Identification

• Cohort, name
  The STEPS Study (Steps to the Healthy Development and Well-being of Children)
  
  Cohort, abbreviation
  STEPS Study
  
  Cohort, country
  Finland (Suomi)
  
  Cohort, website
  https://sites.utu.fi/hyvan-kasvun-avaimet/
  
  Key reference
  Int J Epidemiol. 2013 Oct;42(5):1273-84. doi: 10.1093/ije/dys150
  
  Date of filling in this questionnaire:
  2024-10-11
  
  
• Principal investigator(s), name
  Hanna Lagström
  
  Principal investigator(s), e-mail address
  hanlag@utu.fi
  
  Principal investigator(s), institution
  University of Turku, Public Health Unit and Centre fo Population Research Centre, 20014 Turun yliopisto
  
  Contact person(s), name
  Hanna Lagström
  
  Contact person(s), e-mail address
  hanlag@utu.fi
  
  Contact person(s), institution address
  University of Turku, Public Health Unit and Centre fo Population Research Centre, 20014 University of Turku
  
  

Basic description

• Main aim of cohort
  The overall objective is to contribute to a comprehensive, integrated view of healthy development: to improve the understanding of the early development of children, and their health and well-being beginning from the prenatal period up to school age; and also to determine the long-term effects of their early development later on in life. The STEPS Study endeavours to especially shed light on how various areas of development are interrelated during the first years of life. MAIN OUTCOMES Postnatal growth patterns, owerweigh and obesity Recurrent (respiratory) infections Asthma and allergy Chronic diseases Neurological disorders, cognition Normative picture of typical development and difficulties Mono- and bilingual development Child’s emotional and social development Child’s (early) peer relations MAIN EXPOSURES: Biological determinants - Foetal and postnatal growth characteristics - Parental anthropometrics - Genetic variants in the child and parents - Prevalence and incidence of diseases - Information from registers Psychosocial determinants - Child temperament - Relationships between the child and parent(s) - Parenting self-efficacy, maternal and paternal depression, social phobia, anxiety, loneliness, dyadic and triadic relationships Social and demographic determinants - Parental education, employment and household income - Parental marital status, etc. Environmental determinants - Parental life style habits - Housing conditions - Health and social care utilization system - Early child care contexts (home and day care)
  
  Recruited number of:
  1805 children / 1797 mothers / 1658 fathers / 0 grand parents / 0 other family members
  
  Approximate proportion of source population included
  20
  
  Source population
  Region-based
  
  
• Period of enrollment
  Start: 2007-09-01, End: 2010-03-31
  
  Enrollment period
  Pregnancy, week 10 to 15
  
  Enrollment criteria, please specify
  The cohort group (SFBC) consist of all children born in the Hospital District of Southwest Finland in years 2008-2010 (n=14,946) and their mothers (n=13,436). The mothers were recruited to the STEPS Study from that cohort during the first trimester of pregnancy or after delivery.
  
  Planned age of children at end of follow-up
  Life-long / unrestricted

Questionnaire or registry data and biological samples

• Children
• Mothers
• Fathers

General information	---------- Child age (years) at assessment ----------
	<1	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	>18
Home address	X	X	X	X	X	X	X	X	X	X	X	X	X	X	X	X
School address

Birth outcomes
Birth weight	X
Birth length	X
Gestational age at birth	X
Apgar score	X
Congenital malformations	X
Stillbirth (>= 22 weeks)	X
Child’s sex	X
Head circumference	X
Biparietal diameter

Child exposures	---------- Child age (years) at assessment ----------
	<1	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	>18
Breast feeding	X	X	X
Diet	X	X	X	X		X	X
Dietary supplements
Childcare attendance	X	X	X	X	X	X	X
Active smoking																X
Passive smoking			X	X		X	X
Alcohol consumption
Physical activity		X	X	X		X	X		X			X	X	X
Substance use
Medicine intake	X	X	X	X	X	X	X	X	X
Vaccinations	X	X	X	X	X	X	X	X	X
Psychological distress (e.g. bullying)
Air pollution
Access to green spaces	X	X	X	X	X	X	X	X	X	X	X	X	X	X
Built environment	X	X	X	X	X	X	X	X	X	X	X	X	X	X
Noise
Radiation, electromagnetic fields
Water contamination
Pets	X		X	X		X	X					X	X	X
Farm animal exposure
Biomarkers of exposure
Mercury
Lead
Cadmium
Arsenic
Other metals
Polychlorinated biphenyl esters
Dicloro difenil tricloroetano
Hexachlorobenzene
Brominated flame retardants
Perflouralkyl compounds
Bisphenol A
Other bisphenols
Parabens
Benzophenones
Triclosan
Phthalates
Cotinine

