ORANGE HealthGeneration R
Characteristic | Description
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Name of the cohort | Generation R |
Description / aim of the cohort | The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. The study is designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health from fetal life, childhood and young adulthood. This multidisciplinary study focuses on several health outcomes including behaviour and cognition, body composition, eye development, growth, hearing, heart and vascular development, infectious disease and immunity, oral health and facial growth, respiratory health, allergy and skin disorders of children and their parents. Main exposures of interest include environmental, endocrine, genomic (genetic, epigenetic, microbiome), lifestyle related, nutritional and sociodemographic determinants.
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Description of the cohort population (age, specific characteristics, e.g. adults with cardiovascular disease, low SEP) | Prospective multi-ethnic birth cohort.
The population consists of 9,749 live-born children followed from fetal life onwards.
They were recruited via 9,778 pregnant women living in Rotterdam with an expected delivery date between April 2002 and January 2006.
The cohort includes a diverse ethnic population; major groups include Dutch, Surinamese, Turkish, and Moroccan. A specific subgroup ("Focus Cohort") of ~1,000 children of Dutch ethnicity undergoes more detailed measurements.
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Location of the cohort | Rotterdam, the Netherlands
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Institution | Erasmus MC
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Cohort size (n) | Total enrolled: 9,778 mothers. Live births (Child cohort): 9,749 children.
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Start year of the cohort | 2001 (Pilot phase started December 2001; Full recruitment started April 2002)
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Follow-up (years and n) | Preschool period (age: 0-4 years old), n = 7893 Early school age (age: 6 years old), n = 8305 Mid childhood period (age: 10 years old), n =7393 Early adolescence period (age: 13 years old), n= 6842 Adolescence period (age: 17 years old), n=6524 Young adults (age 22 years old), ongoing
Note: These numbers represent the total participating cohort. The actual n for specific oral health outcomes (questionnaire or clinical exam) varies per wave due to non-response or skipped measurements.
Dental Record Linkage possible.
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Types of variables (e.g., health behaviours, psychosocial factors, clinical health outcomes, demographic characteristics) Measurement methods (e.g., questionnaires, clinical assessments, biosamples) | Questionnaires (Parent & Child reported): Longitudinal data on socio-demographics, lifestyle (diet via FFQ, physical activity), and psychosocial well-being (CBCL, TRF). Specific Health Domains: Respiratory health (asthma/allergies), infectious diseases, and Oral Health (habits, dental care utilization, and quality of life via COHIP).
Physical Examinations: Standardized anthropometrics (height, weight, BMI), blood pressure, and Dental Status (clinical inspection of caries/fillings and facial development at ages 6, 9/10, and 13).
Advanced Imaging: Dental: Orthopantomograms (OPGs) to assess dental development and agenesis (specifically at age 9/10). Body/Bone: Dual X-ray Absorptiometry (iDXA) for body composition/bone density and pQCT scans. MRI: High-resolution 3.0 Tesla MRI (GE Discovery MR750) scanning of the brain and body (from age 5 onwards). Ultrasound: Fetal growth/organ development and postnatal abdominal/thoracic structures.
Biological Samples (Biobanking): Collection of blood (DNA/genetics), urine, saliva (cortisol/genetics), hair, feces, saliva, nasal swabs, and Dental Plaque (microbiome analysis).
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Oral health variables (questionnaire/self-reported) | Age 3 years (Parent-reported): Toothache and difficulties eating Caries diagnosed by dentist Tooth brushing frequency First dental visit (age and reason)
Age 6 years (Parent-reported): Tooth brushing frequency First dental visit (age and reason) Dental visits (frequency)
Age 9 years (Parent-reported): Tooth brushing frequency Dental visits Oral Health-Related Quality of Life (COHIP short form) Subjective orthodontic treatment need Suspected obstructive sleep apnea
Age 13 years (Parent/Child-reported): Tooth brushing frequency Dental visits Oral Health-Related Quality of Life Subjective orthodontic treatment need Type of orthodontic treatment Subjective result of orthodontic treatment Permanent teeth extraction for orthodontics Abnormal oral or mouth habits Oral hygiene methods Visits to oral hygienist
Age 17 years: Tooth brushing frequency Dental visits Abnormal oral or mouth habits Oral hygiene methods Visits to oral hygienist Maternal dental care insurance Removal third molars Oral Health-Related Quality of Life Periodontitis risk (Verhulst et al 2019)
Age 22 years (ongoing): Tooth brushing frequency Dental visits Dental care insurance Periodontis risk (Verhulst et al 2019)
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Oral health variables (clinically assessed) | Age 6 years: Dental Caries in primary dentition (dmft index) Developmental Defects of Enamel (MIH/DMH)
Age 9 years: Orthodontic Treatment Need (IOTN index) Dental Development (Dental age, hypodontia/agenesis) Craniofacial Morphology (Cephalometrics & 3D facial endophenotypes)
Age 13 years: Dental Caries in permanent dentition (DMFT index) Dental Development (Third molar development) Mandibular Bone Quality (Cortical thickness indices: MI/PMI) Craniofacial Morphology (Cephalometrics & 3D facial endophenotypes) MIH
Age 17 years: dental caries (DMFT), craniofacial growth (3D), and dental development, panoramic x-rays [LK1]
Age 22 years dental caries (DMFT), panoramic x-rays
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Oral health variables (biological, e.g., microbiome data, saliva) | Dental biofilm (microbiome) collected at age 13 17, 22 (ongoing).
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Reference to design paper | Design and cohort update 2017:
Biobank update 2015:
Design paper oral and craniofacial research in Generation R: van Meijeren - van Lunteren., et al 2023
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Website |
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Procedure for requesting data | The study has an "open policy" for collaboration. Requests must be submitted to the principal investigator (regarding oral health : l.kragt@erasmusmc.nl;). Proposals are discussed by the Management Team regarding aims, overlap with ongoing studies, logistic consequences, and finances. Approval by the Medical Ethical Committee is required before data release.
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Procedure for data storage | Centralized electronic database with data cleaning and coding. Datasets for researchers are anonymized (unique ID numbers). Remote access environments are being explored.
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Associated costs for data requests (yes/no) | The type of collaboration determines whether a data fee applies.
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Contact person / principal investigator | Vincent Jaddoe (v.jaddoe@erasmuscmc.nl)
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