frequent consumption of meat and fruit.
  • The specific interventions may be needed for areas at high risk of low diet variety such as location far away from food store especially supermarket or convenience store.

Volume 32, Issue 5(May 2022)

Exploring the Causal Roles of Circulating Remnant Lipid Profile on Cardiovascular and Cerebrovascular Diseases: Mendelian Randomization Study
  • This study explored the metabolic risk of the conventional lipids and remnant lipids.
  • The remnant lipid profiles have heterogeneity for the risk of CHD and IS by the particle size of triglyceride-rich lipoproteins.
  • The different TGLs presented positive and negative effects for different CVD that suggest not all remnant lipids was harmful that required intervention.
  • This research provides causal evidence for potential intervention targets of remnant lipids.
Did Expanded Dental Insurance Improve Chewing Ability in the Older Korean Population? Results of an Interrupted Time-series Analysis
  • We aimed to explore the causal inference of expanded dental insurance on older adults’ chewing ability using multi-group interrupted time-series analysis (ITSA) model.
  • We used data from the Korea National Health and Nutrition Examination Survey conducted from 2007 to 2016–2018.
  • The ITS analysis showed that chewing difficulty decreased annually by 0.93% and 0.38% after the policy extension in older than 65 and younger than 65, respectively.
  • Chewing difficulty decreased over time in the both eligible and ineligible groups after the expansion of dental insurance in South Korea. These trends appear to be attributable to forces external to changes in dental insurance benefits.
  • These trends appear to be attributable to forces external to changes in dental insurance benefits.
Combined Associations of Liver Enzymes and Obesity With Diabetes Mellitus Prevalence: The Tohoku Medical Megabank Community-based Cohort Study
  • Alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) are enzymes associated with diabetes mellitus (DM) prevalence.
  • We examined whether ALT and GGT enzymes combined is associated with the prevalence of DM regardless of obesity in a general Japanese population.
  • High ALT and GGT levels are associated with DM prevalence in obese and non-obese participants.
  • This finding suggests that correcting ALT and GGT levels and controlling obesity are important for the prevention of DM.
Study Design and Participants’ Profile in the Sub-Cohort Study in the Japan Environment and Children’s Study (JECS)
  • The Japan Environment and Children’s Study (JECS) is a nationwide birth cohort study investigating environmental effects on children’s health and development. A Sub-Cohort Study has measured extended exposure and outcomes by randomly selecting a subgroup from the JECS Main Study.
  • Participants are followed up at 1.5 and 3 years old for home visits, and 2, 4, 6 and 8 years old for developmental/medical examination. The details of protocols after age 10 are under discussion.
  • Of 10,302 selected children, 5,017 participated. The profiles of the participating mothers, fathers and children did not substantially differ between the Main Study and Sub-Cohort Study.
  • The JECS Sub-Cohort Study offers a platform for investigating associations between environmental exposure and outcomes.
Short Communication
Association Between Long-term Weight Change Since Midlife and Risk of Incident Disabling Dementia Among Elderly Japanese: The Ohsaki Cohort 2006 Study
  • Previous studies indicated weight loss was associated with dementia among Caucasians, but it remained unclear among Asians.
  • Our study is the first to report the association between weight loss and incident dementia among elderly Japanese.
  • Our study suggests that a ≤-3.5kg weight loss was associated with a higher risk of incident dementia.

