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Maternal weight and infections in early childhood: a cohort study
  1. Samuel Videholm1,2,
  2. Sven-Arne Silfverdal1,
  3. Georges Reniers3,4
  1. 1 Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden
  2. 2 Unit of Research, Development, and Education, Östersund Hospital, Östersund, Sweden
  3. 3 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  4. 4 School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
  1. Correspondence to Samuel Videholm, Department of Clinical Sciences, Paediatrics, Umeå University, Umeå 901 87, Sweden; vivi0001{at}student.umu.se

Abstract

Objective The aim of this study was to examine this association between maternal weight during pregnancy and the incidence of hospitalisations for infectious diseases during early childhood.

Design A population-based cohort study.

Setting A national cohort was created by combining data from the Swedish Medical Birth Register, the National Inpatient Register, the Cause of Death Register, the Total Population Register and the Longitudinal integration database for health insurance and labour market studies.

Patients 693 007 children born in Sweden between 1998 and 2006.

Main outcome measures Number of hospitalisations for infectious diseases during the first 5 years of life, overall and for categories of infectious diseases (lower respiratory, enteric, upper respiratory, genitourinary, perinatal, skin and soft tissue, neurological and eye, digestive tract, bloodstream and other infections).

Results Overweight (body mass index (BMI) 25.0–29.9) and obesity (BMI≥30) during pregnancy were associated with a higher overall incidence of hospitalisations for infectious diseases, adjusted incidence rate ratio (IRR) 1.05 (95% CI 1.03 to 1.06) and adjusted IRR 1.18 (95% CI 1.16 to 1.21). Overweight and obesity during pregnancy were strongly associated with perinatal infections, adjusted IRR 1.34 (95% CI 1.25 to 1.44) and adjusted IRR 1.72 (95% CI 1.57 to 1.88). In contrast, we found no association between maternal weight during pregnancy and infections of skin and soft tissue, the nervous system, the digestive tract or the bloodstream.

Conclusions We observed an association between overweight and obesity during pregnancy, and hospitalisations for infectious diseases during early childhood.

  • infectious diseases
  • public health
  • obesity
  • epidemiology
  • community child health

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Footnotes

  • Contributors SV conceptualised and designed the study, performed data analyses and wrote the manuscript. GR contributed to the design, assisted with the statistical analyses and revised the manuscript. S-AS created the database contributed to the design and revised the manuscript. All authors approved the final manuscript.

  • Funding This study was supported by a grant from the Oskarsfonden (Box 36, 932 51 Bureå, Sweden. Epost: info@oskarfonden.se).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the Regional Ethical Review Board in Umeå (nr 2012-265-31M and 2013-320-32M) and by the MSc Research Ethics Committee at London School of Hygiene Tropical Medicine (nr 10852). The retrieval and use of register data were also approved through a separate review of data safety and confidentiality by Swedish National Board of Health and Welfare and by Statistics Sweden.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data used in this study were obtained from third parties. It includes sensitive information and some access restrictions apply to the data. Interested researchers need to obtain data directly from National Board of Health and Welfare in Sweden and from Statistics Sweden. Children included in the study were identified in the Medical Birth Register, data on hospitalisations were obtained from the Swedish National Patient Register and data on deaths were obtained from the Cause of Death Register. All of these registers are maintained by National Board of Health and Welfare in Sweden. Data on maternal education were obtained from the Longitudinal Integration Database for Health Insurance and Labour market Studies and data on migration were obtained from the Swedish Total Population Register, both registers are maintained by Statistics Sweden.

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