Effect of maternal hypertensive disorders during pregnancy on offspring's early childhood body weight: A population-based cohort study.

OBJECTIVE: The prevalence of hypertensive disorder during pregnancy (HDP) and childhood obesity is increasing worldwide. HDP or obesity in mothers can increase the risk of overweight/obesity (OWOB) in their children. Few longitudinal studies have examined the associations of maternal body weight with the growth and risk factors for overweight in infants born to mothers with HDP. This study examined the risk factors for childhood OWOB through the age of 66 months in children born to mothers with HDP. MATERIALS AND METHODS: In total, 24,200 pairs of mothers and their children were selected from the Taiwan Birth Cohort Study. The children's body weights were classified and analyzed to determine infant growth at birth and at the ages of 12, 24, 36, and 66 months. Multiple logistic regression analyses with different model settings were performed to identify the factors affecting growth and childhood OWOB in the children of mothers with HDP. RESULTS: The average birth weight of children was lower in the HDP group than in the non-HDP group. The catch-up phenomenon began at the age of 18 months. The incidence of OWOB was higher in the children in the HDP group than in those in the non-HDP group from the age of 24 months and increased with the children's age. At every age point, maternal overweight before pregnancy was the main risk factor for childhood OWOB, and this effect increased with the children's age (odds ratio [OR]: 1.83 at 66 months). The effect of excessive maternal gestational weight gain on childhood OWOB was significant (OR: 1.26-1.44 for various age points). CONCLUSION: Maternal overweight is the main risk factor for OWOB in children born to mothers with HDP. After adjusting for related confounders, we determined that HDP did not exert a significant effect on the risk of childhood OWOB.

Factors affecting the growth of children till the age of three years with overweight whose mothers have diabetes mellitus: A population-based cohort study.

BACKGROUND: The prevalence of diabetes mellitus (DM) during pregnancy and childhood obesity is increasing worldwide. Factors affecting the growth of children with overweight whose mothers had DM are complicated and inconclusive. Few longitudinal studies have focused on the growth of infants with macrosomia born to mothers with DM and the factors influencing their overweight. This study explored risk factors for childhood overweight/obesity (OWOB) among children of mothers with DM. Perinatal, maternal socio-demographic, infant care, and maternal body weight characteristics as well as child growth until age 3 years were analyzed using a longitudinal design. METHODS: In total, 24,200 pairs of mothers and their children from the Taiwan Birth Cohort Study were included. Combined Taiwan Children Growth Curve report classifications were analyzed for infant growth at birth and at 6, 12, 18, 24, and 36 months old (m/o). A multiple logistic regression analysis with different model settings was used to assess factors affecting the growth of high birth weight children of mothers with diabetic mellitus (HODM). RESULTS: Children in the HODM group had a higher average body weight than did those in the non-DM group at different age stages. Relative to the non-DM group, weight gain in the HODM group was slower before 18 m/o but faster from 18 to 36 m/o, particularly after 24 m/o. Maternal DM was a major risk factor for childhood OWOB (odds ratio [OR]: 3.25-3.95). After adjustment for related confounders, the OR was 2.19-3.17. Maternal overweight or obesity and higher gestational weight gain were greater risk factors for childhood OWOB at 3 years old after adjusted maternal DM and other selected confounders (OR: 1.45 and 1.23, respectively). Breastfeeding until 6 m/o was a protective factor against childhood OWOB (OR: 0.95). The HODM and non-DM groups did not differ significantly in perinatal, maternal socio-demographic, or infant care characteristics. CONCLUSIONS: Maternal DM is a major factor of childhood OWOB. Maternal body weight before and after pregnancy affects childhood OWOB, and this effect increases with the child's age.

Economic cost and burden of dengue during epidemics and non-epidemic years in Taiwan.

BACKGROUND: Determining the disease and economic burden of dengue is critical for the allocation of public health resources. Several studies have used disability-adjusted life-years (DALYs) to estimate the disease burden of dengue in different regions. However, there are no published studies discussing the estimates of dengue-related economic and disease burden specifically in Taiwan. OBJECTIVES: We assessed the economic cost and disease burden of dengue infections in Taiwan for the period 1998-2014, and compared these during epidemic and non-epidemic years. METHODS: We estimated the annual DALYs per million population using the disability weights for dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS), and death cases. Economic costs were estimated and divided into direct (medical costs) and indirect costs (lost work days and caregiver fees). RESULTS: For the period 1998-2014, a mean of 115.3 (range: 6.3-934.3) DALYs per million population annually were lost to dengue. In epidemic years, direct costs associated with dengue resulted mostly from hospitalization (86.09%), emergency (7.77%), outpatient (6.10%), and drug costs (0.03%). For indirect costs, lost productivity due to death (70.76%) was the dominant contributor. Overall, the costs were 12.3 times higher in epidemic years than in non-epidemic years (Wilcoxon rank sum test, p<0.05). CONCLUSIONS: This study is the first to evaluate the economic costs and disease burden of dengue infections for this period in Taiwan, and reveals significant differences in economic impact between epidemic and non-epidemic years.