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Published on: August 7, 2017
Socioeconomic circumstances, health-related behaviours and paediatric infections: a mediation analysis
Samuel Videholm1,2, Sven Arne Silfverdal3, Per E Gustafsson4
1Department of Clinical Sciences, Pediatrics, Umeå University, Umea, Sweden samuel.videholm@umu.se.
Insights
Disadvantaged socioeconomic circumstances increase paediatric infection risk, with pregnancy smoking, maternal excess weight, and breastfeeding practices mediating a significant portion of this effect. Addressing these behaviors can reduce health inequalities in children.
Area of Science:
- Pediatric Infectious Diseases
- Maternal Health
- Socioeconomic Determinants of Health
Background:
- Socioeconomic disadvantages are linked to increased risks of pediatric infections.
- Understanding the mediating factors is crucial for developing targeted interventions.
Purpose of the Study:
- To investigate how pregnancy smoking, maternal excess weight, and breastfeeding mediate the association between socioeconomic disadvantage and pediatric infection risk.
- To identify potential public health strategies for reducing health inequalities in children.
Main Methods:
- Population-level retrospective cohort study utilizing Swedish national registers.
- Inclusion of 63,216 singletons born in Uppsala Region, Sweden (1997-2015).
- Analysis focused on hospital admissions for infectious diseases.
Main Results:
- Low maternal education, a marker of socioeconomic disadvantage, was associated with a higher risk of pediatric infections.
- Pregnancy smoking, maternal excess weight, and breastfeeding practices mediated 33%-64% of this association.
- These factors significantly contributed to the socioeconomic gradient in pediatric infections.
Conclusions:
- Pregnancy smoking, maternal excess weight, and breastfeeding are key mediators linking socioeconomic disadvantage to pediatric infectious diseases.
- Public health policies targeting these modifiable behaviors can help reduce health inequalities in children.
- Interventions addressing maternal health behaviors are essential for mitigating the impact of socioeconomic factors on child health.
Objective:
To examine how the effect of disadvantaged socioeconomic circumstances on the risk of paediatric infections is mediated by pregnancy smoking, excess weight during pregnancy and breast feeding in children under 5 years of age.
Design:
A population-level, retrospective cohort study. The Swedish Medical Birth Register was combined with the National Patient Register, the longitudinal integration database for health insurance and labour market studies, the Cause of Death Register and a local register held by the Child Health Care Unit in Uppsala Region.
Setting:
Uppsala Region, Sweden.
Patients:
63 216 term and post-term singletons born to women who resided in Uppsala Region, Sweden between 1997 and 2015.
Main Outcome Measures:
Number of hospital admissions for infectious diseases. Secondary outcomes were the number of hospitalisations for respiratory and enteric infections, respectively.
Results:
The effect of disadvantaged socioeconomic circumstances, that is, low maternal education on the overall risk of paediatric infections was mediated to a considerable (33%-64%) proportion by pregnancy smoking, excess weight during pregnancy and breast feeding.
Conclusions:
Pregnancy smoking, excess weight during pregnancy and breast feeding mediate a considerable proportion of the association between deprived socioeconomic circumstances and paediatric infectious diseases. Therefore, inequalities in paediatric infectious diseases may be reduced by public health policies addressing these health-related behaviours.
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