Child development and health	---------- Child age (years) at assessment ----------
	<1	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	>18
Anthropometry
Weight	X	X	X	X	X	X	X	X	X			X	X	X		X
Height	X	X	X	X	X	X	X	X	X			X	X	X		X
Head circumference	X
Abdominal circumference
Arm circumference
Wrist circumference
Waist circumference			X	X		X										X
Clinical examinations
Blood pressure		X	X	X		X						X	X	X		X
Carotida intima media thickness
Pulse wave velocity
Cardiac ultrasound
Renal ultrasound
Brain MRI
Other MRI
DEXA‐scan results
Skin folds
Bio impedence			X	X		X						X	X	X
Oscilometry
Spirometry												X	X	X
Skin prick test
Bronchial challenge test
Reversibility test
Dental observations
Mental and neurological development
Cognitive function															X	X
School performance
Language		X	X	X	X	X									X
ADHD
Autism
Sleep disturbances															X
Mental health		X	X	X	X	X						X	X	X	X
Respiratory health
Asthma		X	X	X		X	X					X	X	X	X
Allergy		X	X	X		X	X					X	X	X	X
Allergic rhinitis		X	X	X		X	X					X	X	X	X
Eczema		X	X	X		X	X					X	X	X	X
Respiratory tract infections	X	X	X	X	X	X						X	X	X	X
Senses
Vision
Hearing
Musculo-skeletal health
Back pain
Neck pain
Growing pains
Sexual maturation
Tanner stage
Pubertal development stage
Age at menarche
Age at voice change
2D/4D digit ratio
Nocturnal ejaculation
Acne
Other health outcomes
Cancer
Diabetes		X	X	X	X	X
Congenital anomalies
Biomarkers of health
Nephrology (e.g. creatinine, albumin)
Thyroid hormones
Inflammatory markers (e.g. C-reactive protein cytokines)
Immunologic markers (e.g. immunoglobulines)		X	X	X
Cortisol
Vitamines and micronutrients
Gonadal axis hormones (e.g. testosterone, estradiol)
Metabolism (e.g. cholesterol, LDL, HDL, insulin, triglycerides)
Metabolomics
DNA methylation
Transcriptomics (mRNA, miRNA)
Genome-wide association study (GWAS)

Child biological samples	---------- Child age (years) at sampling ----------
	At birth	0	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	>18
Whole blood			X	X	X		X					X	X	X
Serum			X	X	X		X					X	X	X
Plasma			X	X	X		X					X	X	X
Buffy coat					X
Urine
Hair																	X
Teeth
Nails
Saliva			X
Purified DNA			X
Purified RNA
Red blood cells
Umbilical cord blood/tissue	X
Blood smear
Faeces/meconium					X	X								X	X	X
Exhaled breathe condensate
Sputum induction
Placenta

General information
	Pre-pregnancy	During pregnancy	<1	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18
Education	X	X
Income	X	X
Employment status
Job title
Single parenthood		X
Home address
Work address

Maternal characteristics related to the index pregnancy/child
Age at birth	X
Ethnicity	X
Country of birth
Planned pregnancy	X
Time to pregnancy	X
Fertility treatment	X
Prior spontaneous abortion (<22w)	X
Prior births	X
Ultrasound measurements
Doppler measurements
Preeclampsia
Gestational diabetes
Gestational hypertension
Gestational duration	X
Mode of delivery	X
Prenatal diagnostics	X
Medical termination of pregnancy	X

Maternal Exposures	---------- Timing of assessment ----------
	Pre-pregnancy	First trimester	Second trimester	Third trimester	Post pregnancy
Diet				X	X
Dietary supplements
Active smoking	X			X	X
Passive smoking
Alcohol consumption				X	X
Physical activity				X	X
Substance use				X	X
Medicine intake				X	X
Coffee drinking
Psychological distress (e.g. life-events, health behaviors, perceived stress)				X	X
Occupational exposures
Heavy lifts
Work hours
Air pollution
Access to green spaces
Built environment
Noise
Radiation, electromagnetic fields
Water contamination
Binge drinking				X	X
Pets
Farm animal exposure
Biomarkers of exposure
Mercury
Lead
Cadmium
Arsenic
Other metals
Polychlorinated biphenyl esters
Dicloro difenil tricloroetano
Hexachlorobenzene
Brominated flame retardants
Perflouralkyl compounds
Bisphenol A
Other bisphenols
Parabens
Benzophenones
Triclosan
Phthalates
Cotinine

