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alspac_91_yhal
YOUR HOME & LIFESTYLE
Finding out how the environment and lifestyle affects mothers and their babies will help us to make the environment and lifestyle a healthier place.
This questionnaire asks about your environment and lifestyle. It asks about where you live and work, and about what you do.
All the answers you give are confidential. We would be grateful if you would answer as many questions as you can.
If there is any question you don't want to answer just leave it blank.
THANK YOU VERY MUCH FOR YOUR HELP
SECTION A: YOUR HOME ENVIRONMENT

How long have you lived in or near Avon?

1
less than 1 year
2
1 - 4 years
3
5 - 9 years
4
10 years or more
5
all my life

When did you move to your present address?

Generic date

How many times have you moved home in the last 5 years?

How many

Is your home:

0
being bought/mortgaged
1
owned - with no mortgage to pay
2
rented from council
3
rented from private landlord - furnished
4
rented from private landlord - unfurnished
5
rented from housing association
6
other (please describe)
Other

Do you live in your own home or do you live with your parents or others?

1
live in own home
2
live with parents in their home
3
other situation (please describe)
Other

Do you currently live in:

1
a whole detached house (or bungalow)
2
a whole semi-detached house/bungalow
3
a whole terraced house
4
a flat/maisonette (self contained)
5
room in someone else's house
6
other (please describe)
Other

What is the lowest level of your living accommodation: 2nd floor or above, give floor ...

78
basement
0
ground floor
1
1st floor
Generic text

In the coldest time of year, describe the temperature in your: living rooms

1
Very warm
2
Warm
3
About right
4
Cold
5
Very cold

In the coldest time of year, describe the temperature in your: bedrooms

1
Very warm
2
Warm
3
About right
4
Cold
5
Very cold

In your home do you ever use: central heating or storage heaters

1
Yes
2
No

In your home do you ever use: wood stoves or wood fires

1
Yes
2
No

In your home do you ever use: coal fires

1
Yes
2
No

In your home do you ever use: paraffin heaters

1
Yes
2
No

In your home do you ever use: gas fires (mains gas)

1
Yes
2
No

In your home do you ever use: gas fires (calor gas)

1
Yes
2
No

In your home do you ever use: other types of heating (please describe)

1
Yes
2
No
Other

What is your main method of heating in winter?

Generic text
During this pregnancy have you heated your bed using any of the following:
-

1 - No

2 - Yes sometimes

3 - Yes most days

4 - Yes every day

hot water bottle
electric under blanket
electric over blanket
electric pad
electric water bed

During this pregnancy have you heated your bed using any of the following: other (please describe)

1
No
2
Yes sometimes
3
Yes most days
4
Yes every day
Other

Do you use gas for cooking?

1
yes, ring
2
yes, oven
3
yes, rings and oven
4
no, not at all

Do you use the cooker for any other purpose than cooking (e.g. drying clothes, heating the room)?

1
Yes
2
No
If yes,
qc_A11_a_i == 1

please describe:

Generic text

How old is your cooker?

1
More than 10 years old
2
5-10 years old
3
2-4 years old
4
Less than 2 years old
9
Don't know
Does your home have the following?
-

1 - Yes sole use

2 - Yes shared with other house-hold(s)

3 - No

kitchen where there is space to sit and eat
kitchen for cooking only
indoor flushing toilet
Apart from the kitchen or kitchen/dining room, how many living rooms and bedrooms do you have?
-
How many
number of living rooms:
number of bedrooms: (not regularly used as living rooms)
Do you have sole use of the following amenities or are they shared with other household(s)?
-

1 - Yes sole use

2 - Yes shared

3 - No

running hot water
bath
shower
garden or yard
balcony

Is there a working telephone in your home?

1
Yes
2
No
If no,
qc_A13_a == 2

where is the nearest working telephone that you can use in an emergency?

1
pay phone in the building
2
pay phone in the street
3
neighbour's phone
4
none within 5 minutes walk
5
other

Do you or your partner have the use of a car (including vans, minibuses, etc.)?

1
Yes
2
No
If yes,
qc_A14_a == 1

how often do you yourself have the use of a car?

1
never
2
not every day
3
almost every day
7
not applicable/do not drive

How often do you have any windows open in your home: In summer: day

1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open

How often do you have any windows open in your home: In summer: night

1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open

How often do you have any windows open in your home: In winter: day

1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open

How often do you have any windows open in your home: In winter: night

1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open

at night the window in my bedroom is:

1
almost always open
2
sometimes open
3
almost never open

Are any of your windows double glazed?

1
yes all of them
2
yes some of them
3
no none of them
9
don't know

Do you have any pets?

1
Yes
2
No
If no, go to A17, on page 9.
If yes,,
qc_A16_a == 1

How many of the following pets do you have? cats

How many

How many of the following pets do you have? dogs

How many

How many of the following pets do you have? rabbits

How many

How many of the following pets do you have? rodents (mice, hamster, gerbil, etc.)

How many

How many of the following pets do you have? birds (budgerigar, parrot, etc.)

How many

How many of the following pets do you have? other pets (please describe)

How many
Other
Do any of the following animals or insects inhabit or invade your home or cause dirty conditions in your balcony, garden or yard?
-

1 - Yes frequently

2 - Yes occasionally

3 - No not at all

rats
mice
pigeons
cats
cockroaches
ants
dogs

Do any of the following animals or insects inhabit or invade your home or cause dirty conditions in your balcony, garden or yard? other (please describe)

1
Yes frequently
2
Yes occasionally
3
No not at all
Other

Is there ever any damp, condensation or mould in your home?

1
Yes
2
No
If no, go to A19.a, on page 11.
If yes,
qc_A18_a == 1

How much of a problem is damp or condensation?

1
no damp or condensation
2
not serious
3
fairly serious
4
very serious

How much of a problem is mould?

1
no mould
2
not serious
3
fairly serious
4
very serious
Please tick the boxes relating to the problems you get in each room.
-

1 - Condensation on windows/walls/ceilings

2 - Damp patches on walls

3 - Mould on walls

4 - Damp on furniture, carpets or clothes

5 - Mould on furniture, carpets or clothes

6 - None

kitchen (or kitchen/diner)
living room (or lounge/diner)
hall/landing
my bedroom
other bedrooms
bathroom/toilet
other rooms

Does your roof leak at all? (If you have an other flat above yours, please tick 'does not apply').

