Maternal pre-pregnancy weight status and health care use for mental health conditions in the offspring

Abstract

Objectives: The objective of this study was to examine the relationship between pre-pregnancy maternal weight status and offspring physician visits for mental health conditions in childhood and adolescence. Methods: We conducted a population-based retrospective cohort study of singleton infants born between the years of 1989 and 1993 using a linkage of the Nova Scotia Atlee Perinatal Database with administrative health data. Offspring were followed from birth to age 18 years. Maternal weight status was categorized according to WHO body mass index cutoffs. The number of physician visits for any mental health condition, mood, anxiety, and adjustment disorders, conduct disorder, and attention deficit hyperactivity disorder (ADHD) from age 0-18 years was determined from ICD codes in physician billings and hospital discharge abstract data. Compound Poisson regression adjusting for sociodemographics, maternal psychiatric disorders and smoking was used to model the association. Results: In total, 38,211 mother-offspring pairs were included in the cohort. Within the first 18 years of life, offspring of mothers with obesity had significantly more physician visits for any mental health condition (adjusted incidence rate ratio [IRR] 1.21, 95% CI 1.14-1.28), mood, anxiety, and adjustment disorders (IRR 1.13, 95% CI 1.04-1.23), conduct disorder (IRR 1.16, 95% CI 1.17-2.11), and ADHD (IRR 1.44, 95% CI 1.19-1.74) compared to mothers of normal weight. Associations for mood, anxiety, and adjustment disorders and conduct disorder were strongest at 13-18 years. Conclusions: Offspring of mothers with obesity appear to use health care for mental health conditions more frequently than offspring of normal weight mothers.