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Maternal and perinatal conditions and the risk of developing celiac disease during childhood
Fredinah Namatovu1, Cecilia Olsson2, Marie Lindkvist3
1Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden. fredinah.namatovu@epiph.umu.se.
Insights
Maternal factors like age and income may reduce celiac disease (CD) risk in children. However, elective cesarean delivery and maternal UTIs increase CD risk, suggesting early life microbial influences.
Area of Science:
- Pediatric Gastroenterology
- Environmental Epidemiology
- Reproductive Health
Background:
- Celiac disease (CD) incidence is rising globally, potentially linked to environmental and lifestyle shifts.
- Investigating early-life exposures is crucial for understanding CD development.
- Maternal, delivery, and neonatal factors may significantly influence childhood CD onset.
Purpose of the Study:
- To examine the association between maternity, delivery, and neonatal period conditions and the risk of celiac disease in children.
- To identify specific risk and protective factors during early life for celiac disease development.
Main Methods:
- Utilized Swedish national registers for data on 1,912,204 children born between 1991 and 2009.
- Identified 6,596 children diagnosed with CD before age 15.
- Employed logistic regression analyses to assess associations between early-life factors and CD.
Main Results:
- Higher maternal age (≥35 years) and high maternal income were associated with reduced CD risk (OR 0.8 and 0.9, respectively).
- Elective cesarean delivery increased CD risk in boys (OR 1.2).
- Repeated maternal urinary tract infections increased CD risk in girls (OR 1.1), while maternal overweight and low birth weight showed protective associations.
Conclusions:
- Elective cesarean delivery and maternal urinary tract infections are linked to increased childhood CD risk, suggesting early-life dysbiosis.
- High maternal age and income may offer protection against CD, possibly through feeding practices and lifestyle.
- Childhood celiac disease risk is influenced by a complex interplay of maternal and neonatal factors.
Background:
Celiac disease (CD) is increasing worldwide, which might be due to the changing environmental and lifestyle exposures. We aimed to explore how conditions related to maternity, delivery and the neonatal period influence CD onset during childhood.
Methods:
Using Sweden's national registers we had access to information on 1 912 204 children born between 1991 and 2009, 6 596 of whom developed CD before 15 years of age. Logistic regression analyses were performed to determine how CD is associated with maternity, delivery and the neonatal period.
Results:
Regardless of sex, a reduction in CD risk was observed in children born to mothers aged ≥35 years (odds ratio [OR] 0.8; 95 % confidence interval [CI] 0.7-0.9) and with high maternal income (OR 0.9; 95 % CI 0.8-0.9). Being a second-born child, however, was positively associated with CD. Among boys, elective caesarean delivery increased the risk of CD (OR 1.2; 95 % CI 1.0-1.4), while maternal overweight (OR 0.9; 95 % CI 0.8-0.9), premature rupture of the membrane (OR 0.4; 95 % CI 0.2-0.8) and low birth weight showed a negative association. Girls had an increased CD risk compared to boys and in girls the risk was increased by repeated maternal urinary tract infections (OR 1.1; 95 % CI 1.0-1.2).
Conclusions:
Elective caesarean delivery and repeated maternal urinary tract infections during pregnancy are associated with increased risk of CD onset during childhood, suggesting the role of dysbiosis during early life. High maternal age and high income reduced the risk of CD, which might be due to infant-feeding practices and life style.
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