7
does not apply
1
no leak
2
yes, slight leak
3
yes, serious leak

In wet weather, does water get in from anywhere else, such as through badly fitting windows or doors?

1
no leaks
2
yes, slight leaks
3
yes, serious leaks

Taking everything into account, which of the following best describes your feelings about your home?

1
satisfied
2
fairly satisfied
3
dissatisfied
4
very dissatisfied
In the past year have any of the following rooms been decorated or had any brand new furniture?
-

1 - Yes

2 - No

9 - Don't know

Your bedroom: painted
Your bedroom: wall papered
Your bedroom: new carpet
Your bedroom: new furniture
Your living room: painted
Your living room: wall papered
Your living room: new carpet
Your living room: new furniture
Your kitchen: painted
Your kitchen: wall papered
Your kitchen: new carpet
Your kitchen: new furniture
Any other rooms: painted
Any other rooms: wall papered
Any other rooms: new carpet
Any other rooms: new furniture

In the past year have any of the following rooms been decorated or had any brand new furniture? Which room(s)?

Other
SECTION B: CHEMICALS AND MEDICINES
During this pregnancy, how often have you used the following:
-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once week

5 - Not at at all

disinfectant
bleach
window cleaner
carpet cleaner
oven/drain cleaner
dry cleaning fluid
turpentine/white spirit
paint stripper
household paint or varnish
weed killers
pesticides/insect killers (including flea or fly sprays or powders)
aerosols or sprays including hair spray
hair dye/bleach
hair removal creams
air fresheners (spray, stick or aerosol)

During this pregnancy, how often have you used the following: other (please describe)

1
Every day
2
Most days
3
About once a week
4
Less than once week
5
Not at at all
Other
During this pregnancy have you ever taken any medicines, pills or used ointment or suppositories for the following:
-

1 - Yes, taken in 1st 3 months of pregnancy

2 - Yes, taken later in pregnancy

4 - No, not at all

nausea
heartburn
vomiting
anxiety
infection
migraine
difficulty going to sleep
pain
allergies
skin condition
bleeding
depression
piles
constipation
cough

During this pregnancy have you ever taken any medicines, pills or used ointment or suppositories for the following: other reason (please describe)

1
Yes, taken in 1st 3 months of pregnancy
2
Yes, taken later in pregnancy
4
No, not at all
Other

During this pregnancy have you been taking any of the following? iron

1
Yes
2
No

During this pregnancy have you been taking any of the following? zinc

1
Yes
2
No

During this pregnancy have you been taking any of the following? calcium

1
Yes
2
No

During this pregnancy have you been taking any of the following? folic acid/folate

1
Yes
2
No

During this pregnancy have you been taking any of the following? vitamins (please describe)

1
Yes
2
No
Generic text

During this pregnancy have you been taking any of the following? other supplements or diet foods (please describe)

1
Yes
2
No
Other

Do you ever take homeopathic medicines?

1
Yes often
2
Yes sometimes
3
No
If yes,
qc_B4_a == 1 || qc_B4_a == 2

please describe:

Generic text
Please indicate how often you have taken the following pills during this pregnancy.
-

1 - Every day

2 - Most days

3 - Sometimes

4 - Not at at all

aspirin
paracetamol
codeine/anadin
mogadon, or other sleeping tablets
valium, or other tranquillisers
Please describe all pills, medicines and ointments you have taken or used in the first month of this pregnancy.
What did you take: About how many days did you take or use it How many weeks pregnant were you?
How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
SECTION C: THINGS YOU DO
Since you became pregnant, how often have you used any of the following, whether at work or as a hobby:
-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once week

5 - Not at at all

dental amalgam
ceramics/enamels
dry cleaning fluids
electroplating
glues
leather working
fabric/textiles
dyes
insecticides
plastics
metal cleaners/degreasers, polishers
petrol
paint
photographic chemicals/other chemicals
electrical wiring
machining
soldering
radiation (x-ray or other)
Since becoming pregnant how often have you done the following whether at work or as a hobby:
-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once a week

5 - Not at at all

domestic work in other people's homes
hairdressing
farm work
hospital work
shift work

Have you ever had a paid job?

1
Yes
2
No
If no, go to D1, on page 21
qc_C3 == 2
Else

What is your present job? If you are not working, what was your most recent job?

Generic text

Are/were you working:

1
full-time
2
part-time
3
casually

type of industry or service given:

Generic text

About how long does/did it take you altogether to travel, to get to and from work each day? ... hours ... minutes

Hours
Minutes

How do/did you travel to work?

1
By foot
2
By public transport
3
By bicycle
4
By car
5
Work at home
6
Other (please describe)
Other
What is your job like: (If you are no longer working answer for your most recent job).
-

1 - Yes, always

2 - Yes, mostly

3 - Sometimes

4 - Not very often

5 - Never

Do you enjoy your job?
Do you have problems at work?
Are the people at your work friendly?
Are the people at your work supportive?
Is it very noisy?
Do you work in a smoky atmosphere?
In the year before this pregnancy, in the first months of this pregnancy, and now did/do you do any of the following (whether at home, at school, at work or elsewhere):
In the year before this pregnancy In the first 3 months of this pregnancy From 4 months of this pregnancy until now

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

Did/do you use a VDU? (television type screen)
Are/were you mostly sitting?
Are/were you bending a lot?
Are/were you standing most of the time?
Are/were you doing repetitive, boring tasks?
Did/does your job involve challenging and mentally demanding tasks?
Are/were you using a lot of physical energy?
In your job are/were you in contact with fumes or chemicals (please describe)

In the year before this pregnancy, in the first months of this pregnancy, and now did/do you do any of the following (whether at home, at school, at work or elsewhere): In your job are/were you in contact with fumes or chemicals? (please describe)

Generic text
What jobs have you had since the age of 16? Include part-time and voluntary work. If you have not worked write 'None'.
Job Materials/machines or chemicals used Date started (month-year) Date stopped (month-year)
Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date
1
2
3
4
5
6
7
8
9
10
SECTION D: YOUR HOUSEHOLD

How many people live in your household? (including yourself) ... adults (over 18 years)

How many

How many people live in your household? (including yourself) ... young adults (16 - 18 years)

How many

How many people live in your household? (including yourself) ... children (0 - 15 years)

How many
Please indicate who the adults over 18 in your household are:
-

1 - Yes

2 - No

yourself
your partner
your parent(s)
your partner's parent(s)
other relation(s) of yourself
other relations of your partner
friend(s)
lodger

Please indicate who the adults over 18 in your household are: other (please describe)

1
Yes
2
No
Other

Do you currently have a partner?