Volume 32, Issue 4(April 2022)

Special Article
AI Implementation Science for Social Issues: Pitfalls and Tips
  • Outcomes of social implementation should be carefully set while staying close to the field and achieving consensus on which issues should be solved.
  • It is important to design social implementation that can repeat the loop of practice and evaluation using data.
  • The cycle of retaining new system functions that worked well and improving those that did not is repeated quickly from research to social implementation.
  • When implementing a product in a society, researchers must always create an exit strategy to expand the product’s implementation and maximize social impact.
  • A sustainable service team as research and development (SSTRD) model should be developed for social implementation.
Epidemiological Study of Hospital Admissions for Food-Induced Anaphylaxis Using the Japanese Diagnosis Procedure Combination Database
  • Food-induced anaphylaxis is a serious disease with a risk of death.
  • We identified 9,079 patients from the Japanese Diagnosis Procedure Combination Database who were admitted for treatment for FIA from April 1, 2014 through March 31, 2017.
  • The most common causative food of FIA among patients aged 0–3, 4–6, 7–19 and ≥ 20 years old was hen’s egg, cow’s milk, peanuts and wheat, respectively.
  • Taking measures to prevent peanut allergies in school is important.
Association Between Birth Weight and Risk of Pregnancy-Induced Hypertension and Gestational Diabetes in Japanese Women: JPHC-NEXT Study
  • No large epidemiological study on women of Asian ancestry have studied whether birth weight is associated with risk of complications during pregnancy.
  • Utilizing a large cross-sectional database, we observed higher risk of pregnancy induced hypertension among Japanese women born with lower birthweight.
  • The risk of GDM was significantly higher among women born with birthweight of 1500-2500 grams compared to those born with 2500-3500 grams, albeit non-significant association among women in other birthweight categories.
The Association Between Informal Caregiving and Poor Self-rated Health Among Ever-married Women in Japan: A Nationally Representative Survey
  • Informal caregiving (childcare, nursing care, dual care) could negatively affect caregivers’ health due to multiple burden.
  • However, no previous research studied the health effects of combining these different types of informal caregiving.
  • We assessed self-rated health (SRH) of informal caregivers using the nationally representative 2013 Comprehensive Survey of Living Conditions data.
  • Nursing and dual caregivers were more likely to have poor SRH than non-caregivers; dual caregivers showed the highest odds ratio among all groups (no care, childcare, nursing care, and dual care).
  • The association between types of informal caregiving and SRH was not different by socio-economic conditions.
Changes in Smoking Habits and Behaviors Following the Introduction and Spread of Heated Tobacco Products in Japan and Its Effect on FEV1 Decline: A Longitudinal Cohort Study
  • In our cohort study in Japan, dual users of both cigarettes and HTPs, tended to smoke/use more tobacco products when they started to use HTPs.
  • FEV1 appears to have declined more strongly in these dual users than in the combustible cigarette-only smokers and HTP-only users.
  • Individuals who switched to HTP-only use a mean of 1.7 years before had a similar reduction in FEV1 as those who had exclusively smoked cigarettes.
  • This study could provide evidence that dual users should be addressed as a high-risk group when tobacco policies for HTPs are considered.
Economic Hardships and Self-reported Deterioration of Physical and Mental Health Under the COVID-19 Pandemic: A Cross-sectional Study, 2020, Japan
  • During Apr-Sep 2020, COVID-19-related income loss, money shortage, and financial anxiety predicted deterioration of physical/mental health in Japan.
  • Regardless of whether pre-existing or newly induced, money shortage and financial anxiety were associated with adverse health outcomes.
  • Financial exploitation was associated with deterioration of physical/mental health only among non-working individuals.

Volume 32, Issue 3(March 2022)

