Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years

Maina Kariuki; Alessandra Raudino; Melissa J Green; Kristin R Laurens; Kimberlie Dean; Sally A Brinkman; Rhoshel K Lenroot; Enwu Liu; Felicity Harris; Luming Luo; Vaughan J Carr

doi:10.1111/jpc.13239

Hospital admission for infection during early childhood influences developmental vulnerabilities at age 5 years

J Paediatr Child Health. 2016 Sep;52(9):882-8. doi: 10.1111/jpc.13239. Epub 2016 Jul 20.

Authors

Maina Kariuki^{1

2}, Alessandra Raudino^{1

2}, Melissa J Green^{1

2}, Kristin R Laurens^{1

2}, Kimberlie Dean^{1

3}, Sally A Brinkman^{4

5}, Rhoshel K Lenroot^{1

2

6}, Enwu Liu^{1

2}, Felicity Harris^{1

2}, Luming Luo^{1

2}, Vaughan J Carr^{7

8

9}

Affiliations

¹ School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
² Schizophrenia Research Institute, Sydney, New South Wales, Australia.
³ Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia.
⁴ Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
⁵ School of Population Health, University of Adelaide, Adelaide, South Australia, Australia.
⁶ Neuroscience Research Australia, Sydney, New South Wales, Australia.
⁷ School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. v.carr@unsw.edu.au.
⁸ Schizophrenia Research Institute, Sydney, New South Wales, Australia. v.carr@unsw.edu.au.
⁹ Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia. v.carr@unsw.edu.au.

PMID: 27439883
DOI: 10.1111/jpc.13239

Abstract

Aim: Childhood infectious diseases can be associated with later physical and psychological ill health, and the effects of this association may be evident during early childhood development. This study aimed to examine the effects of hospitalisation for early life infection on early childhood development.

Methods: Hospital admission data for infection were obtained from the New South Wales Ministry of Health Admitted Patient Data Collection for 87 026 children, for whom the Australian Early Development Census (AEDC) was completed in their first year of formal schooling (age approximately 5 years). The AEDC provides estimates of each child's level of functioning on five domains of development spanning social and emotional skills, communication skills, numeracy and literacy and physical health. Multinomial logistic regressions were used to determine the relationship between exposure to hospital admissions for infectious disease prior to age 4 years and vulnerability on the AEDC. Models were adjusted for the effects of potential confounding factors related to the perinatal period, exposure to maltreatment and family characteristics.

Results: Single and multiple hospitalisation(s) for infections were consistently associated with increased likelihood of being developmentally vulnerable on all AEDC domains, with odds ratios ranging from 1.02 to 1.28, after adjustment for confounding factors.

Conclusions: This study demonstrates a pervasive effect of early life infections that require hospital admission on multiple aspects of early child development, even after adjustment for potential confounding factors. Relatively, severe infection during early childhood constitutes a risk factor for developmental vulnerability by the time of entry to school.

Keywords: child; child development; hospitalised; infection; medical record linkage.

MeSH terms

Child Development*
Child Health*
Child, Preschool
Developmental Disabilities / diagnosis
Developmental Disabilities / etiology*
Female
Health Surveys
Hospitalization*
Humans
Infant
Infant, Newborn
Infections / complications*
Logistic Models
Male
Risk Factors