1
yes, husband
2
yes, other male partner
3
no, not at all
4
other (please describe)
Other
If no, go to D4, on page 22.
If yes,
qc_D2_a == 1 || qc_D2_a == 2 || qc_D2_a == 4

is your partner the father of your unborn child?

1
Yes
2
No
3
Not sure

does your partner live with you?

1
Yes
2
No
If your partner does live with you:
qc_D2_c == 1

how long have you lived together? ... years ... months

Years
Months

How would you assess your partner's physical health

1
always fit and well
2
usually fit and well
3
sometimes unwell
4
often unwell
5
always unwell

What is your present marital status?

1
never married
2
widowed
3
divorced
4
separated
5
married (once only)
6
married for second or third time
If married,
qc_D4_a == 5 || qc_D4_a == 6

what was the date of the most recent marriage?

Generic date

How many other marriages/live-in partners have you had?

How many
Please indicate how many of the children (aged 18 or under) living with you have:
Number of children
How many
you and your partner as their natural parents
you as their natural mother (but their natural father is not present)
your partner as the natural father (but you are not their natural mother)

Please indicate how many of the children (aged 18 or under) living with you have: neither you nor your partner as natural parents (please describe whether you have adopted, fostered etc.)

How many
Other
Are there other children of yourself or your partner who do not live with you?
-

1 - Yes

2 - No

children of my partner
children of myself
children of partner & self

Do any of the people living in your household, including yourself and your children have a long lasting disorder, illness or disabling condition? (e.g. asthma, epilepsy, arthritis, depression)

1
Yes
2
No
If yes, please describe:
qc_D7_a == 1

nature of illness/condition:

Generic text

person involved:

Generic text

the consequences for the household:

Generic text

Were you deliberately trying to get pregnant this time?

1
Yes
2
No
If no, go to D9, on page 24.
If yes,
qc_D8_a == 1

for how long had you been trying?

1
under 6 months
2
6-11 months
3
1-2 years
4
3 years or more

How would you describe your reaction when you first found you were pregnant?

1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings

Does becoming a mother mean giving up something that is important to you? Please add any extra comments you wish to make:

1
yes, a great deal
2
yes, quite a lot
3
not really
4
definitely not
9
don't know
Generic text

Does becoming a mother give you new opportunities and interests? Please add any extra comments you wish to make:

1
yes, a great deal
2
yes, quite a lot
3
not really
4
definitely not
9
don't know
Generic text

How do you feel about your pregnancy now?

1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings

How do you think your partner feels about your pregnancy?

1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings
7
have no partner

How has your partner reacted to you since you have become pregnant? When he first knew

1
supportive
2
indifferent
3
resentful
7
have no partner
4
other (please describe)
Other

How has your partner reacted to you since you have become pregnant? Now

1
supportive
2
indifferent
3
resentful
7
have no partner
4
other (please describe)
Other
SECTION E: YOUR PREVIOUS PREGNANCIES

Have you ever been pregnant before?

1
Yes
2
No
If no, go to Section F, on page 29.
If yes,
qc_E1 == 1

How many times have you been pregnant altogether before this time?

How many

Is this the first pregnancy with your present partner?

1
Yes
2
No
9
Am not sure

How many children still living, of your own do you have?

How many

Do they all live with you?

1
Yes
2
No
7
Don't have children

Have you ever had any miscarriages?

1
Yes
2
No
If yes,
qc_E4_a == 1

how many times have you miscarried?

How many

Have you ever had any abortions or terminations?

1
Yes
2
No
If yes,
qc_E5_a == 1

how many ?

How many

Have you ever had a stillborn baby ?

1
Yes
2
No
If yes,
qc_E6_a == 1

how many?

How many

Have you ever had any babies who were born alive but died later?

1
Yes
2
No
If yes, please describe:
qc_E7_a == 1

how many?

How many

what caused their death?

Generic text

how old were they when they died?

Generic text

Were any of your babies under 5lb 8oz (2500 grammes) at birth?

1
Yes
2
No
9
Don't know

Were any of your babies born more than 3 weeks early?

1
Yes
2
No
9
Don't know

Have you ever had a caesarean section?

1
Yes
2
No
9
Don't know

How old were you when you became pregnant for the very first time? ... years

Age

What was the outcome of the last pregnancy before this pregnancy?

1
miscarriage
2
abortion or termination
3
stillbirth
4
liveborn baby that died
5
liveborn baby still alive
6
other (please describe)
Other

Please give the date of your last birth/miscarriage/abortion or termination before this pregnancy:

Generic date

Did you breast feed your last baby?

1
Yes
2
No
7
Have not had a baby
If yes,
qc_E11_c == 1

for how long?

1
under 1 month
2
1-3 months
3
more than 3 months
SECTION F: ABOUT YOURSELF

In general: I feel insecure when I say goodbye to people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I worry about the effect I have on other people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I avoid saying what I think for fear of being rejected

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I feel uneasy meeting new people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: If others knew the real me, they would not like me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I feel secure when I'm in a close relationship

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I don't get angry with people for fear that I may hurt them

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: After a row with a friend, I feel uncomfortable until I have made peace

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I am always aware of how other people feel

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I worry about being criticised for things I have said or done

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I always notice if someone doesn't respond to me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I worry about losing someone close to me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I feel that people generally like me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I will do something I don't want to do rather than offend or upset someone

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I can only believe that something I have done is good when someone tells me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I will go out of my way to please someone I am close to

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I feel anxious when I say goodbye to people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I feel happy when someone compliments me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I fear that my feelings will overwhelm me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I can make other people feel happy

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I find it hard to get angry with people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I worry about criticising people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: If someone is critical of something I do, I feel bad

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: If other people knew what I am really like, they would think less of me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I always expect criticism

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I can never be really sure if someone is pleased with me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I don't like people to really know me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: If someone upsets me, I am not able to put it easily out of my mind

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I feel others do not understand me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I worry about what others think of me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I don't feel happy unless people I know admire me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I am never rude to anyone

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I worry about hurting the feelings of other people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I feel hurt when someone is angry with me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: My value as a person depends enormously on what others think of me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

In general: I care about what people feel about me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
SECTION G: YOUR LIFESTYLE

Have you ever been a smoker?

