Do Maternal and Neonatal Factors Predict Long-term Child Health and Health Care Utilization?

Normal development of the fetus during pregnancy is important for the child's future health. Development of the fetus in turn is influenced by the mother's health before and during pregnancy. The negative influence of growth abnormalities and maternal health problems on the short-term health after birth are well described. However, recent studies also increasingly recognize the importance of pregnancy- and birth-related factors for the long-term health of the child. For instance, excess maternal weight and low birth weight put a child at an increased risk for heart disease later in life. These trans-generational and life course health issues that have their origin in pregnancy or earlier likely constitute a considerable burden to the health care system. Predictions of these long-term health care costs will aid resource allocation planning and will allow policy makers to weigh prevention strategy costs against future health care cost savings. To examine the health care costs incurred as a result of poor maternal or infant health, we propose a follow-up study of 50,000 infants born in Nova Scotia between 1989 and 1993 and followed through 2012. Detailed data on the mothers and children in the study are available through the Nova Scotia Atlee Perinatal Database and Nova Scotia administrative health databases. We will use mathmatical modeling to identify pregnancy- and birth-related determinants of long-term health and health care use in the offspring. We will also develop a prediction model that will quantify the impact of the health of the mother and infant on future health care costs. The project greatly expands on previous literature by extending the evaluation period well beyond the neonatal period thereby providing information on the influence of pregnancy- and birth-related factors on the health on Nova Scotia children that is relevant to researchers, clinicians, and policymakers alike.