Regulation of Electronic Cigarette Use in Public and Private Areas in 48 Countries Within the WHO European Region: A Survey to In-country Informants
  • Less than 60% of countries in the WHO European Region had nationwide legislation on e-cigarette use.
  • More European Union than non-European Union countries legislated e-cigarette use.
  • Countries had different number of places covered by e-cigarette use legislation, and education facilities were the most protected place by the legislation.
  • There was a moderate level of challenges for adopting e-cigarette use legislation.
  • Countries may need different assistance in dealing with the issues encountered while enacting and enforcing the e-cigarette use regulations.
Short Communication
Use and Awareness of Heated Tobacco Products in Europe
  • In our large pan-European cross-sectional study, heated tobacco products (HTPs) use was still limited in 2017-2018 among the general population.
  • However, dual use of HTPs with other tobacco products, their high use among younger generations and the interest of non-smokers are worrying.
  • These results indicate the need for close monitoring in terms of prevalence and user characteristics.
Short Communication
The Association Between Sleeping Pill Use and Metabolic Syndrome in an Apparently Healthy Population in Japan: JMS-II Cohort Study
  • Compared to non-users, sleeping pill users with a short sleep duration had a 3-fold higher risk of metabolic syndrome.
  • The frequency of sleeping pill use was positively associated with the prevalence of metabolic syndrome.
  • It also increased the risk of metabolic syndrome components such as obesity, hypertension, dyslipidemia, and glucose intolerance.
  • Attention must be paid to the metabolic status and atherosclerosis risk among sleeping pill users with a short sleep duration.

Volume 32, Issue 2(February 2022)

Review Article
Online Peer Support and Well-being of Mothers and Children: Systematic Scoping Review
  • Systematic scoping review was conducted to examine the effectiveness of online peer support groups on maternal and child well-being.
  • Our review on 21 studies revealed that mothers received informational and emotional support and felt a sense of connection and community.
  • Although some positive effects on mothers’ mental well-being were found, the effects of online-based peer support groups were inconclusive.
Maternal Baseline Characteristics and Perinatal Outcomes: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
  • The maternal baseline profile and perinatal data of participating mothers and infants of The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study were demonstrated.
  • The baseline maternal sociodemographic characteristics, results of prenatal screening tests, and obstetric outcomes were analyzed according to the maternal age group.
  • A total of 23,406 pregnancies involving 23,730 fetuses resulted in 23,143 live births.
  • The distribution of maternal baseline characteristics and the range of perinatal outcomes according to maternal age group were clearly demonstrated.
  • This cohort study can provide strategic information for creating breakthroughs in the developmental origins of health and diseases by collaborative data visiting or sharing.
Comparison of Disease Patterns and Outcomes Between Non-Japanese and Japanese Patients at a Single Tertiary Emergency Care Center in Japan
  • Our baseline data consisted of 19,420 patients requiring tertiary care or ICU or HCU admission to the ED at the Tokyo Medical and Dental University.
  • Among non-Japanese patients, there were more anaphylaxis, burn, and infectious disease diagnoses and less cardiovascular diagnoses compared to Japanese patients.
  • When compared with the Japanese patient sample, there were significantly more anaphylaxis diagnoses for the Caucasian and Hispanic group as well as the East Asian group, whereas the South/Southeast Asian and Middle Eastern group had significantly more burn and overdose diagnoses.
  • All non-Japanese anaphylaxis cases were food-induced, of which 71% were triggered by the Japanese traditional “soba” noodles, fish, or shellfish.
  • There were no notable patient care outcome differences between Japanese and non-Japanese in a tertiary emergency care setting.
Transmission Network of Measles During the Yamagata Outbreak in Japan, 2017
  • A 60-case measles outbreak occurred in Yamagata, Japan in 2017.
  • Analysis of temporal data allowed us to assess the reproduction number over generations.
  • Using a transmission network, variance in the number of secondary transmissions was shown to have declined over time.
  • High viral shedding from the throat was identified as a potential predictor of transmissibility.
Serologic Survey of IgG Against SARS-CoV-2 Among Hospital Visitors Without a History of SARS-CoV-2 Infection in Tokyo, 2020–2021
  • Serum of 23,234 visitors to Tokyo hospitals from September 2020 through March 2021 was tested for IgG antibodies against SARS-CoV-2.
  • The overall anti–SARS-CoV-2 IgG seroprevalence among all participants was 1.83% (95% CI, 1.66–2.01%).
  • After adjusting for population age and sex, the estimated seroprevalence in Tokyo in March 2021 was 3.40%.
  • The estimated number of people with a history of SARS-CoV-2 infection was 3.9-fold higher than the number of confirmed cases.