1
Yes
2
No
If no, please go to G2, on page 33.
If yes,
qc_G1_a == 1

at what age did you start smoking regularly? ... years

Age

which of the following have you smoked regularly? cigarette

1
Yes
2
No

which of the following have you smoked regularly? pipe

1
Yes
2
No

which of the following have you smoked regularly? cigar

1
Yes
2
No

which of the following have you smoked regularly? other

1
Yes
2
No

What was the maximum number of times a day you smoked?

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0

Have you now stopped smoking?

1
Yes
2
No
If yes,
qc_G1_e == 1

how long ago? ... years ... months

Years
Months

Did you smoke regularly at any of the following times in the last 9 months? Before pregnancy

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other

Did you smoke regularly at any of the following times in the last 9 months? First 3 months of pregnancy

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other

Did you smoke regularly at any of the following times in the last 9 months? Last 2 weeks

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other

how many times per day did you smoke - just before you became pregnant per day

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0

how many times per day did you smoke - in the first 3 months of your pregnancy per day

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0

how many times per day did you smoke - in the last 2 weeks? per day

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0

What brand and type of cigarette or tobacco do/did you usually smoke? brand:

Generic text

What brand and type of cigarette or tobacco do/did you usually smoke? type:

1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar
Please send us an empty packet/carton of the brand you usually smoke.

Did your mother ever smoke?

1
Yes
2
No
9
Don't know
If yes,
qc_G2_a == 1

did she smoke when she was expecting you?

1
Yes
2
No
9
Don't know

Did your father ever smoke?

1
Yes
2
No
9
Don't know

Does your partner smoke?

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
7
Don't have a partner
Other
If no, or don't have a partner, go to G4, on page 34.
Go to G4, on page 34.
If yes,
qc_G3_a == 2 || qc_G3_a == 3 || qc_G3_a == 4 || qc_G3_a == 5

about how many times per day does your partner smoke at the moment?

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
99
don't know

what brand, and type of cigarette/tobacco does your partner smoke? brand:

Generic text

what brand, and type of cigarette/tobacco does your partner smoke? type:

1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar

at what age did your partner start smoking? ... years

Age
99
don't know

Apart from yourself and your partner, are there any other members of your household who smoke?

1
Yes
2
No
If yes,
qc_G4_a == 1

how many:

How many
How often did you smoke marijuana/grass/cannabis/ganja -
-

1 - Every day

2 - 2-4 times a week

3 - Once a week

4 - Less than once a week

5 - Not at all

In the 6 months before you conceived
In the first 3 months of pregnancy
Between 3 months and now

How often have you taken the following during this pregnancy: amphetamines

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all

How often have you taken the following during this pregnancy: barbiturates

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all

How often have you taken the following during this pregnancy: crack

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all

How often have you taken the following during this pregnancy: cocaine

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all

How often have you taken the following during this pregnancy: heroin

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all

How often have you taken the following during this pregnancy: methadone

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all

How often have you taken the following during this pregnancy: ecstasy

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all

How often have you taken the following during this pregnancy: other (please describe)

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
Other
How often have you drunk alcoholic drinks? Please indicate for each of the following times:
-

1 - Never

2 - Less than once a week

3 - At least once a week

4 - 1-2 glasses every day

5 - At least 3-9 glasses every day

6 - At least 10 glasses every day

Before this pregnancy
1st 3 months of this pregnancy
At around the time you first felt the baby move

How many days in the past month have you drunk the equivalent of 2 pints of beer, 4 glasses of wine or 4 pub measures of spirit?

5
everyday
4
more than 10 days
3
5-10 days
2
3-4 days
1
1-2 days
0
none

Which is the alcoholic drink you have most often drunk during this pregnancy?

1
wine
2
beer/lager
3
sherry/port
4
gin/whisky/vodka/brandy
5
other (please describe)
7
don't drink at all
Other

How would you describe your partner's alcohol drinking? Which of the following statements best applies:

1
Never drinks alcohol
2
Very occasionally (less than once a week)
3
Occasionally (at least once a week)
4
Drinks 1-2 glasses nearly every day
5
Drinks 3-9 glasses every day
6
Drinks at least 10 glasses a day
7
Don't have a partner
9
Don't know
At present how much of the following do you usually drink in a day:
Weekday Weekend day
How manyHow manyHow manyHow many How manyHow manyHow manyHow many
ordinary tea (cups)
decaffeinated tea (cups)
coffee (cups)
decaffeinated coffee (cups)
beer or lager (half-pints)
wine (glasses)
spirits (pub-measures)
cola/pepsi (cans)
decaffeinated cola/pepsi cans
other alcoholic drinks (pub measures)
milk (glasses)
other drinks (please describe)

At present how much of the following do you usually drink in a day: other drinks (please describe)

Other
SECTION H: YOUR SOCIAL ENVIRONMENT

What do you think of your neighbourhood as a place to live?

1
a very good place to live
2
a fairly good place to live
3
not a very good place to live
4
not at all a good place to live

Do the other people in your neighbourhood: visit your home

1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always

Do the other people in your neighbourhood: argue with you

1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always

Do the other people in your neighbourhood: look after your children

1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always

Do the other people in your neighbourhood: keep to themselves

1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always

Do you: visit the home of your neighbours

1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always

Do you: argue with your neighbours

1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always

Do you: look after your neighbours children

1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always

Do you: keep to yourself

1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always
How worried are you that in your neighbourhood:
-

1 - Very worried

2 - Fairly worried

3 - Not very worried

4 - Not at all worried

9 - Don't know

you might have your home broken into and something stolen
you might be mugged or robbed
you might be sexually assaulted or pestered
you might have your home or property damaged by vandals

Is your neighbourhood: lively

1
Yes usually
2
Yes sometimes
3
No not at all

Is your neighbourhood: friendly

1
Yes usually
2
Yes sometimes
3
No not at all

Is your neighbourhood: noisy

1
Yes usually
2
Yes sometimes
3
No not at all

Is your neighbourhood: clean

1
Yes usually
2
Yes sometimes
3
No not at all

Is your neighbourhood: attractive

1
Yes usually
2
Yes sometimes
3
No not at all

Is your neighbourhood: polluted/dirty

1
Yes usually
2
Yes sometimes
3
No not at all
SECTION I

Please put the date of completing this questionnaire:

Generic date

Please give your date of birth:

Generic date
N.B. Have you remembered to enclose an empty cigarette packet?

