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), i.e. the trimesters in which
fetal brain myelination occurs. Infection-related prescriptions were not associated with any
clear increase in odds of having at least one developmental concern after
confounders/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.
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), i.e. the trimesters in which
fetal brain myelination occurs. Infection-related prescriptions were not associated with any
clear increase in odds of having at least one developmental concern after
confounders/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.
| Original language | English |
|---|---|
| Journal | Journal of Child Psychology and Psychiatry |
| Publication status | Accepted/In press - 25 Apr 2024 |