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Gestational age and the long-term impact on children’s infectious urinary morbidity

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Given the negative impact of prematurity on offspring’s health, we sought to determine whether different gestational ages at birth impact differently on the prevalence of childhood infectious urinary morbidity in the offspring.

Methods

In this population-based cohort analysis, all singleton deliveries occurring between 1991 and 2014 at a single regional tertiary medical center were included. Gestational age upon delivery was sub-divided into early preterm (< 34 weeks), late preterm (34–36 6/7 weeks), early term (37–38 6/7 weeks), full term (39–40 6/7 weeks), late term (41–41 6/7 weeks) and post-term (> 42 weeks). Congenital malformations were excluded. Rates of infectious urinary morbidity-related hospitalizations of offspring up to age 18 years were assessed using a survival curve and a Cox multivariable model.

Results

During the study period, 238,620 deliveries met the inclusion criteria. Urinary-related hospitalization (n = 1395) rates decreased as gestational age increased, from 1.7% in the early preterm group, 0.9% in the late preterm group, 0.6% in the early-term group and only 0.5% in the full, late and post-term groups (p > 0.001; chi-square test for trends). In the Cox model, controlled for maternal age, preterm as well as early-term deliveries exhibited an independent association with pediatric urinary morbidity as compared with full term (early preterm: aHR—3.305, 95% CI 2.4–4.54; late preterm: aHR—1.63, 95% CI 1.33–1.99; early term: aHR—1.26, 95% CI 1.1–1.43, p = 0.01).

Conclusions

Deliveries occurring at preterm and at early term are independently associated with pediatric urinary morbidity in the offspring. This risk decreases as gestational age advances.

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Acknowledgements

Elisheva Padeh wrote the first draft of the manuscript. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript.

Funding

This study was not funded.

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Author notes

  1. Elisheva Padeh and Tamar Wainstock are equal contributors and should be considered as first authors.

Authors and Affiliations

  1. Joyce and Irving Goldman Medical School, Ben-Gurion University of the Negev, Beersheba, Israel

    Elisheva Padeh

  2. Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel

    Tamar Wainstock

  3. Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel

    Eyal Sheiner & Asnat Walfisch

  4. Department of Neonatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel

    Daniella Landau

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  1. Elisheva Padeh
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  2. Tamar Wainstock
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  3. Eyal Sheiner
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  4. Daniella Landau
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  5. Asnat Walfisch
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Contributions

EP: manuscript writing. TW: manuscript writing, data analysis. ES: manuscript editing. DL: data collection. AW: project development, manuscript editing.

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Correspondence to Elisheva Padeh.

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All authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Padeh, E., Wainstock, T., Sheiner, E. et al. Gestational age and the long-term impact on children’s infectious urinary morbidity. Arch Gynecol Obstet 299, 385–392 (2019). https://doi.org/10.1007/s00404-018-4973-4

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  • DOI: https://doi.org/10.1007/s00404-018-4973-4

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