Epidemiology and Risk Factors of Infection in Early Childhood

Pediatrics. 2018 Jun;141(6):e20170933. doi: 10.1542/peds.2017-0933. Epub 2018 May 24.

Abstract

Background: There is a large, unexplained variation in the frequency of childhood infections. We described incidence and risk factors of infections in early childhood.

Methods: Simple infections were captured during the first 3 years of life in the Copenhagen Prospective Studies on Asthma in Childhood 2000 birth cohort. Environmental exposures were analyzed by quasi-Poisson regression and sparse principal component analysis.

Results: The 334 children experienced a median of 14 (range 2-43) infectious episodes at ages 0 to 3 years. The overall rate of infections was associated with the number of children in the day care (adjusted incidence rate ratio [aIRR] 1.09 [1.2-1.16]) and the m2 per child in the day care (aIRR 0.96 [0.92-0.99]). Upper respiratory infections were also associated with the number of children in the day care (aIRR 1.11 [1.03-1.20]) and the m2 per child in the day care (aIRR 0.95 [0.91-0.99]), whereas lower respiratory infections were associated with caesarean section (aIRR 1.49 [1.12-1.99]), maternal smoking (aIRR 1.66 [1.18-2.33]), older siblings (aIRR 1.54 [1.19-2.01]), and the age at entry to day care (aIRR 0.77 [0.65-0.91]). The sparse principal component analysis revealed a risk factor profile driven by tobacco exposure, social circumstances, and domestic pets, but could only be used to explain 8.4% of the infection burden.

Conclusions: Children experienced around 14 infections during the first 3 years of life, but incidences varied greatly. Environmental exposures only explained a small fraction of the variation, suggesting host factors as major determinants of infectious burden.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cesarean Section / statistics & numerical data
  • Child Day Care Centers
  • Child, Preschool
  • Cohort Studies
  • Denmark / epidemiology
  • Drug Prescriptions / statistics & numerical data
  • Female
  • Fever / drug therapy
  • Fever / epidemiology*
  • Gastroenteritis / drug therapy
  • Gastroenteritis / epidemiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Principal Component Analysis
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / epidemiology*
  • Risk Factors
  • Siblings
  • Tobacco Smoke Pollution / statistics & numerical data

Substances

  • Anti-Bacterial Agents
  • Tobacco Smoke Pollution