Abstract
Background/objectiveThe association between maternal pre-pregnancy obesity and adverse child health outcomes is well described, but there are few data on the relationship with offspring health service use. We examined the influence of maternal pre-pregnancy obesity on offspring health care utilization and costs over the first 18 years of life.MethodsThis was a population-based retrospective cohort study of children (n = 35,090) born between 1989 and 1993 and their mothers, who were identified using the Nova Scotia Atlee Perinatal Database and linked to provincial administrative health data from birth through 2014. The primary outcome was health care utilization as determined by the number and cost of physician visits, hospital admissions and days, and high utilizer status (>95th percentile of physician visits). The secondary outcome was health care utilization by ICD chapter. Maternal pre-pregnancy weight was categorized as normal weight, overweight, or obese. Multivariable-adjusted regression models were used to examine the association between maternal weight status and offspring health care use.ResultsChildren of mothers with pre-pregnancy obesity had more physician visits (10%), hospital admissions (16%), and hospital days (10%) than children from mothers of normal weight over the first 18 years of life. Offspring of mothers with obesity had C$356 higher physician costs and C$1415 hospital costs over 18 years than offspring of normal weight mothers. Children of mothers with obesity were 1.74 times more likely to be a high utilizer of health care and had higher rates of physician visits and hospital stays for nervous system and sense organ disorders, respiratory disorders, and gastrointestinal disorders compared to children of normal weight mothers.ConclusionOur findings suggest that maternal pre-pregnancy overweight and obesity are associated with slightly higher offspring health care utilization and costs in the first 18 years of life.
Highlights
Obesity is considered a significant public health concern in high income countries
After removing children for whom maternal weight information was unavailable (n = 3535) or who did not live in the province for the full 18 years (n = 4374), the final analysis sample included 35,090 children delivered by 29,392 mothers in Nova Scotia between 1989 and 1993
Descriptive characteristics of the sample are summarized by maternal pre-pregnancy weight status in Table 1. 16 and 15% of children were born to mothers with overweight and obesity, respectively
Summary
Obesity is considered a significant public health concern in high income countries. In Canada, 13% of women of childbearing age are obese, with the highest rates for obesity occurring in the Atlantic provinces at 24% [1]. Childhood obesity in turn is associated with a broad range of health conditions [8] including asthma and other respiratory disorders [9, 10], sleep apnea [11], metabolic syndrome and type 2 diabetes [12, 13], and mental health problems [14]. May be related these childhood conditions through mediation by birth weight or offspring body mass index (BMI) in childhood. In keeping with this hypothesis, associations between maternal obesity and childhood health outcomes such as asthma [15,16,17], metabolic syndrome [18, 19], and mental health conditions [20, 21] have been reported
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