Space for any comments you might like to make:

Long text
VERY MANY THANKS FOR ALL YOUR HELP
When completed, put in the envelope provided and either bring to the clinic or post to:
Children of the Nineties - ALSPAC, Institute of Child Health
Please remember, because this is strictly confidential, the people who look at this booklet will not know your name. They will be unable to give you any help or contact anyone after reading what you have written. If you feel you need advice, please feel free to contact our hotline ( during office hours). Alternatively your General Practitioner should be able to advise you.
End

alspac_91_yhal

YOUR HOME & LIFESTYLE
Finding out how the environment and lifestyle affects mothers and their babies will help us to make the environment and lifestyle a healthier place.
This questionnaire asks about your environment and lifestyle. It asks about where you live and work, and about what you do.
All the answers you give are confidential. We would be grateful if you would answer as many questions as you can.
If there is any question you don't want to answer just leave it blank.
THANK YOU VERY MUCH FOR YOUR HELP

SECTION A: YOUR HOME ENVIRONMENT

How long have you lived in or near Avon?
1
less than 1 year
2
1 - 4 years
3
5 - 9 years
4
10 years or more
5
all my life
When did you move to your present address?
Generic date
How many times have you moved home in the last 5 years?
How many
Is your home:
0
being bought/mortgaged
1
owned - with no mortgage to pay
2
rented from council
3
rented from private landlord - furnished
4
rented from private landlord - unfurnished
5
rented from housing association
6
other (please describe)
Other
Do you live in your own home or do you live with your parents or others?
1
live in own home
2
live with parents in their home
3
other situation (please describe)
Other
Do you currently live in:
1
a whole detached house (or bungalow)
2
a whole semi-detached house/bungalow
3
a whole terraced house
4
a flat/maisonette (self contained)
5
room in someone else's house
6
other (please describe)
Other
What is the lowest level of your living accommodation: 2nd floor or above, give floor ...
78
basement
0
ground floor
1
1st floor
Generic text
In the coldest time of year, describe the temperature in your: living rooms
1
Very warm
2
Warm
3
About right
4
Cold
5
Very cold
In the coldest time of year, describe the temperature in your: bedrooms
1
Very warm
2
Warm
3
About right
4
Cold
5
Very cold
In your home do you ever use: central heating or storage heaters
1
Yes
2
No
In your home do you ever use: wood stoves or wood fires
1
Yes
2
No
In your home do you ever use: coal fires
1
Yes
2
No
In your home do you ever use: paraffin heaters
1
Yes
2
No
In your home do you ever use: gas fires (mains gas)
1
Yes
2
No
In your home do you ever use: gas fires (calor gas)
1
Yes
2
No
In your home do you ever use: other types of heating (please describe)
1
Yes
2
No
Other
What is your main method of heating in winter?
Generic text

During this pregnancy have you heated your bed using any of the following:

-

1 - No

2 - Yes sometimes

3 - Yes most days

4 - Yes every day

hot water bottle
electric under blanket
electric over blanket
electric pad
electric water bed
During this pregnancy have you heated your bed using any of the following: other (please describe)
1
No
2
Yes sometimes
3
Yes most days
4
Yes every day
Other
Do you use gas for cooking?
1
yes, ring
2
yes, oven
3
yes, rings and oven
4
no, not at all
Do you use the cooker for any other purpose than cooking (e.g. drying clothes, heating the room)?
1
Yes
2
No
please describe:
Generic text
How old is your cooker?
1
More than 10 years old
2
5-10 years old
3
2-4 years old
4
Less than 2 years old
9
Don't know

Does your home have the following?

-

1 - Yes sole use

2 - Yes shared with other house-hold(s)

3 - No

kitchen where there is space to sit and eat
kitchen for cooking only
indoor flushing toilet

Apart from the kitchen or kitchen/dining room, how many living rooms and bedrooms do you have?

-
How many
number of living rooms:
number of bedrooms: (not regularly used as living rooms)

Do you have sole use of the following amenities or are they shared with other household(s)?

-

1 - Yes sole use

2 - Yes shared

3 - No

running hot water
bath
shower
garden or yard
balcony
Is there a working telephone in your home?
1
Yes
2
No
where is the nearest working telephone that you can use in an emergency?
1
pay phone in the building
2
pay phone in the street
3
neighbour's phone
4
none within 5 minutes walk
5
other
Do you or your partner have the use of a car (including vans, minibuses, etc.)?
1
Yes
2
No
how often do you yourself have the use of a car?
1
never
2
not every day
3
almost every day
7
not applicable/do not drive
How often do you have any windows open in your home: In summer: day
1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open
How often do you have any windows open in your home: In summer: night
1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open
How often do you have any windows open in your home: In winter: day
1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open
How often do you have any windows open in your home: In winter: night
1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open
at night the window in my bedroom is:
1
almost always open
2
sometimes open
3
almost never open
Are any of your windows double glazed?
1
yes all of them
2
yes some of them
3
no none of them
9
don't know
Do you have any pets?
1
Yes
2
No
If no, go to A17, on page 9.
How many of the following pets do you have? cats
How many
How many of the following pets do you have? dogs
How many
How many of the following pets do you have? rabbits
How many
How many of the following pets do you have? rodents (mice, hamster, gerbil, etc.)
How many
How many of the following pets do you have? birds (budgerigar, parrot, etc.)
How many
How many of the following pets do you have? other pets (please describe)
How many
Other

Do any of the following animals or insects inhabit or invade your home or cause dirty conditions in your balcony, garden or yard?

-

1 - Yes frequently

2 - Yes occasionally

3 - No not at all

rats
mice
pigeons
cats
cockroaches
ants
dogs
Do any of the following animals or insects inhabit or invade your home or cause dirty conditions in your balcony, garden or yard? other (please describe)
1
Yes frequently
2
Yes occasionally
3
No not at all
Other
Is there ever any damp, condensation or mould in your home?
1
Yes
2
No
If no, go to A19.a, on page 11.
How much of a problem is damp or condensation?
1
no damp or condensation
2
not serious
3
fairly serious
4
very serious
How much of a problem is mould?
1
no mould
2
not serious
3
fairly serious
4
very serious

Please tick the boxes relating to the problems you get in each room.

