Prenatal maternal infections and early childhood developmental outcomes: analysis of linked administrative health data for Greater Glasgow & Clyde, Scotland

IF 6.5 1区医学 Q1 PSYCHIATRY

Journal of Child Psychology and Psychiatry Pub Date : 2024-06-27 DOI:10.1111/jcpp.14028

Iain Hardie, Aja Murray, Josiah King, Hildigunnur Anna Hall, Emily Luedecke, Louise Marryat, Lucy Thompson, Helen Minnis, Philip Wilson, Bonnie Auyeung

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引用次数: 0

Abstract

Background

Previous research has linked prenatal maternal infections to later childhood developmental outcomes and socioemotional difficulties. However, existing studies have relied on retrospectively self-reported survey data, or data on hospital-recorded infections only, resulting in gaps in data collection.

Methods

This study used a large linked administrative health dataset, bringing together data from birth records, hospital records, prescriptions and routine child health reviews for 55,856 children born in Greater Glasgow & Clyde, Scotland, 2011–2015, and their mothers. Logistic regression models examined associations between prenatal infections, measured as both hospital-diagnosed prenatal infections and receipt of infection-related prescription(s) during pregnancy, and childhood developmental concern(s) identified by health visitors during 6-8 week or 27-30 month health reviews. Secondary analyses examined whether results varied by (a) specific developmental outcome types (gross-motor-skills, hearing-communication, vision-social-awareness, personal-social, emotional-behavioural-attention and speech-language-communication) and (b) the trimester(s) in which infections occurred.

Results

After confounder/covariate adjustment, hospital-diagnosed infections were associated with increased odds of having at least one developmental concern (OR: 1.30; 95% CI: 1.19–1.42). This was broadly consistent across all developmental outcome types and appeared to be specifically linked to infections occurring in pregnancy trimesters 2 (OR: 1.34; 95% CI: 1.07–1.67) and 3 (OR: 1.33; 95% CI: 1.21–1.47), that is the trimesters in which foetal brain myelination occurs. Infection-related prescriptions were not associated with any clear increase in odds of having at least one developmental concern after confounder/covariate adjustment (OR: 1.03; 95% CI: 0.98–1.08), but were associated with slightly increased odds of concerns specifically related to personal-social (OR: 1.12; 95% CI: 1.03–1.22) and emotional-behavioural-attention (OR: 1.15; 95% CI: 1.08–1.22) development.

Conclusions

Prenatal infections, particularly those which are hospital-diagnosed (and likely more severe), are associated with early childhood developmental outcomes. Prevention of prenatal infections, and monitoring of support needs of affected children, may improve childhood development, but causality remains to be established.

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产前孕产妇感染与儿童早期发育结果：苏格兰大格拉斯哥和克莱德地区关联行政健康数据分析。

背景：以往的研究表明，产前母体感染与儿童日后的发育结果和社会情感障碍有关。然而，现有的研究依赖于回顾性自我报告的调查数据，或仅依赖于医院记录的感染数据，导致数据收集存在缺口：本研究使用了一个大型关联行政健康数据集，该数据集汇集了 2011-2015 年间苏格兰大格拉斯哥和克莱德地区出生的 55856 名儿童及其母亲的出生记录、住院记录、处方和常规儿童健康检查数据。逻辑回归模型检验了产前感染（以医院诊断的产前感染和孕期接受感染相关处方为衡量标准）与健康访视员在 6-8 周或 27-30 个月健康检查中发现的儿童发育问题之间的关联。二次分析研究了以下两方面的结果是否存在差异：(a) 具体的发育结果类型（粗大运动技能、听力-沟通、视力-社会认知、个人-社会、情绪-行为-注意力和言语-语言-沟通）；(b) 感染发生的三个月：经混淆因素/变量调整后，医院诊断感染与至少一种发育问题的几率增加有关（OR：1.30；95% CI：1.19-1.42）。这种情况在所有发育结果类型中都大致相同，并且似乎与发生在孕期第 2 个孕期（OR：1.34；95% CI：1.07-1.67）和第 3 个孕期（OR：1.33；95% CI：1.21-1.47）的感染特别相关，而这两个孕期正是胎儿脑髓形成的时期。在对混杂因素/变量进行调整后，感染相关处方与至少一种发育问题几率的明显增加无关（OR：1.03；95% CI：0.98-1.08），但与个人-社会（OR：1.12；95% CI：1.03-1.22）和情绪-行为-注意力（OR：1.15；95% CI：1.08-1.22）发育问题相关的几率略有增加：结论：产前感染，尤其是医院诊断的产前感染（可能更严重），与儿童早期发育结果有关。预防产前感染和监测受影响儿童的支持需求可能会改善儿童发育，但因果关系仍有待确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Child Psychology and Psychiatry 医学-精神病学

CiteScore

13.80

自引率

5.30%

发文量

169

审稿时长

1 months

期刊介绍： The Journal of Child Psychology and Psychiatry (JCPP) is a highly regarded international publication that focuses on the fields of child and adolescent psychology and psychiatry. It is recognized for publishing top-tier, clinically relevant research across various disciplines related to these areas. JCPP has a broad global readership and covers a diverse range of topics, including: Epidemiology: Studies on the prevalence and distribution of mental health issues in children and adolescents. Diagnosis: Research on the identification and classification of childhood disorders. Treatments: Psychotherapeutic and psychopharmacological interventions for child and adolescent mental health. Behavior and Cognition: Studies on the behavioral and cognitive aspects of childhood disorders. Neuroscience and Neurobiology: Research on the neural and biological underpinnings of child mental health. Genetics: Genetic factors contributing to the development of childhood disorders. JCPP serves as a platform for integrating empirical research, clinical studies, and high-quality reviews from diverse perspectives, theoretical viewpoints, and disciplines. This interdisciplinary approach is a key feature of the journal, as it fosters a comprehensive understanding of child and adolescent mental health. The Journal of Child Psychology and Psychiatry is published 12 times a year and is affiliated with the Association for Child and Adolescent Mental Health (ACAMH), which supports the journal's mission to advance knowledge and practice in the field of child and adolescent mental health.