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Maternal Pre-Gravid Obesity and Early Childhood Respiratory Hospitalization: A Population-Based Case–Control Study

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Abstract

Inflammation in utero is linked to childhood respiratory and infectious complications. Obesity is an increasingly common chronic inflammatory state, yet little is known about its role in childhood respiratory illness. We sought to examine the association between maternal pre-gravid BMI and early childhood respiratory hospitalization. We conducted a population-based case–control study using the Washington State Comprehensive Hospital Abstract Reporting System and linked birth certificate data. Cases were children age 0–5 years, born in Washington state, with a respiratory hospitalization between 2003 and 2008. We identified 15,318 cases, frequency matching each case to two controls by birth year (total 31,060 controls). We used logistic regression to estimate the risk (approximated by odds ratios) of early childhood respiratory hospitalization according to maternal pre-gravid body mass index (BMI) category (underweight, normal, overweight, obese), after adjustment for maternal and infant characteristics. An elevated maternal pre-gravid BMI was associated with increased risk of childhood respiratory hospitalization, with an adjusted odds ratio OR [95 % CI] = 1.08 [1.03–1.14] for overweight mothers (BMI 25–29.9 kg/m2), and OR = 1.29 [1.22–1.36] for obese mothers (BMI ≥ 30 kg/m2). An elevated maternal pre-gravid BMI was associated with higher risk of early childhood respiratory hospitalization. Childhood respiratory illness may be an important complication of excess maternal weight that should be shared with expectant mothers.

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Acknowledgments

The authors would like to thank the Washington State Department of Health for their assistance in maintaining the databases used in this project. The authors would also like to thank the following individuals at the University of Washington School of Public Health for their valuable assistance in this project without compensation: Professors Beth Mueller and Stephen Hawes, for their insightful critiques during the planning of this analysis; and Mr. William O’Brien, for programming assistance. This study was supported by National Institutes of Health T32 training grant HL007287. Dr. Parsons receives support from a Veterans Affairs Health Services Research and Development Fellowship (TPM 61-037). The views expressed are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA

    Elizabeth C. Parsons

  2. Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA

    Elizabeth C. Parsons & Kevin Patel

  3. Division of Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, IL, USA

    Betty T. Tran

  4. Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA

    Alyson J. Littman

  5. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Alyson J. Littman

  6. Harborview Medical Center, 325 Ninth Avenue, Box 359762, Seattle, WA, 98104, USA

    Elizabeth C. Parsons

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  1. Elizabeth C. Parsons
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  2. Kevin Patel
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Correspondence to Elizabeth C. Parsons.

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Parsons, E.C., Patel, K., Tran, B.T. et al. Maternal Pre-Gravid Obesity and Early Childhood Respiratory Hospitalization: A Population-Based Case–Control Study. Matern Child Health J 17, 1095–1102 (2013). https://doi.org/10.1007/s10995-012-1092-x

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