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Maternal pre-pregnancy weight status and health care use for mental health conditions in the offspring

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Abstract

The objective of this study was to examine the relationship between pre-pregnancy maternal weight status and offspring physician visits for mental health conditions in childhood and adolescence. We conducted a population-based retrospective cohort study of singleton infants born between the years of 1989 and 1993 using a linkage of the Nova Scotia Atlee Perinatal Database with administrative health data. Offspring were followed from birth to age 18 years. Maternal weight status was categorized according to WHO body mass index cutoffs. The number of physician visits for any mental health condition, mood, anxiety, and adjustment disorders, conduct disorder, and attention-deficit hyperactivity disorder (ADHD) from age 0–18 years was determined from ICD codes in physician billings and hospital discharge abstract data. Negative binomial regression adjusting for sociodemographics, maternal psychiatric disorders and smoking was used to model the association. In total, 38,211 mother–offspring pairs were included in the cohort. Within the first 18 years of life, offspring of mothers with obesity had significantly more physician visits for any mental health condition [adjusted incidence rate ratio (IRR) 1.26, 95% CI 1.19–1.34], mood, anxiety, and adjustment disorders (IRR 1.16, 95% CI 1.07–1.25), conduct disorder (IRR 1.25, 95% CI 1.08–1.45), and ADHD (IRR 1.45, 95% CI 1.24–1.69) compared to mothers of normal weight. Associations for mood, anxiety, and adjustment disorders and conduct disorder were strongest at 13–18 years. Offspring of mothers with obesity appear to use health care for mental health conditions more frequently than offspring of normal weight mothers.

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Acknowledgements

This work was supported by a Canadian Institutes of Health Research operating grant awarded to Dr. Stefan Kuhle (FRN #134531). Alexa Grudzinski held an Andrew Putnam Summer Research Studentship from the Faculty of Medicine, Dalhousie University. Leslie Anne Campbell holds a Sobey Family Chair in Child & Adolescent Mental Health Outcomes. Mary Margaret Brown received a Nova Scotia Research and Innovation Graduate Scholarship from the Government of Nova Scotia and a Scotia Scholar Doctoral Award from the Nova Scotia Health Research Foundation. Portions of the data used in this report were made available by Health Data Nova Scotia of Dalhousie University. Although this research is based on data obtained from the Nova Scotia Department of Health and Wellness, the observations and opinions expressed are those of the authors and do not represent those of either Health Data Nova Scotia or the Department of Health and Wellness.

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Authors and Affiliations

  1. Faculty of Medicine, Dalhousie University, Halifax, NS, Canada

    Alexa Grudzinski

  2. Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada

    Leslie Anne Campbell

  3. Departments of Obstetrics and Gynaecology and Pediatrics, Perinatal Epidemiology Research Unit, Dalhousie University, Halifax, NS, Canada

    Lihui Liu, Mary Margaret Brown, Linda Dodds & Stefan Kuhle

  4. Perinatal Epidemiology Research Unit, IWK Health Centre, 5980 University Avenue, Halifax, NS, B3K 6R8, Canada

    Stefan Kuhle

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  1. Alexa Grudzinski
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Correspondence to Stefan Kuhle.

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Grudzinski, A., Campbell, L.A., Liu, L. et al. Maternal pre-pregnancy weight status and health care use for mental health conditions in the offspring. Eur Child Adolesc Psychiatry 28, 1499–1506 (2019). https://doi.org/10.1007/s00787-019-01312-w

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