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Asymptomatic bacteriuria (ASB) is a well-acknowledged infectious entity during pregnancy; yet its long-term implications are not well investigated. The present study aimed to test the association between maternal ASB during pregnancy and long-term offspring infectious hospitalizations. A population-based cohort analysis was conducted, comparing the incidence of long-term infectious-related hospitalizations of offspring born to mothers who were diagnosed with ASB during pregnancy, and those who did not have ASB. The study was conducted at a tertiary medical center and included all singleton deliveries between the years 1991 and 2014. Infectious morbidities were based on a predefined set of International Classification of Disease-9 codes. A Kaplan−Meier survival curve compared cumulative infectious hospitalization incidence between the groups, and a Cox regression model was used to adjust for confounding variables. During the study period, 212,984 deliveries met inclusion criteria. Of them, 5378 (2.5%) were diagnosed with ASB. As compared to offspring of non-ASB mothers, total long-term infectious hospitalizations were significantly higher among children to mothers who were diagnosed with ASB (13.1% vs. 11.1%, OR = 1.2, 95% CI 1.11–1.30, P ≤ 0.001). Likewise, a Kaplan−Meier curve demonstrated higher cumulative incidence of infectious hospitalizations among children born to mothers with ASB (log rank, P = 0.006). In the Cox regression model, while controlling for maternal age, diabetes mellitus, ethnicity, hypertensive disorders, and gestational age, maternal ASB was noted as an independent risk factor for long-term infectious morbidity in the offspring (adjusted HR = 1.1, 95% CI 1.01–1.17, P = 0.042). ASB during pregnancy increases offspring susceptibility to long-term infectious hospitalizations.

A population-based cohort analysis including singleton pregnancies delivered between the years 1991 to 2014 in a tertiary referral hospital was conducted. Incidence of hospitalizations (up to age 18 years) due to various gastro-intestinal diseases was compared between offspring of GDM-complicated pregnancies and normoglycemic pregnancies. Gastro-intestinal related morbidities included hospitalizations involving a pre-defined set of ICD-9 codes. Mothers with pregestational diabetes, insufficient prenatal care, infants with congenital malformations, multiple gestations, and perinatal deaths were excluded from the analysis. Kaplan-Meyer curves were used to assess cumulative hospitalization incidence. Cox proportional hazards model was used to control for baseline selected confounders. RESULTS: The study population included 218,989 newborns which met the inclusion criteria; among them 4.4% (9,534) were born to mothers with GDMA1 and 0.3% were born to mothers with GDMA2. During the follow-up period, there was not significant high rate of gastro-intestinal morbidity among children exposed in utero to GDM (5.7% of those without exposure to GDM vs. 5.4% of those who were exposed to GDM, p¼0.219). Some specific gastro-intestinal morbidities such as gastro-duodenal and appendix morbidities were higher among those exposed to GMD in utero (p¼0.004). While adjusting for confounders the association remained non significant with an adjusted hazards ratio of 0.87 (95% CI 0.90-1.07, p¼0.771). Using a Kaplan-Meier survival curve, children exposed to GDM did not have a significantly higher cumulative incidence of long term gastro-intestinal morbidity (Log Rank¼0.182). CONCLUSION: There is no significant association between GDM and the rate of overall gastro-intestinal hospitalizations of the offspring, but among the study population offspring born to mothers with GDM have significant higher rate of specific gastro-intestinal morbidities.

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