Maternal Obesity and Offspring Long-Term Infectious Morbidity

Gil Gutvirtz,Eyal Sheiner,Tamar Wainstock,Daniella Landau

doi:10.3390/jcm8091466

Gil Gutvirtz, Eyal Sheiner + Show 2 more

Open Access

https://doi.org/10.3390/jcm8091466

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Abstract

Obesity is a leading cause of morbidity world-wide. Maternal obesity is associated with adverse perinatal outcomes. Furthermore, Obesity has been associated with increased susceptibility to infections. The purpose of this study was to evaluate long-term pediatric infectious morbidity of children born to obese mothers. This population-based cohort analysis compared deliveries of obese (maternal pre-pregnancy BMI ≥ 30 kg/m2) and non-obese patients at a single tertiary medical center. Hospitalizations of the offspring up to the age of 18 years involving infectious morbidities were evaluated according to a predefined set of ICD-9 codes. A Kaplan–Meier survival curve was used to compare cumulative hospitalization incidence between the groups and Cox proportional hazards model was used to control for possible confounders. 249,840 deliveries were included. Of them, 3399 were children of obese mothers. Hospitalizations involving infectious morbidity were significantly more common in children born to obese mothers compared with non-obese patients (12.5% vs. 11.0%, p < 0.01). The Kaplan–Meier survival curve demonstrated a significantly higher cumulative incidence of infectious-related hospitalizations in the obese group (log rank p = 0.03). Using the Cox regression model, maternal obesity was found to be an independent risk factor for long-term infectious morbidity of the offspring (adjusted HR = 1.125, 95% CI 1.021–1.238, p = 0.017).

Highlights

Obesity, defined as a body mass index (BMI) of 30 kg/m2 or more, is a leading cause of morbidity with increasing prevalence worldwide [1]
We found that children born to obese mothers had increased risk for pediatric infectious morbidity such as respiratory and viral infections, ENT and ophthalmic infections
This study found a link between maternal obesity in pregnancy and future pediatric infectious morbidity

Summary

Introduction

Obesity, defined as a body mass index (BMI) of 30 kg/m2 or more, is a leading cause of morbidity with increasing prevalence worldwide [1]. Obesity is a known risk factor for an array of adverse maternal, fetal and offspring outcomes [5]. These include pregnancy complications such as gestational diabetes mellitus [6] and hypertensive disorders of pregnancy [7], which may increase the risk for medically indicated preterm deliveries. Intrapartum complications, including higher rate of failure to progress in labor and elevated risk for cesarean delivery [8] Postpartum complications such as venous thromboembolism and cesarean scar wound infection are more likely to occur in obese women [9,10]. In the long-term, obesity during pregnancy was found to be associated with future maternal cardiovascular morbidity [11], ophthalmic complications [12], and even malignancies such as ovarian and breast cancer [13,14]

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