Maternal health	---------- Timing of assessment ----------
	Pre-pregnancy	First trimester	Second trimester	Third trimester	Post pregnancy
Anthropometry
Weight	X	X	X	X	X
Height	X	X	X	X	X
Waist circumference
Clinical examinations
Blood pressure			X		X
Carotida intima media thickness
Pulse wave velocity
DEXA scans
Bioimpedence
Mental and neurological development
Mental health			X		X
Cognitive function (e.g. intelligence quotient)
Respiratory health
Asthma
Allergy
Musculo‐skeletal disease			X		X
Back pain
Neck pain
Arthritis
Other health outcomes
Cancer			X		X
Diabetes		X	X		X
Cardio‐vascular disease			X		X
Family history of chronic disease
Infectious disease			X		X
Fever
Autoimmune disease			X		X
Urinary symptoms
Sexual problems
Sleep disturbance
Biomarkers of health
Nephrology (e.g. creatinine, albumin)
Thyroid hormones
Inflammatory markers (e.g. C-reactive protein cytokines)
Immunologic markers (e.g. immunoglobulines)
Cortisol
Vitamines and micronutrients
Gonadal axis hormones (e.g. testosterone, estradiol)
Metabolism (e.g. cholesterol, LDL, HDL, insulin, triglycerides)
Metabolomics
DNA methylation
Transcriptomics (mRNA, miRNA)
Genome-wide association study (GWAS)

Maternal biological samples	---------- Timing of sampling ----------
	Pre-pregnancy	First trimester	Second trimester	Third trimester	Post pregnancy
Breast milk					X
Whole blood					X
Serum					X
Plasma
Buffy coat
Urine
Hair
Nails
Saliva					X
Purified DNA					X
Purified RNA
Red blood cells
Faeces

General information
	Pre-pregnancy	During pregnancy	<1	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18
Education		X
Income		X
Employment status
Job title
Single parenthood
Home address
Work address

Paternal characteristics related to the index pregnancy/child
Fertility treatment
Age at child's birth	X
Ethnicity	X
Country of birth

Paternal exposures	---------- Timing of assessment ----------
	Pre-pregnancy	During pregnancy	Post pregnancy
Diet		X	X
Dietary supplements
Active smoking		X	X
Passive smoking
Alcohol consumption		X	X
Physical activity		X	X
Substance use		X	X
Medicine intake
Coffee drinking
Psychological distress (e.g. life-events, health behaviors, perceived stress)		X	X
Occupational exposures		X	X
Heavy lifts
Work hours
Air pollution
Access to green spaces
Built environment
Noise
Radiation, electromagnetic fields
Water contamination
Binge drinking
Pets
Farm animal exposure
Biomarkers of exposure
Mercury
Lead
Cadmium
Arsenic
Other metals
Polychlorinated biphenyl esters
Dicloro difenil tricloroetano
Hexachlorobenzene
Brominated flame retardants
Perflouralkyl compounds
Bisphenol A
Other bisphenols
Parabens
Benzophenones
Triclosan
Phthalates
Cotinine

Paternal health	---------- Timing of assessment ----------
	Pre-pregnancy	During pregnancy	Post pregnancy
Anthropometry
Weight		X	X
Height		X	X
Waist circumference
Clinical examinations
Blood pressure		X	X
Carotida intima media thickness
Pulse wave velocity
DEXA scans
Bio impedence
Mental and neurological development
Mental health		X	X
Cognitive function (e.g. intelligence quotient)
Respiratory health
Asthma
Allergy
Musculo‐skeletal disease		X	X
Back pain
Neck pain
Arthritis
Other health outcomes
Cancer		X	X
Diabetes		X	X
Cardio‐vascular disease		X	X
Family history of chronic disease
Infectious disease		X	X
Fever
Autoimmune disease		X	X
Urinary symptoms
Sexual problems
Sleep disturbance
Biomarkers of health
Nephrology (e.g. creatinine, albumin)
Thyroid hormones
Inflammatory markers (e.g. C-reactive protein cytokines)
Immunologic markers (e.g. immunoglobulines)
Cortisol
Vitamines and micronutrients
Gonadal axis hormones (e.g. testosterone, estradiol)
Metabolism (e.g. cholesterol, LDL, HDL, insulin, triglycerides)
Metabolomics
DNA methylation
Transcriptomics (mRNA, miRNA)
Genome-wide association study (GWAS)

Paternal biological samples	---------- Timing of sampling ----------
	Pre-pregnancy	During pregnancy	Post pregnancy
Semen
Whole blood			X
Serum			X
Plasma
Buffy coat
Urine
Hair
Nails
Saliva			X
Purified DNA			X
Purified RNA
Red blood cells
Faeces

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