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Adulthood mortality of infants isolated at birth due to tuberculosis in the family

Department of Psychiatry, University of Oulu, Finland, jveijola{at}cc.oulu.fi

Pirjo H. Mäki

Department of Psychiatry, University of Oulu, Finland

Matti I. Joukamaa

Department of Psychiatry, University of Oulu, Finland

Esa Läärä

Department of Mathematical Sciences, University of Oulu, Finland

Helinä Hakko

Department of Psychiatry, University of Oulu, Finland

Markku M. Nieminen

Department of Pulmonary Diseases, Tampere University Hospital, Finland

Matti K. Isohanni

Department of Psychiatry, University of Oulu, Finland

Aims: In 1936 the Finnish Anti-Tuberculosis Association founded the first nursery, ``Joulumerkkikoti '', into which infants born into tuberculous families were admitted and given BCG vaccination to reduce the risk of tuberculosis. This prophylactic regimen was effective in reducing infant mortality and morbidity of tuberculosis. We investigated the mortality of these children later in childhood and adulthood. Methods: The index cohort consisted of 3,020 subjects born between 1945 and 1965 in Finland and isolated from their family immediately after birth. The average separation time was 218 days. The subjects alive on 1 January 1971 were identified. For every index subject two reference subjects were chosen, the matching criteria being sex, year, and place of birth. Data on causes of deaths were obtained from the Finnish Cause of Death Registry by the end of 1998. Results: The relative mortality rate (RR) was higher in the index cohort than in the reference cohort for all causes of death (RR 1.4; 95% CI 1.2—1.7), and particularly for unnatural deaths: RR 1.5 (1.1—1.9) for men and RR 1.9 (1.0—3.7) for women. Conclusions : The mortality in the index subjects later in childhood and adulthood was somewhat elevated. This may be explained by a variety of risks experienced during pregnancy, delivery, and childhood. The fall in the socioeconomic status of the family of origin due to tuberculosis may partially explain the result. Another interpretation is that the very early separation from the mother had unfavourable effects on later psychological developments in some children.

Key Words: follow-up • infant • isolation • maternal • mortality • separation • tuberculosis.

Scandinavian Journal of Public Health, Vol. 31, No. 1, 69-72 (2003)
DOI: 10.1080/14034940210133906


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