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He WQ, Moore HC, Miller JE, Burgner DP, Swann O, Lain SJ, Nassar N. Impact of early childhood infection on child development and school performance: a population-based study. J Epidemiol Community Health 2024; 79:27-35. [PMID: 39216990 PMCID: PMC11671983 DOI: 10.1136/jech-2024-222040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/25/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Childhood infection might be associated with adverse child development and neurocognitive outcomes, but the results have been inconsistent. METHODS Two population-based record-linkage cohorts of all singleton children born at term in New South Wales, Australia, from 2001 to 2014, were set up and followed up to 2019 for developmental outcome (N=276 454) and school performance (N=644 291). The primary outcome was developmentally high risk (DHR) at age 4-6 years and numeracy and reading below the national minimum standard at age 7-9 years. Cox regression was used to assess the association of childhood infection ascertained from hospital records with each outcome adjusting for maternal, birth and child characteristics, and sensitivity analyses were conducted assessing E-values and sibling analysis for discordant exposure. RESULTS A higher proportion of children with an infection-related hospitalisation were DHR (10.9% vs 8.7%) and had numeracy (3.7% vs 2.7%) and reading results (4.3% vs 3.1%) below the national minimum standard, compared with those without infection-related hospitalisation. In the multivariable analysis, children with infection-related hospitalisation were more likely to be DHR (adjusted HR 1.12, 95% CI 1.08 to 1.15) and have numeracy (adjusted HR 1.22, 95% CI 1.18 to 1.26) and reading results (adjusted HR 1.16, 95% CI 1.12 to 1.20) below the national minimum standard. However, these results may be impacted by unmeasured confounding, based on E-values of 1.48-1.74, and minimal association with education outcome was found in the sibling analysis. CONCLUSIONS Infection-related hospitalisation was modestly associated with adverse child development and school performance, but the association may be explained by shared familial factors, particularly in those with most socioeconomic disadvantages.
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Affiliation(s)
- Wen-Qiang He
- Child Population and Translational Health Research, Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Hannah Catherine Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Perth, Australia
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Jessica E Miller
- Murdoch Children’s Research Institute, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - David P Burgner
- Murdoch Children’s Research Institute, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Olivia Swann
- Department of Child Life and Health, The University of Edinburgh, Edinburgh, UK
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Samantha J Lain
- Child Population and Translational Health Research, Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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Selvaratnam RJ, Wallace EM, Rolnik DL, Davey MA. Childhood school outcomes for infants born to women with hypertensive disorders during pregnancy. Pregnancy Hypertens 2022; 30:51-58. [DOI: 10.1016/j.preghy.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022]
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