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Perinatal and Other Risk Factors for Common Infections in Infancy: A Prospective Cohort Study
Sanni Hyvönen1,2, Terhi Tapiainen3,4,5, Tytti Pokka3,6
1From the Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
Insights
Perinatal factors like delivery mode do not increase common infant infections. However, cesarean delivery is linked to a higher risk of urinary tract infections in the first year of life.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Limited prospective data exist on perinatal risk factors for common childhood infections in high-income nations.
- This study investigated the hypothesis that perinatal factors influence infectious episodes in infants during their first year of life.
Purpose of the Study:
- To examine the association between perinatal factors and the incidence and duration of common infections in infants.
- To identify specific perinatal exposures that may increase the risk of infections in the first year of life.
Main Methods:
- A prospective birth cohort study (Health and Early Life Microbiota) included 1052 full-term infants born between 2016-2018.
- Infection episodes were tracked online weekly/monthly, with analysis using multivariate regression for perinatal factors (delivery mode, intrapartum antibiotics) and environmental exposures.
- Outcomes measured were the number and duration of infectious episodes in the first year of life.
Main Results:
- Infants experienced an average of 4.2 infection episodes and 44 days of symptoms in the first year.
- Perinatal factors, including delivery mode and intrapartum antibiotics, were not associated with the overall number or duration of infections.
- Cesarean section was associated with an increased occurrence of urinary tract infections (UTIs) in infancy (aOR: 3.6, 95% CI: 1.13-11.1).
- Male sex and having siblings were associated with a higher number of infection episodes.
Conclusions:
- Perinatal factors, delivery mode, and intrapartum antibiotics do not appear to be significant risk factors for common infant infections.
- Cesarean delivery is identified as a specific risk factor for urinary tract infections in infancy.
- Further research may explore the mechanisms behind the UTI risk associated with cesarean delivery.
Objective:
Limited data from prospective cohort studies in high-income countries are available on the perinatal risk factors for common infections in children. Our hypothesis was that perinatal factors may be risk factors for infectious episodes during the first year of life.
Methods:
In this prospective Health and Early Life Microbiota birth cohort study of full-term infants (n = 1052) born in 2016-2018, the number and duration of infection episodes were collected online at weekly to monthly intervals. In a multivariate regression model, the main exposures were perinatal factors such as mode of delivery and intrapartum antibiotics. Environmental factors were additional exposures. The outcomes were the number and duration of infectious episodes in the first year of life.
Results:
The mean number of infection episodes was 4.2 (2.9 SD). The mean duration of infection symptoms was 44 days (40 SD). Upper respiratory infections accounted for 83% of the episodes (3674/4455). Perinatal factors were not associated with the number nor the duration of infection episodes, but cesarean section was associated with an increased occurrence of urinary tract infections in infancy [adjusted odds ratio (aOR): 3.6; 95% confidence interval (CI): 1.13-11.1]. Of the additional exposures male sex (aOR: 1.1; 95% CI: 1.0-1.2) and the presence of siblings (aOR: 1.3; 95% CI: 1.2-1.4) were associated with the number of infection episodes.
Conclusions:
This prospective cohort study showed that perinatal factors, mode of delivery and intrapartum antibiotics were not associated with the risk of common infections in infancy, but cesarean delivery was associated with a risk of urinary tract infections.
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