-

1 - Condensation on windows/walls/ceilings

2 - Damp patches on walls

3 - Mould on walls

4 - Damp on furniture, carpets or clothes

5 - Mould on furniture, carpets or clothes

6 - None

kitchen (or kitchen/diner)
living room (or lounge/diner)
hall/landing
my bedroom
other bedrooms
bathroom/toilet
other rooms
Does your roof leak at all? (If you have an other flat above yours, please tick 'does not apply').
7
does not apply
1
no leak
2
yes, slight leak
3
yes, serious leak
In wet weather, does water get in from anywhere else, such as through badly fitting windows or doors?
1
no leaks
2
yes, slight leaks
3
yes, serious leaks
Taking everything into account, which of the following best describes your feelings about your home?
1
satisfied
2
fairly satisfied
3
dissatisfied
4
very dissatisfied

In the past year have any of the following rooms been decorated or had any brand new furniture?

-

1 - Yes

2 - No

9 - Don't know

Your bedroom: painted
Your bedroom: wall papered
Your bedroom: new carpet
Your bedroom: new furniture
Your living room: painted
Your living room: wall papered
Your living room: new carpet
Your living room: new furniture
Your kitchen: painted
Your kitchen: wall papered
Your kitchen: new carpet
Your kitchen: new furniture
Any other rooms: painted
Any other rooms: wall papered
Any other rooms: new carpet
Any other rooms: new furniture
In the past year have any of the following rooms been decorated or had any brand new furniture? Which room(s)?
Other

SECTION B: CHEMICALS AND MEDICINES

During this pregnancy, how often have you used the following:

-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once week

5 - Not at at all

disinfectant
bleach
window cleaner
carpet cleaner
oven/drain cleaner
dry cleaning fluid
turpentine/white spirit
paint stripper
household paint or varnish
weed killers
pesticides/insect killers (including flea or fly sprays or powders)
aerosols or sprays including hair spray
hair dye/bleach
hair removal creams
air fresheners (spray, stick or aerosol)
During this pregnancy, how often have you used the following: other (please describe)
1
Every day
2
Most days
3
About once a week
4
Less than once week
5
Not at at all
Other

During this pregnancy have you ever taken any medicines, pills or used ointment or suppositories for the following:

-

1 - Yes, taken in 1st 3 months of pregnancy

2 - Yes, taken later in pregnancy

4 - No, not at all

nausea
heartburn
vomiting
anxiety
infection
migraine
difficulty going to sleep
pain
allergies
skin condition
bleeding
depression
piles
constipation
cough
During this pregnancy have you ever taken any medicines, pills or used ointment or suppositories for the following: other reason (please describe)
1
Yes, taken in 1st 3 months of pregnancy
2
Yes, taken later in pregnancy
4
No, not at all
Other
During this pregnancy have you been taking any of the following? iron
1
Yes
2
No
During this pregnancy have you been taking any of the following? zinc
1
Yes
2
No
During this pregnancy have you been taking any of the following? calcium
1
Yes
2
No
During this pregnancy have you been taking any of the following? folic acid/folate
1
Yes
2
No
During this pregnancy have you been taking any of the following? vitamins (please describe)
1
Yes
2
No
Generic text
During this pregnancy have you been taking any of the following? other supplements or diet foods (please describe)
1
Yes
2
No
Other
Do you ever take homeopathic medicines?
1
Yes often
2
Yes sometimes
3
No
please describe:
Generic text

Please indicate how often you have taken the following pills during this pregnancy.

-

1 - Every day

2 - Most days

3 - Sometimes

4 - Not at at all

aspirin
paracetamol
codeine/anadin
mogadon, or other sleeping tablets
valium, or other tranquillisers

Please describe all pills, medicines and ointments you have taken or used in the first month of this pregnancy.

What did you take: About how many days did you take or use it How many weeks pregnant were you?
How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

SECTION C: THINGS YOU DO

Since you became pregnant, how often have you used any of the following, whether at work or as a hobby:

-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once week

5 - Not at at all

dental amalgam
ceramics/enamels
dry cleaning fluids
electroplating
glues
leather working
fabric/textiles
dyes
insecticides
plastics
metal cleaners/degreasers, polishers
petrol
paint
photographic chemicals/other chemicals
electrical wiring
machining
soldering
radiation (x-ray or other)

Since becoming pregnant how often have you done the following whether at work or as a hobby:

-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once a week

5 - Not at at all

domestic work in other people's homes
hairdressing
farm work
hospital work
shift work
Have you ever had a paid job?
1
Yes
2
No
What is your present job? If you are not working, what was your most recent job?
Generic text
Are/were you working:
1
full-time
2
part-time
3
casually
type of industry or service given:
Generic text
About how long does/did it take you altogether to travel, to get to and from work each day? ... hours ... minutes
Hours
Minutes
How do/did you travel to work?
1
By foot
2
By public transport
3
By bicycle
4
By car
5
Work at home
6
Other (please describe)
Other

What is your job like: (If you are no longer working answer for your most recent job).

-

1 - Yes, always

2 - Yes, mostly

3 - Sometimes

4 - Not very often

5 - Never

Do you enjoy your job?
Do you have problems at work?
Are the people at your work friendly?
Are the people at your work supportive?
Is it very noisy?
Do you work in a smoky atmosphere?

In the year before this pregnancy, in the first months of this pregnancy, and now did/do you do any of the following (whether at home, at school, at work or elsewhere):

In the year before this pregnancy In the first 3 months of this pregnancy From 4 months of this pregnancy until now

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

Did/do you use a VDU? (television type screen)
Are/were you mostly sitting?
Are/were you bending a lot?
Are/were you standing most of the time?
Are/were you doing repetitive, boring tasks?
Did/does your job involve challenging and mentally demanding tasks?
Are/were you using a lot of physical energy?
In your job are/were you in contact with fumes or chemicals (please describe)
In the year before this pregnancy, in the first months of this pregnancy, and now did/do you do any of the following (whether at home, at school, at work or elsewhere): In your job are/were you in contact with fumes or chemicals? (please describe)
Generic text

What jobs have you had since the age of 16? Include part-time and voluntary work. If you have not worked write 'None'.

