Maternal weight tied to early-onset neonatal bacterial sepsis
Risk for early-onset neonatal bacterial sepsis (EOS) increases with maternal overweight and obesity, particularly in term infants, according to a study recently published in Clinical Infectious Diseases.
Eduardo Villamor, M.D., M.P.H., from the University of Michigan School of Public Health in Ann Arbor, and colleagues used data from 1,971,346 live singleton infants born in Sweden (1997 to 2016) to identify a diagnosis of culture-confirmed EOS in the first three days of life.
The researchers found that EOS risk per 1,000 live births was 1.48 but was higher in preterm infants (0.76 in term versus 15.52 in preterm infants). EOS risk increased with maternal body mass index (BMI) categories: For BMI <18.5 kg/m², the adjusted hazard ratio (aHR) was 1.07 (95 percent confidence interval [CI], 0.83 to 1.40); for BMI 25.0 to 29.9 kg/m², aHR was 1.19 (95 percent CI, 1.08 to 1.32); for BMI 30.0 to 34.9 kg/m², aHR was 1.70 (95 percent CI, 1.49 to 1.94); for BMI 35.0 to 39.9 kg/m², aHR was 2.11 (95 percent CI, 1.73 to 2.58); and for BMI ≥40.0 kg/m², aHR was 2.50 (95 percent CI, 1.86 to 3.38), versus normal-weight mothers (BMI of 18.5 to 24.9 kg/m²). This increased risk was seen for EOS due to group B Streptococcus, Staphylococcus aureus, and Escherichia coli. However, half of the association was mediated by preeclampsia, cesarean section delivery, and preterm delivery. There was a dose-response association only in term infants. Every kg/m² interpregnancy BMI change in sibling-controlled analyses was associated with a mean 8.3 percent increase in EOS risk.
“Increasing awareness of obesity as a risk factor for EOS might result in reduced EOS risk,” the authors write.