Investigating low birthweight and preterm birth as potential mediators in the relationship between prenatal infections and early child development: A linked administrative health data analysis
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Background: Prenatal infections are associated with childhood developmental outcomes
such as reduced cognitive abilities, emotional problems and other developmental
vulnerabilities. However, there is currently a lack of research examining whether this arises
due to potential intermediary variables like low birthweight or preterm birth, or due to some
other mechanisms of maternal immune activation arising from prenatal infections.
Methods: Administrative data from the National Health Service (NHS) health board of Greater
Glasgow & Clyde, Scotland, was used, linking birth records to hospital records and universal
child health review records for 55,534 children born from 2011-2015, and their mothers.
Causal mediation analysis was conducted to examine the extent to which low birthweight and
preterm birth mediate the relationship between hospital-diagnosed prenatal infections and
having developmental concern(s) identified by a health visitor during 6-8 week or 27-30 month
child health reviews.
Results: Model estimates suggest that 5.18% [95% CI: 3.77-7.65%] of the positive association
observed between hospital diagnosed prenatal infections and developmental concern(s) was
mediated by low birthweight, whilst 7.37% [95% CI: 5.36-10.88%] was mediated by preterm
birth.
Conclusion: Low birthweight and preterm birth appear to mediate the relationship between
prenatal infections and childhood development, but only to a small extent. Maternal immune
activation mechanisms unrelated to low birthweight and preterm birth remain the most likely
explanation for associations observed between prenatal infections and child developmental
outcomes, although other factors (e.g. genetic factors) may also be involved.
Originalsprog | Engelsk |
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Tidsskrift | Journal of Epidemiology & Community Health |
ISSN | 0143-005X |
DOI | |
Status | Accepteret/In press - 2024 |
ID: 392872326