HELMi (Health and Early Life Microbiota) is a longitudinal, prospective general population birth cohort, set up to identify environmental, lifestyle and genetic factors that modify the intestinal microbiota development in the first years of life, and their relation to the child health and well-being. Awareness of the potential long-term consequences of the early life gut microbiota development is individual health is increasing, and accumulating evidence indicates a key role for the early gut microbiome in the Developmental Origins of Health and Disease (DOHaD).
The HELMi cohort consists of 1055 healthy term infants born in 2016-2018 mainly at the capital region of Finland, and their parents. The cohort is currently being followed up from pregnancy until 2 years of age. Funding has been secured to organize a 4-year follow-up in 2020-2022. Birth mode, nutrition, and antibiotic intake all are known to affect the development of early life microbiota. Our goal is to broaden the understanding of how families’ lifestyle and care practices as well as the clinical practices e.g. regarding antenatal antibiotic prophylaxis affect the child’s microbiota development. In addition, we study the impact of these exposures and early microbiota features on growth, overall health and development of diseases, such as allergies.
Early microbiota development is analysed based on frequent fecal sampling from the child (9 samples during 0-24 months). Additionally, parental fecal samples, breast milks samples from the mother and DNA sample from the child are collected. Extensive metadata from both the child and the parents are collected using electronic questionnaires; parents fill 57 questionnaires per family at weekly to monthly intervals to record e.g. nutrition, crying, sleep as well as indoor and outdoor environmental exposures. Illnesses, medication and supplements are recorded continuously. National health care and drug purchase registries will be utilized for objective assessment of the clinical diagnoses and purchase of antibiotics and other drugs that are available only via prescriptions. Child’s cognitive, social and motor development is assessed with standardized questionnaires and additionally the majority of the children undergoes cognitive test performed by a psychologist.
A 4 year follow up will be organized in 2020-2022.
Being most sensitive to environmental stimuli and most influential on the host physiology, the early microbiota is attainable target to reduce the risk of later disease. By combining and analyzing the above specified data our project will provide fundamental understanding on how infants’ microbiota develop, forming a basis for predicting and (re)directing it to support healthy development and future.
Trial registration number NCT03996304
The cohort profile article has been published in 2019 and the first publications on the results are under preparation.
Principal investigators: Docent Anne Salonen and Professor Willem de Vos, Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Finland
Responsible MD: Professor Kaija-Leena Kolho, University of Helsinki, Finland
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Funding: Main funder is Tekes, the Finnish Funding agency for Technology and Innovation (currently Business Finland). The grant involves co-funding from Valio Ltd, Dupont Nutrition and Health, and Oriola, and in-kind support from the Finnish Red Cross Blood service and Pikkujätti medical centers. H2020-MSCA-ITN-2018 grant 8144102, Academy of Finland (grants 1297765, 1308255 and 325103), Paulo Foundation, Päivikki ja Sakari Sohlberg Foundation, Biocodex Microbiota Foundation, Foundation for Nutrition Research grant.