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Fever during pregnancy and motor development in children: a study within the Danish National Birth Cohort
Charlotte Holst1, Sanne Ellegaard Jørgensen1, Jan Wohlfahrt1
1Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Insights
Maternal fever during pregnancy was linked to an increased risk of developmental coordination disorder (DCD) in children by age 7. However, no link was found with early motor milestones like sitting or walking.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Fever during pregnancy is a common concern for expectant mothers.
- Understanding its impact on child development is crucial for prenatal care.
- Previous research has yielded mixed results on the effects of maternal fever on offspring.
Purpose of the Study:
- To investigate the association between maternal fever during pregnancy and motor development in children.
- To assess the risk of developmental coordination disorder (DCD) in children exposed to prenatal fever.
- To examine milestones such as sitting unsupported and walking unassisted.
Main Methods:
- A cohort study utilizing data from the Danish National Birth Cohort.
- Fever exposure data collected prospectively during pregnancy.
- Motor development assessed via milestones and the DCDQ'07 questionnaire at age 7.
Main Results:
- No association was observed between prenatal fever and achieving 'sitting unsupported' or 'walking unassisted' milestones.
- A significant association was found between maternal fever in utero and an increased odds of DCD indication at age 7 (OR 1.29).
- No dose-response relationship was identified, suggesting underlying fever causes may be responsible.
Conclusions:
- Maternal fever during pregnancy is associated with a higher likelihood of DCD in children at age 7.
- The lack of a dose-response effect suggests the association may be mediated by the etiology of the fever.
- Further research is needed to elucidate the specific mechanisms linking prenatal fever and DCD.
Aim:
The aim of this study was to examine how fever during pregnancy is associated with motor development in the child.
Method:
This cohort study was based on data from females and their children, from the Danish National Birth Cohort, who took part in an 18-month and/or 7-year follow-up study. Information regarding fever (number of episodes, temperature, duration, and pregnancy week) was obtained around gestation week 12 and at the end of pregnancy. Assessments of motor development in early childhood were based on the ages at which the motor milestones 'sitting unsupported' (n=44,256) and 'walking unassisted' (n=53,959) were attained. The Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07) was used to identify children with indication of developmental coordination disorder (DCD) at age 7 years (n=29,401). Any associations between the exposure to fever during pregnancy and motor development were estimated using Cox regression and logistic regression analyses.
Results:
Fever during pregnancy was reported by 15,234 (28.0%) participants in the 18-month follow-up and by 7965 (26.9%) participants in the 7-year follow-up. Adjusted analyses showed no association between prenatal exposure to fever and either 'sitting unsupported' or 'walking unassisted'. The proportion of children with indication of DCD was 3.1%. The odds ratio of indication of DCD if children were exposed to fever in utero was 1.29 (95% CI 1.12-1.49). However, no dose-response association was found.
Interpretation:
We found a significant association between maternal fever during pregnancy and DCD in children at age 7 years. The lack of a dose-response association might suggest that this association is explained by the underlying causes of the fever.