Link Between Maternal Obesity and Increased Infection Risk in Children

A recent study published in BMJ Medicine has revealed a significant correlation between maternal obesity and an increased likelihood of children being hospitalized for infections. Specifically, children born to mothers classified as very obese, with a body mass index (BMI) of 35 or higher, exhibited a heightened risk of hospital admissions due to infections.

This research underscores the importance of maintaining a healthy weight both before and during pregnancy. With projections indicating that the global prevalence of maternal obesity could reach 23% by 2030, the implications are concerning, especially considering the chronic inflammation associated with obesity. Such inflammation can lead to immune system dysfunction, alterations in gene expression, and changes in gut microbiota, all of which can adversely affect fetal development.

Prior studies on the relationship between maternal weight and childhood infections have produced mixed results, leaving questions regarding the influence of modifiable factors like breastfeeding practices and delivery methods. To investigate these associations, researchers utilized data from the Born in Bradford study, which has been examining the effects of various social, environmental, and genetic factors on maternal and child health outcomes.

The study analyzed data from 9,037 women who delivered at the Bradford Royal Infirmary between March 2007 and December 2010, focusing on those for whom height and weight data were available. The sample included a diverse group, with 45% of participants identifying as Pakistani and 40% as White British. Notably, 37% of the mothers came from the most socioeconomically disadvantaged areas in the UK.

Researchers tracked the health of 9,540 children from birth up until the age of 15, monitoring hospital admissions for infections. The types of infections recorded included respiratory, gastrointestinal, skin and soft tissue, and various viral infections.

Throughout the study period, there were a total of 5,009 hospital admissions for infections. Approximately 30% of the children were admitted at least once for an infection before reaching 15 years of age. The data showed a direct correlation between maternal BMI and infection-related hospital admissions. For instance, children of mothers with a healthy weight had an admission rate of 39.7 per 1,000 person-years, compared to 60.7 per 1,000 person-years for those whose mothers were classified as obese (grades 2-3).

After controlling for various influencing factors such as maternal age, ethnicity, and socioeconomic status, the study found that children whose mothers had a BMI in the obesity grades 2-3 category were 41% more likely to be hospitalized for infections during infancy and 53% more likely between the ages of 5 and 15.

The associations were particularly pronounced among male children and those born to Pakistani mothers. Most of the additional hospital admissions were attributed to respiratory, gastrointestinal, and viral infections.

Among the modifiable risk factors evaluated, preterm birth contributed to a small portion of the relationship between high maternal BMI and childhood infections, while C-section deliveries and childhood obesity at ages 4-5 were more significant contributors. Interestingly, breastfeeding for more than six weeks and excessive weight gain during pregnancy did not show a significant correlation.

This observational study has its limitations, including a reliance on data from a single hospital and gaps in breastfeeding and child BMI information. The researchers also acknowledge the inability to consider all environmental and lifestyle factors that could impact outcomes.

Nonetheless, the study's findings emphasize the urgent need for public health initiatives and enhanced support for women of reproductive age in achieving and maintaining healthy body weights. Although the effects of maternal obesity were modest, the potential impact on the health of a large number of children is considerable.