Parental health status and infant outcomes: Upstate KIDS Study

Objective: To assess parental health status inclusive of infertility and infant outcomes. Design: Birth cohort with cross-sectional analysis of parental health status and infant outcomes. Setting: Not applicable. Patient(s): Parents (n = 4,886) and infants (n = 5,845) participating in the Upstate KIDS birth cohort. Intervention(s): None. Main Outcome Measure(s): Infertility was defined as [1] sexually active without contraception for 1+ years without pregnancy, [2] ever requiring ≥12 months to become pregnant, and [3] requiring ≥12 months for index pregnancy. Multivariable linear regression with generalized estimating equations estimated the change (β coefficient and 95% confidence interval [CI]) in infant outcomes (gestation, birthweight, length, head circumference, ponderal index) and relative to each disease, including infertility after adjusting for age, body mass index, and infertility treatment. Result(s): Prevalence of parental chronic diseases ranged from <1% to 19%, and 21% to 54% for infertility. Maternal hypertension was negatively associated with gestation (β, −0.64; 95% CI, −1.03, −0.25) and birthweight (−151.98; −262.30, −41.67) as was asthma and birthweight (−75.01; −130.40, −19.62). Maternal kidney disease was associated with smaller head circumference (−1.09; −2.17, −0.01), whereas paternal autoimmune disease was associated with larger head circumference (0.87; 0.15, 1.60). Infertility was negatively associated with birthweight (−62.18; −103.78, −20.58), length (−0.33; −0.60, −0.06), and head circumference (−0.35; −0.67, −0.03). Conclusion(s): Infertility was significantly associated with reduced infant size even after accounting for infertility treatment, although the magnitude of reduction varied by definition of infertility. Absence of pregnancy within a year of being at risk may be informative about health.