Job Materials/machines or chemicals used Date started (month-year) Date stopped (month-year)
Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date
1
2
3
4
5
6
7
8
9
10

SECTION D: YOUR HOUSEHOLD

How many people live in your household? (including yourself) ... adults (over 18 years)
How many
How many people live in your household? (including yourself) ... young adults (16 - 18 years)
How many
How many people live in your household? (including yourself) ... children (0 - 15 years)
How many

Please indicate who the adults over 18 in your household are:

-

1 - Yes

2 - No

yourself
your partner
your parent(s)
your partner's parent(s)
other relation(s) of yourself
other relations of your partner
friend(s)
lodger
Please indicate who the adults over 18 in your household are: other (please describe)
1
Yes
2
No
Other
Do you currently have a partner?
1
yes, husband
2
yes, other male partner
3
no, not at all
4
other (please describe)
Other
If no, go to D4, on page 22.
is your partner the father of your unborn child?
1
Yes
2
No
3
Not sure
does your partner live with you?
1
Yes
2
No
how long have you lived together? ... years ... months
Years
Months
How would you assess your partner's physical health
1
always fit and well
2
usually fit and well
3
sometimes unwell
4
often unwell
5
always unwell
What is your present marital status?
1
never married
2
widowed
3
divorced
4
separated
5
married (once only)
6
married for second or third time
what was the date of the most recent marriage?
Generic date
How many other marriages/live-in partners have you had?
How many

Please indicate how many of the children (aged 18 or under) living with you have:

Number of children
How many
you and your partner as their natural parents
you as their natural mother (but their natural father is not present)
your partner as the natural father (but you are not their natural mother)
Please indicate how many of the children (aged 18 or under) living with you have: neither you nor your partner as natural parents (please describe whether you have adopted, fostered etc.)
How many
Other

Are there other children of yourself or your partner who do not live with you?

-

1 - Yes

2 - No

children of my partner
children of myself
children of partner & self
Do any of the people living in your household, including yourself and your children have a long lasting disorder, illness or disabling condition? (e.g. asthma, epilepsy, arthritis, depression)
1
Yes
2
No
nature of illness/condition:
Generic text
person involved:
Generic text
the consequences for the household:
Generic text
Were you deliberately trying to get pregnant this time?
1
Yes
2
No
If no, go to D9, on page 24.
for how long had you been trying?
1
under 6 months
2
6-11 months
3
1-2 years
4
3 years or more
How would you describe your reaction when you first found you were pregnant?
1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings
Does becoming a mother mean giving up something that is important to you? Please add any extra comments you wish to make:
1
yes, a great deal
2
yes, quite a lot
3
not really
4
definitely not
9
don't know
Generic text
Does becoming a mother give you new opportunities and interests? Please add any extra comments you wish to make:
1
yes, a great deal
2
yes, quite a lot
3
not really
4
definitely not
9
don't know
Generic text
How do you feel about your pregnancy now?
1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings
How do you think your partner feels about your pregnancy?
1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings
7
have no partner
How has your partner reacted to you since you have become pregnant? When he first knew
1
supportive
2
indifferent
3
resentful
7
have no partner
4
other (please describe)
Other
How has your partner reacted to you since you have become pregnant? Now
1
supportive
2
indifferent
3
resentful
7
have no partner
4
other (please describe)
Other

SECTION E: YOUR PREVIOUS PREGNANCIES

Have you ever been pregnant before?
1
Yes
2
No
If no, go to Section F, on page 29.
How many times have you been pregnant altogether before this time?
How many
Is this the first pregnancy with your present partner?
1
Yes
2
No
9
Am not sure
How many children still living, of your own do you have?
How many
Do they all live with you?
1
Yes
2
No
7
Don't have children
Have you ever had any miscarriages?
1
Yes
2
No
how many times have you miscarried?
How many
Have you ever had any abortions or terminations?
1
Yes
2
No
how many ?
How many
Have you ever had a stillborn baby ?
1
Yes
2
No
how many?
How many
Have you ever had any babies who were born alive but died later?
1
Yes
2
No
how many?
How many
what caused their death?
Generic text
how old were they when they died?
Generic text
Were any of your babies under 5lb 8oz (2500 grammes) at birth?
1
Yes
2
No
9
Don't know
Were any of your babies born more than 3 weeks early?
1
Yes
2
No
9
Don't know
Have you ever had a caesarean section?
1
Yes
2
No
9
Don't know
How old were you when you became pregnant for the very first time? ... years
Age
What was the outcome of the last pregnancy before this pregnancy?
1
miscarriage
2
abortion or termination
3
stillbirth
4
liveborn baby that died
5
liveborn baby still alive
6
other (please describe)
Other
Please give the date of your last birth/miscarriage/abortion or termination before this pregnancy:
Generic date
Did you breast feed your last baby?
1
Yes
2
No
7
Have not had a baby
for how long?
1
under 1 month
2
1-3 months
3
more than 3 months

SECTION F: ABOUT YOURSELF

In general: I feel insecure when I say goodbye to people
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I worry about the effect I have on other people
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I avoid saying what I think for fear of being rejected
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I feel uneasy meeting new people
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: If others knew the real me, they would not like me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I feel secure when I'm in a close relationship
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I don't get angry with people for fear that I may hurt them
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: After a row with a friend, I feel uncomfortable until I have made peace
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I am always aware of how other people feel
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I worry about being criticised for things I have said or done
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I always notice if someone doesn't respond to me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I worry about losing someone close to me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I feel that people generally like me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I will do something I don't want to do rather than offend or upset someone
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I can only believe that something I have done is good when someone tells me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I will go out of my way to please someone I am close to
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I feel anxious when I say goodbye to people
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I feel happy when someone compliments me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I fear that my feelings will overwhelm me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I can make other people feel happy
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I find it hard to get angry with people
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I worry about criticising people
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: If someone is critical of something I do, I feel bad
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: If other people knew what I am really like, they would think less of me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I always expect criticism
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I can never be really sure if someone is pleased with me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I don't like people to really know me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: If someone upsets me, I am not able to put it easily out of my mind
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I feel others do not understand me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I worry about what others think of me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I don't feel happy unless people I know admire me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I am never rude to anyone
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I worry about hurting the feelings of other people
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I feel hurt when someone is angry with me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: My value as a person depends enormously on what others think of me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
In general: I care about what people feel about me
1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me

