Maternal Obesity and Risk of Early-onset Neonatal Bacterial Sepsis: Nationwide Cohort and Sibling-controlled Studies

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Fältnamn	Indikatorer	Metadata
000		03153naa a2200313 4500
001		oai:prod.swepub.kib.ki.se:148205787
003		SwePub
008		240902s2021 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1482057872 URI
024	7	a https://doi.org/10.1093/cid/ciaa7832 DOI
040		a (SwePub)ki
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Villamor, E4 aut
245	1 0	a Maternal Obesity and Risk of Early-onset Neonatal Bacterial Sepsis: Nationwide Cohort and Sibling-controlled Studies
264		c 2020-06-17
264	1	b Oxford University Press (OUP),c 2021
520		a BackgroundMaternal overweight and obesity are related to risks of pregnancy and delivery complications that, in turn, are associated with newborn infections. We examined the associations between early pregnancy body mass index (BMI; kg/m2) and risk of early-onset neonatal bacterial sepsis (EOS).MethodsWe conducted a nationwide population-based retrospective cohort study of 1 971 346 live singleton infants born in Sweden between 1997 and 2016. Outcome was a culture-confirmed EOS diagnosis. We estimated hazard ratios (HR) of EOS according to BMI using proportional hazard models, and identified potential mediators. Among term infants, we conducted sibling-controlled analyses.ResultsEOS risk per 1000 live births was 1.48; 0.76 in term and 15.52 in preterm infants. Compared with infants of normal-weight mothers (BMI, 18.5–24.9), the adjusted HR (95% confidence interval [CI]) of EOS for BMI categories <18.5, 25.0–29.9, 30.0–34.9, 35.0–39.9, and ≥40.0 were, respectively, 1.07 (.83–1.40), 1.19 (1.08–1.32), 1.70 (1.49–1.94), 2.11 (1.73–2.58), and 2.50 (1.86–3.38). Maternal overweight and obesity increased the risk of EOS by group B Streptococcus, Staphylococcus aureus, and Escherichia coli. Half of the association was mediated through preeclampsia, cesarean section delivery, and preterm delivery. A dose-response association was consistently apparent in term infants only. In sibling-controlled analyses, every kilogram per meter squared interpregnancy BMI change was associated with a mean 8.3% increase in EOS risk (95% CI, 1.7%–15.3%; P = .01).ConclusionsRisk of EOS increases with maternal overweight and obesity severity, particularly in term infants.
700	1	a Norman, Mu Karolinska Institutet4 aut
700	1	a Johansson, Su Karolinska Institutet4 aut
700	1	a Cnattingius, Su Karolinska Institutet4 aut
710	2	a Karolinska Institutet4 org
773	0	t Clinical infectious diseases : an official publication of the Infectious Diseases Society of Americad : Oxford University Press (OUP)g 73:9, s. E2656-E2664q 73:9<E2656-E2664x 1537-6591
773	0	t Clinical Infectious Diseasesd : Oxford University Press (OUP)g 73:9, s. E2656-E2664q 73:9<E2656-E2664x 1058-4838
856	4	u https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8757322
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:148205787
856	4 8	u https://doi.org/10.1093/cid/ciaa783

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Av författaren/redakt...: Villamor, E; Norman, M; Johansson, S; Cnattingius, S

Artiklar i publikationen: Clinical infecti ...; Clinical Infecti ...

Av lärosätet: Karolinska Institutet

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