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Fetal and perinatal risk factors for inflammatory bowel disease
Sara Aspberg1, Gisela Dahlquist, Thomas Kahan
1Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Internal Medicine, Stockholm, and Department of Clinical Science, Paediatrics, Umeå University, Sweden. sara.aspberg@ds.se
Insights
Maternal smoking in early pregnancy is linked to a reduced risk of inflammatory bowel disease (IBD) in children. Severe neonatal infections may increase this risk, suggesting early life exposures impact later IBD development.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Perinatal Medicine
Background:
- Inflammatory bowel disease (IBD) encompasses chronic conditions like ulcerative colitis and Crohn's disease.
- Understanding early life risk factors for IBD is crucial for prevention and early intervention.
Purpose of the Study:
- To investigate the impact of pregnancy and perinatal exposures on the risk of developing pediatric inflammatory bowel disease.
Main Methods:
- A Swedish population-based study utilizing national health registers (1987-2000).
- Identified 455 singleton infants diagnosed with IBD and compared their early life data with a control group.
Main Results:
- Maternal smoking during early pregnancy was associated with a reduced risk of IBD (OR 0.71).
- Specific reductions were observed for ulcerative colitis (OR 0.70) and Crohn's disease (OR 0.73).
- Neonatal infections showed a potential increase in IBD risk (OR 17.6), though based on limited cases.
Conclusions:
- Early pregnancy maternal smoking appears protective against childhood IBD hospitalization.
- Severe neonatal infections may be a risk factor for later IBD development.
- Fetal and neonatal exposures can influence the long-term risk of inflammatory bowel disease.
Aim:
To study the influence of specific factors and events during pregnancy and the perinatal period on the risk of children developing inflammatory bowel disease.
Methods:
Population-based national register study. Linkage between the Swedish Medical Birth Register and the Swedish Hospital Discharge Register during the period 1987 to 2000 identified 455 singleton infants who later developed inflammatory bowel disease. Data for these children were compared with data for all children born in Sweden during the same period.
Results:
Smoking during early pregnancy reduced the risk of inflammatory bowel disease (odds ratio (OR) 0.71, 95% CI 0.55-0.91). For ulcerative colitis the odds ratio was 0.70 (95% CI 0.56-0.86), and for Crohn's disease 0.73 (95% CI 0.58-0.94). Infections during the neonatal period seemed to increase the risk of inflammatory bowel disease (OR 17.6, 95% CI 3.6-51.6), but the number of observed events was small. The other factors examined did not influence the risk of inflammatory bowel disease.
Conclusion:
Maternal smoking during early pregnancy reduces the risk for the child to be hospitalized with a diagnosis of inflammatory bowel disease. Severe neonatal infections may increase the risk. Thus, some exposures during the fetal and neonatal period seem to affect the risk of inflammatory bowel disease later in life.
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