SECTION G: YOUR LIFESTYLE

Have you ever been a smoker?
1
Yes
2
No
If no, please go to G2, on page 33.
at what age did you start smoking regularly? ... years
Age
which of the following have you smoked regularly? cigarette
1
Yes
2
No
which of the following have you smoked regularly? pipe
1
Yes
2
No
which of the following have you smoked regularly? cigar
1
Yes
2
No
which of the following have you smoked regularly? other
1
Yes
2
No
What was the maximum number of times a day you smoked?
30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0
Have you now stopped smoking?
1
Yes
2
No
how long ago? ... years ... months
Years
Months
Did you smoke regularly at any of the following times in the last 9 months? Before pregnancy
1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other
Did you smoke regularly at any of the following times in the last 9 months? First 3 months of pregnancy
1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other
Did you smoke regularly at any of the following times in the last 9 months? Last 2 weeks
1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other
how many times per day did you smoke - just before you became pregnant per day
30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0
how many times per day did you smoke - in the first 3 months of your pregnancy per day
30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0
how many times per day did you smoke - in the last 2 weeks? per day
30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
0
0
What brand and type of cigarette or tobacco do/did you usually smoke? brand:
Generic text
What brand and type of cigarette or tobacco do/did you usually smoke? type:
1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar
Please send us an empty packet/carton of the brand you usually smoke.
Did your mother ever smoke?
1
Yes
2
No
9
Don't know
did she smoke when she was expecting you?
1
Yes
2
No
9
Don't know
Did your father ever smoke?
1
Yes
2
No
9
Don't know
Does your partner smoke?
1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
7
Don't have a partner
Other
If no, or don't have a partner, go to G4, on page 34.
Go to G4, on page 34.
about how many times per day does your partner smoke at the moment?
30
30+
25
25-29
20
20-24
15
15-19
10
10-14
5
5-9
1
1-4
99
don't know
what brand, and type of cigarette/tobacco does your partner smoke? brand:
Generic text
what brand, and type of cigarette/tobacco does your partner smoke? type:
1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar
at what age did your partner start smoking? ... years
Age
99
don't know
Apart from yourself and your partner, are there any other members of your household who smoke?
1
Yes
2
No
how many:
How many

How often did you smoke marijuana/grass/cannabis/ganja -

-

1 - Every day

2 - 2-4 times a week

3 - Once a week

4 - Less than once a week

5 - Not at all

In the 6 months before you conceived
In the first 3 months of pregnancy
Between 3 months and now
How often have you taken the following during this pregnancy: amphetamines
1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
How often have you taken the following during this pregnancy: barbiturates
1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
How often have you taken the following during this pregnancy: crack
1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
How often have you taken the following during this pregnancy: cocaine
1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
How often have you taken the following during this pregnancy: heroin
1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
How often have you taken the following during this pregnancy: methadone
1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
How often have you taken the following during this pregnancy: ecstasy
1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
How often have you taken the following during this pregnancy: other (please describe)
1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
Other

How often have you drunk alcoholic drinks? Please indicate for each of the following times:

-

1 - Never

2 - Less than once a week

3 - At least once a week

4 - 1-2 glasses every day

5 - At least 3-9 glasses every day

6 - At least 10 glasses every day

Before this pregnancy
1st 3 months of this pregnancy
At around the time you first felt the baby move
How many days in the past month have you drunk the equivalent of 2 pints of beer, 4 glasses of wine or 4 pub measures of spirit?
5
everyday
4
more than 10 days
3
5-10 days
2
3-4 days
1
1-2 days
0
none
Which is the alcoholic drink you have most often drunk during this pregnancy?
1
wine
2
beer/lager
3
sherry/port
4
gin/whisky/vodka/brandy
5
other (please describe)
7
don't drink at all
Other
How would you describe your partner's alcohol drinking? Which of the following statements best applies:
1
Never drinks alcohol
2
Very occasionally (less than once a week)
3
Occasionally (at least once a week)
4
Drinks 1-2 glasses nearly every day
5
Drinks 3-9 glasses every day
6
Drinks at least 10 glasses a day
7
Don't have a partner
9
Don't know

At present how much of the following do you usually drink in a day:

Weekday Weekend day
How manyHow manyHow manyHow many How manyHow manyHow manyHow many
ordinary tea (cups)
decaffeinated tea (cups)
coffee (cups)
decaffeinated coffee (cups)
beer or lager (half-pints)
wine (glasses)
spirits (pub-measures)
cola/pepsi (cans)
decaffeinated cola/pepsi cans
other alcoholic drinks (pub measures)
milk (glasses)
other drinks (please describe)
At present how much of the following do you usually drink in a day: other drinks (please describe)
Other

SECTION H: YOUR SOCIAL ENVIRONMENT

What do you think of your neighbourhood as a place to live?
1
a very good place to live
2
a fairly good place to live
3
not a very good place to live
4
not at all a good place to live
Do the other people in your neighbourhood: visit your home
1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always
Do the other people in your neighbourhood: argue with you
1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always
Do the other people in your neighbourhood: look after your children
1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always
Do the other people in your neighbourhood: keep to themselves
1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always
Do you: visit the home of your neighbours
1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always
Do you: argue with your neighbours
1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always
Do you: look after your neighbours children
1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always
Do you: keep to yourself
1
No,never
2
Rarely
3
Sometimes
4
Often
5
Always

How worried are you that in your neighbourhood:

-

1 - Very worried

2 - Fairly worried

3 - Not very worried

4 - Not at all worried

9 - Don't know

you might have your home broken into and something stolen
you might be mugged or robbed
you might be sexually assaulted or pestered
you might have your home or property damaged by vandals
Is your neighbourhood: lively
1
Yes usually
2
Yes sometimes
3
No not at all
Is your neighbourhood: friendly
1
Yes usually
2
Yes sometimes
3
No not at all
Is your neighbourhood: noisy
1
Yes usually
2
Yes sometimes
3
No not at all
Is your neighbourhood: clean
1
Yes usually
2
Yes sometimes
3
No not at all
Is your neighbourhood: attractive
1
Yes usually
2
Yes sometimes
3
No not at all
Is your neighbourhood: polluted/dirty
1
Yes usually
2
Yes sometimes
3
No not at all

SECTION I

Please put the date of completing this questionnaire:
Generic date
Please give your date of birth:
Generic date
N.B. Have you remembered to enclose an empty cigarette packet?
Space for any comments you might like to make:
Long text
VERY MANY THANKS FOR ALL YOUR HELP
When completed, put in the envelope provided and either bring to the clinic or post to:
Children of the Nineties - ALSPAC, Institute of Child Health
Please remember, because this is strictly confidential, the people who look at this booklet will not know your name. They will be unable to give you any help or contact anyone after reading what you have written. If you feel you need advice, please feel free to contact our hotline ( during office hours). Alternatively your General Practitioner should be able to advise you.
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