Corinne Bois and Marie-Noëlle Dufourg

ELFE, which stands for Etude Longitudinale Française depuis l’Enfance (French longitudinal study of children), is the first large birth-cohort study in metropolitan France; it will be following more than 18,000 children born in 2011 from birth to adulthood. Several points are at issue in the health segment: our aim is to better describe early exposure (as early as conception), the children’s medical-social trajectories and their development while taking into account environment in the broad sense of the term. This project is being carried out by a multidisciplinary team in the INED-INSERM-EFS mixed research unit headed by Marie-Aline Charles.
Participating families were recruited in maternity hospitals from April to December 2011 and interviewed for the first time by phone two months later. At age one, 92.7% of the families were interviewed a second time.

The health data concern growth, psychomotor development, physical activities, infectious diseases, respiratory disorders, eating and diet, accidents and injuries, any medical treatment, and sleep. Parents are a crucial source of health information, and they will be regularly consulted by means of interviews. Interviews at the maternity hospital were face-to-face; interviews at 2 months, one year and two years of age are by phone; for particular matters such as feeding and diet there are Internet or paper questionnaires. But to clarify certain points we have to supplement parent interviews by direct questioning of health professionals. This was the case in the maternity units-the professional midwives who were doing the interviews also had access to the medical file-and it is currently underway for the "examination at 24 months"; there’s a form to fill out, parents are requested to have their regular physician fill out the form during the mandatory appointment, then to send it in to the ELFE team with information on vaccinations, possible hospitalizations, growth, psychomotor development, prior histories and any current disorders, sensory testing results and medical orientations. Later, other arrangements will be put in place to collect medical information directly, with parents’ consent; namely, a partnership with some départements for a PMI health check-up in kindergarten at age 3 to 4) and a medical exam at age 7 to 8 during which biological samples will be collected. The other types of data to be collected are on the borderline between social science and health.

The health data concern growth, psychomotor development, physical activities, infectious diseases, respiratory disorders, eating and diet, accidents and injuries, any medical treatment, and sleep. Parents are a crucial source of health information, and they will be regularly consulted by means of interviews. Interviews at the maternity hospital were face-to-face; interviews at 2 months, one year and two years of age are by phone; for particular matters such as feeding and diet there are Internet or paper questionnaires. But to clarify certain points we have to supplement parent interviews by direct questioning of health professionals. This was the case in the maternity units-the professional midwives who were doing the interviews also had access to the medical file-and it is currently underway for the "examination at 24 months"; there’s a form to fill out, parents are requested to have their regular physician fill out the form during the mandatory appointment, then to send it in to the ELFE team with information on vaccinations, possible hospitalizations, growth, psychomotor development, prior histories and any current disorders, sensory testing results and medical orientations. Later, other arrangements will be put in place to collect medical information directly, with parents’ consent; namely, a partnership with some départements for a PMI health check-up in kindergarten at age 3 to 4) and a medical exam at age 7 to 8 during which biological samples will be collected. The other types of data to be collected are on the borderline between social science and health.

Regarding diet, for example, we are just as interested in the socio-cultural determinants of what a child learns in his or her family around eating and meals as we are in the effects of prolonged breastfeeding and early introduction of different foods on the child’s future health. Regarding social inequalities in the area of health, the socioeconomic, cultural and health-related data will all be complementary and can therefore fuel research in the areas of public health or health economics.  

The data collected in maternity units was made available in Spring 2013 to researchers associated with the ELFE study, through a strict data-accessing procedure. The data from the "2 months" survey, made available in late 2013, and the data from the "1 year" survey, to be made available in 2014, will be used to get the first longitudinal analyses under way. After a period of 18 months during which the data will be reserved for direct contributors to the ELFE project, outside researchers will be given access according to a similar procedure. The first publications should come out in 2014.