From the Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
Department of Pediatrics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Pediatr Infect Dis J. 2023 Dec 1;42(12):e447-e453. doi: 10.1097/INF.0000000000004112. Epub 2023 Sep 14.
Limited data from prospective cohort studies in high-income countries are available on the perinatal risk factors for common infections in children. Our hypothesis was that perinatal factors may be risk factors for infectious episodes during the first year of life.
In this prospective Health and Early Life Microbiota birth cohort study of full-term infants (n = 1052) born in 2016-2018, the number and duration of infection episodes were collected online at weekly to monthly intervals. In a multivariate regression model, the main exposures were perinatal factors such as mode of delivery and intrapartum antibiotics. Environmental factors were additional exposures. The outcomes were the number and duration of infectious episodes in the first year of life.
The mean number of infection episodes was 4.2 (2.9 SD). The mean duration of infection symptoms was 44 days (40 SD). Upper respiratory infections accounted for 83% of the episodes (3674/4455). Perinatal factors were not associated with the number nor the duration of infection episodes, but cesarean section was associated with an increased occurrence of urinary tract infections in infancy [adjusted odds ratio (aOR): 3.6; 95% confidence interval (CI): 1.13-11.1]. Of the additional exposures male sex (aOR: 1.1; 95% CI: 1.0-1.2) and the presence of siblings (aOR: 1.3; 95% CI: 1.2-1.4) were associated with the number of infection episodes.
This prospective cohort study showed that perinatal factors, mode of delivery and intrapartum antibiotics were not associated with the risk of common infections in infancy, but cesarean delivery was associated with a risk of urinary tract infections.
来自高收入国家的前瞻性队列研究提供了有限的数据，说明围产期因素与儿童常见感染的关系。我们的假设是，围产期因素可能是婴儿期感染发作的危险因素。
在这项针对足月婴儿（n=1052）的前瞻性健康与早期微生物群出生队列研究中，我们在线收集了每周至每月的感染发作次数和持续时间。在多变量回归模型中，主要暴露因素是围产期因素，如分娩方式和产时抗生素。环境因素是额外的暴露因素。结局是婴儿期第一年的感染发作次数和持续时间。
平均感染发作次数为 4.2（2.9 SD）。感染症状的平均持续时间为 44 天（40 SD）。上呼吸道感染占发作的 83%（3674/4455）。围产期因素与感染发作的次数和持续时间无关，但剖宫产与婴儿尿路感染的发生率增加有关[校正优势比（aOR）：3.6；95%置信区间（CI）：1.13-11.1]。额外的暴露因素中，男性（aOR：1.1；95% CI：1.0-1.2）和兄弟姐妹的存在（aOR：1.3；95% CI：1.2-1.4）与感染发作次数有关。
这项前瞻性队列研究表明，围产期因素、分娩方式和产时抗生素与婴儿期常见感染的风险无关，但剖宫产与尿路感染的风险相关。
