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IJE Advance Access published online on May 27, 2004
International Journal of Epidemiology, doi:10.1093/ije/dyh169
© 2004 by International Epidemiological Association
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Accepted February 16, 2004

Original paper

Fetal growth, maternal prenatal smoking, and risk of invasive meningococcal disease: a nationwide case-control study

Henrik Toft Sørensen 1*, Rodrigo Labouriau 2, Elise Snitker Jensen 1, Preben Bo Mortensen 3, Henrik Carl Schønheyder 4

1 Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus C, Denmark
2 National Centre for Register-based Research, University of Aarhus, 8000 Aarhus C, Denmark; Biometry Research Unit, Foulum Research Centre, Denmark
3 National Centre for Register-based Research, University of Aarhus, 8000 Aarhus C, Denmark
4 Department of Clinical Microbiology, Aalborg Hospital, 9000 Aalborg, Denmark

* To whom correspondence should be addressed. E-mail: hts{at}soci.au.dk.


  Abstract

Background The prenatal period may be important for susceptibility to infections. We evaluated whether low birthweight, prematurity, and prenatal maternal smoking were associated with increased risk of invasive meningococcal disease.

Methods We linked the Danish nationwide National Registry of Patients, the Birth Registry, and social registries to obtain data on fetal growth and social factors on 1921 cases of meningococcal disease hospitalized between 1 January, 1980 and 31 December, 1999 (median age 31 months, interquartiles 13-65 months) and 37 451 population controls. The impact of maternal smoking was examined in a subsample of 462 cases and 9240 controls born after 1990, when data on smoking became available in the Birth Registry.

Results The adjusted odds ratios (OR) of meningococcal disease associated with low birthweight (<2500 g) varied between 1.6 (95% CI: 1.1, 2.3) in infants <12 months to 1.5 (95% CI: 1.0, 2.3) in children >60 months of age at hospitalization for meningococcal disease. Premature children had an increased risk of meningococcal disease during the first year of life only (adjusted OR = 1.3, 95% CI: 1.1, 1.9). The effect of low birthweight was very similar among mature and premature children. The adjusted OR for maternal smoking was 1.8 (95% CI: 1.4, 2.2).

Conclusions Low birthweight is associated with an increased risk of meningococcal disease throughout childhood, while an effect of prematurity persists only for 12 months. Maternal prenatal smoking was associated with the risk of meningococcal disease.

Keywords Meningococcal disease, epidemiological factors, infant, low birthweight, small for gestational age, smoking


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