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Parental health status and infant outcomes: Upstate KIDS Study
Germaine M Buck Louis1, Erin Bell2, Yunlong Xie3
1Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Insights
Parental infertility and chronic conditions like hypertension impact infant health, leading to reduced birth weight and size. Infertility, even with treatment, is linked to smaller infants, highlighting its role as a health indicator.
Area of Science:
- Reproductive Health
- Perinatal Epidemiology
- Pediatric Health
Background:
- Parental health status, including chronic diseases and infertility, can influence pregnancy and infant outcomes.
- Understanding these associations is crucial for improving perinatal care and infant health.
- The Upstate KIDS birth cohort provides a valuable dataset for examining these relationships.
Purpose of the Study:
- To assess the association between parental health conditions, including infertility, and various infant outcomes.
- To investigate the impact of maternal and paternal chronic diseases on fetal development and infant anthropometrics.
- To determine if infertility is associated with adverse infant outcomes, even after accounting for infertility treatments.
Main Methods:
- Cross-sectional analysis of data from the Upstate KIDS birth cohort (4,886 parents, 5,845 infants).
- Infertility defined by time to pregnancy and need for fertility treatment.
- Multivariable regression models estimated associations between parental conditions and infant gestation, birthweight, length, and head circumference, adjusting for covariates.
Main Results:
- Prevalence of parental chronic diseases varied, with infertility affecting 21% to 54% of participants.
- Maternal hypertension and asthma were linked to shorter gestation and lower birthweight.
- Infertility was significantly associated with reduced infant birthweight, length, and head circumference, independent of treatment.
Conclusions:
- Parental infertility is a significant predictor of reduced infant size, underscoring its importance as a health indicator.
- Maternal chronic diseases like hypertension and asthma negatively impact infant growth parameters.
- Further research into the mechanisms linking parental health to infant outcomes is warranted.
Objective:
To assess parental health status inclusive of infertility and infant outcomes.
Design:
Birth cohort with cross-sectional analysis of parental health status and infant outcomes.
Setting:
Not applicable.
Patient(S):
Parents (n = 4,886) and infants (n = 5,845) participating in the Upstate KIDS birth cohort.
Intervention(S):
None.
Main Outcome Measure(S):
Infertility was defined as [1] sexually active without contraception for 1+ years without pregnancy, [2] ever requiring ≥12 months to become pregnant, and [3] requiring ≥12 months for index pregnancy. Multivariable linear regression with generalized estimating equations estimated the change (β coefficient and 95% confidence interval [CI]) in infant outcomes (gestation, birthweight, length, head circumference, ponderal index) and relative to each disease, including infertility after adjusting for age, body mass index, and infertility treatment.
Result(S):
Prevalence of parental chronic diseases ranged from <1% to 19%, and 21% to 54% for infertility. Maternal hypertension was negatively associated with gestation (β, -0.64; 95% CI, -1.03, -0.25) and birthweight (-151.98; -262.30, -41.67) as was asthma and birthweight (-75.01; -130.40, -19.62). Maternal kidney disease was associated with smaller head circumference (-1.09; -2.17, -0.01), whereas paternal autoimmune disease was associated with larger head circumference (0.87; 0.15, 1.60). Infertility was negatively associated with birthweight (-62.18; -103.78, -20.58), length (-0.33; -0.60, -0.06), and head circumference (-0.35; -0.67, -0.03).
Conclusion(S):
Infertility was significantly associated with reduced infant size even after accounting for infertility treatment, although the magnitude of reduction varied by definition of infertility. Absence of pregnancy within a year of being at risk may be informative about health.
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