Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road Campus, Old Road, Oxford OX3 7LF, UK.
BMC Infect Dis. 2011 Feb 28;11:51. doi: 10.1186/1471-2334-11-51.
There is current interest in the role of perinatal factors in the aetiology of diseases that occur later in life. Infectious mononucleosis (IM) can follow late primary infection with Epstein-Barr virus (EBV), and has been shown to increase the risk of multiple sclerosis and Hodgkin's disease. Little is known about maternal or perinatal factors associated with IM or its sequelae.
We investigated perinatal risk factors for hospitalised IM using a prospective record-linkage study in a population in the south of England. The dataset used, the Oxford record linkage study (ORLS), includes abstracts of birth registrations, maternities and in-patient hospital records, including day case care, for all subjects in a defined geographical area. From these sources, we identified cases of hospitalised IM up to the age of 30 years in people for whom the ORLS had a maternity record; and we compared perinatal factors in their pregnancy with those in the pregnancy of children who had no hospital record of IM.
Our data showed a significant association between hospitalised IM and lower social class (p = 0.02), a higher risk of hospitalised IM in children of married rather than single mothers (p < 0.001), and, of marginal statistical significance, an association with singleton birth (p = 0.06). The ratio of observed to expected cases of hospitalised IM in each season was 0.95 in winter, 1.02 in spring, 1.02 in summer and 1.00 in autumn. The chi-square test for seasonality, with a value of 0.8, was not significant.Other factors studied, including low birth weight, short gestational age, maternal smoking, late age at motherhood, did not increase the risk of subsequent hospitalised IM.
Because of the increasing tendency of women to postpone childbearing, it is useful to know that older age at motherhood is not associated with an increased risk of hospitalised IM in their children. We have no explanation for the finding that children of married women had a higher risk of IM than those of single mothers. Though highly significant, it may nonetheless be a chance finding. We found no evidence that such perinatal factors as birth weight and gestational age, or season of birth, were associated with the risk of hospitalised IM.
人们对围产期因素在生命后期发生的疾病中的作用产生了兴趣。传染性单核细胞增多症（IM）可继发于 EBV 的原发性感染后，已证实其会增加多发性硬化症和霍奇金病的风险。目前尚不清楚与 IM 或其后遗症相关的母体或围产期因素。
我们通过在英格兰南部的一项前瞻性记录链接研究，调查了住院 IM 的围产期危险因素。我们使用的数据集是牛津记录链接研究（ORLS），它包括所有研究对象的出生登记、产妇和住院病历摘要，包括日间护理。从这些来源中，我们确定了 ORLS 有产妇记录的人群中 30 岁以下住院 IM 病例，并比较了其妊娠与无住院 IM 记录的儿童妊娠的围产期因素。
我们的数据显示，住院 IM 与较低的社会阶层（p = 0.02）显著相关，与单身母亲的孩子相比，已婚母亲的孩子住院 IM 的风险更高（p < 0.001），而且，与单胎出生的关系也具有边缘统计学意义（p = 0.06）。每个季节的观察到的与预期的住院 IM 病例比值分别为冬季 0.95、春季 1.02、夏季 1.02 和秋季 1.00。季节性的卡方检验值为 0.8，无统计学意义。其他研究的因素，包括低出生体重、早产、母亲吸烟、母亲年龄较大，不会增加随后住院 IM 的风险。
由于女性生育年龄推迟的趋势越来越明显，因此了解到母亲年龄较大不会增加其子女住院 IM 的风险是有用的。我们无法解释为什么已婚妇女的孩子比单身母亲的孩子患 IM 的风险更高。虽然这一发现具有高度显著性，但它可能仍然是偶然发现。我们没有发现出生体重和胎龄或出生季节等围产期因素与住院 IM 风险相关的证据。