Volume 32, Issue 1 (January 2022)

Parental Working Hours and Children’s Sedentary Time: A Cross-sectional Analysis of the J-SHINE
  • Parental working conditions were associated with sedentary behavior of children.
  • Children with mothers who worked longer or fathers who did not work had prolonged sedentary time.
  • When limited to children whose fathers worked, there was no statistically significant association between children’s sedentary time and paternal working hours.
  • Supplementing the shortages in resources for childcare may be necessary among families with diverse parental working conditions.
Occupational and Non-occupational Injuries Can Result in Prolonged Augmentation of Psychiatric Disorders
  • Considerable effort has been devoted to reducing occupational injury globally. However, little is known about psychiatric consequences occurring after such injury, particularly measures for preventing such conditions.
  • We used a nationally representative cohort to determine the psychiatric consequences among workers with occupational injury, nonoccupational injury, and no injury. Compared with workers with no injury, workers with occupational injury had a higher risk of developing psychiatric disorders, similar to workers with nonoccupational injury.
  • In contrast to general belief, time did not attenuate these psychiatric conditions, even up to 10 years after injury.
Incidence of Mumps Deafness in Japan, 2005–2017: Analysis of Japanese Insurance Claims Database
  • Japanese health insurance claims data were used to estimate the incidence of mumps deafness reported during 2005–2017.
  • The overall incidence of mumps deafness per 10,000 mumps cases was 15.0.
  • The incidence was 8.4 times higher in 16–64-year-olds than in 0–15-year-olds and 7.2 times higher in 6–15-year-olds than in 0–5-year-olds.
  • Peak age at onset was 6–15 years, followed by 26–35 years, indicating that these two age groups are at highest risk for developing mumps deafness.
Impact of the Clinical Trials Act on Noncommercial Clinical Research in Japan: An Interrupted Time-series Analysis
  • This study is the first to verify Japan’s Clinical Trials Act’s (CTA) impact on number of clinical studies using interrupted time-series analysis.
  • Trends and levels of the monthly numbers of new clinical studies decreased significantly during one year following the CTA implementation.
  • In the analysis using the multigroup ITSA, the trend decreased especially for the studies with smaller sample sizes, interventional designs, and nonprofit funding sponsors.
  • Establishing a new system to promote clinical studies in Japan, while ensuring research transparency and safety, is vital.
A Nationwide Epidemiological Survey of Adolescent Patients With Diverse Symptoms Similar to Those Following Human Papillomavirus Vaccination: Background Prevalence and Incidence for Considering Vaccine Safety in Japan
  • We aimed to estimate prevalence and incidence of severe diverse symptoms among Japanese adolescents without a history of human papillomavirus (HPV) vaccination.
  • A descriptive nationwide epidemiological survey was conducted in Japan in 2016, covering a 6-month target period from July to December, 2015.
  • The 6-month period prevalence and annual incidence among girls aged 12–18 years without HPV vaccination was 20.2 and 7.3 per 100,000, respectively.
  • Adolescent Japanese girls without HPV vaccination also visited hospitals with diverse symptoms similar to those of girls following HPV vaccination.
  • Our findings predict the medical demands for coincident diverse symptoms, which are temporally associated with but not caused by HPV vaccination of Japanese adolescents.
Study Profile
Study Design and Baseline Profiles of Participants in the Tianjin Birth Cohort (TJBC) in China Study Profile
  • The Tianjin Birth Cohort Study (TJBC) is a large-scale prospective cohort in northern China, aiming to explore the link between early-life exposures and health consequences.
  • Pregnant women and their spouses are recruited at early pregnancy, and followed at mid-pregnancy, late pregnancy, delivery, 42 days after delivery, 6 months after delivery, and each year until 6 year-old.
  • A diverse range of biological samples are periodically collected including blood, urine, faeces, placental tissues, products of conception and breastmilk.