Abstract
BackgroundThere is current interest in the role of perinatal factors in the aetiology of diseases that occur later in life. Infectious mononucleosis (IM) can follow late primary infection with Epstein-Barr virus (EBV), and has been shown to increase the risk of multiple sclerosis and Hodgkin's disease. Little is known about maternal or perinatal factors associated with IM or its sequelae.MethodsWe investigated perinatal risk factors for hospitalised IM using a prospective record-linkage study in a population in the south of England. The dataset used, the Oxford record linkage study (ORLS), includes abstracts of birth registrations, maternities and in-patient hospital records, including day case care, for all subjects in a defined geographical area. From these sources, we identified cases of hospitalised IM up to the age of 30 years in people for whom the ORLS had a maternity record; and we compared perinatal factors in their pregnancy with those in the pregnancy of children who had no hospital record of IM.ResultsOur data showed a significant association between hospitalised IM and lower social class (p = 0.02), a higher risk of hospitalised IM in children of married rather than single mothers (p < 0.001), and, of marginal statistical significance, an association with singleton birth (p = 0.06). The ratio of observed to expected cases of hospitalised IM in each season was 0.95 in winter, 1.02 in spring, 1.02 in summer and 1.00 in autumn. The chi-square test for seasonality, with a value of 0.8, was not significant.Other factors studied, including low birth weight, short gestational age, maternal smoking, late age at motherhood, did not increase the risk of subsequent hospitalised IM.ConclusionsBecause of the increasing tendency of women to postpone childbearing, it is useful to know that older age at motherhood is not associated with an increased risk of hospitalised IM in their children. We have no explanation for the finding that children of married women had a higher risk of IM than those of single mothers. Though highly significant, it may nonetheless be a chance finding. We found no evidence that such perinatal factors as birth weight and gestational age, or season of birth, were associated with the risk of hospitalised IM.
Highlights
There is current interest in the role of perinatal factors in the aetiology of diseases that occur later in life
Numbers of people admitted for Infectious mononucleosis (IM) were highest in the 15-19 age group, and a larger number of over 20s were admitted than children under 5 (Table 1)
There was no significant association between IM in the child and maternal IM, smoking, parity, ABO blood group and rhesus status (Table 2)
Summary
There is current interest in the role of perinatal factors in the aetiology of diseases that occur later in life. Infectious mononucleosis (IM) can follow late primary infection with Epstein-Barr virus (EBV), and has been shown to increase the risk of multiple sclerosis and Hodgkin’s disease. Infectious mononucleosis (IM) can follow a pathologically strong immune response to primary infection with Epstein-Barr Virus (EBV), mainly during adolescence or young adulthood [1]. The majority of individuals have a primary infection with EBV during infancy and childhood, and are asymptomatic or only experience a mild clinical course [2,3]. Epidemiological and laboratory data show that EBV infection is associated with several other diseases. EBV infection has been known for many years to be associated with nasopharyngeal carcinoma in some parts of the world, [6] and with Hodgkin’s disease (HD), [7,8,9] associations that have been amply confirmed [3]. Factors that are relevant to the epidemiology of IM may have some relevance to the epidemiology of Hodgkin’s disease and MS, and vice versa
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