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Risk of Prevalent Asthma among Children Affected by Inflammatory Bowel Disease: A Population-Based Birth Cohort Study
Claudio Barbiellini Amidei1, Fabiana Zingone2, Loris Zanier3
1Unit of biostatistics, Epidemiology and Public Health. Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35100 Padua, Italy.
Insights
Children with inflammatory bowel disease (IBD) face a higher risk of asthma, particularly males and those with very early-onset IBD (VEO-IBD). Increased vigilance for respiratory symptoms in these groups is recommended.
Area of Science:
- Pediatric gastroenterology
- Respiratory medicine
- Epidemiology
Background:
- Limited and conflicting literature exists on asthma risk in children with inflammatory bowel disease (IBD).
- Previous studies have not specifically analyzed asthma association with different childhood IBD onset types: pediatric IBD (10-17 years), early-onset IBD (EO-IBD, 0-9 years), and very early-onset IBD (VEO-IBD, 0-5 years).
- These IBD subtypes exhibit distinct clinical progressions.
Purpose of the Study:
- To investigate the association between childhood-onset IBD and the risk of asthma.
- To differentiate asthma risk based on specific IBD onset age categories (pediatric, EO-IBD, VEO-IBD).
- To identify specific subgroups of children with IBD at higher risk for asthma.
Main Methods:
- A nested matched case-control design utilizing a longitudinal cohort of 213,515 newborns.
- Conditional binomial regression models were employed to calculate odds ratios (OR) and 95% confidence intervals (CI).
- Comparison of asthma risk between children with IBD (n=162) and matched controls (n=1620).
Main Results:
- Overall, childhood-onset IBD was associated with an increased risk of asthma (OR: 1.49, 95% CI 1.05-2.12).
- A significant asthma risk was observed in males with IBD (OR: 1.60, 95% CI 1.02-2.51).
- Children with VEO-IBD showed the highest asthma risk (OR: 2.75, 95% CI 1.26-6.02), while pediatric IBD and EO-IBD risks were not statistically significant.
Conclusions:
- Childhood-onset IBD is linked to a higher prevalence of asthma, particularly in males and children with VEO-IBD.
- The risk of asthma appears inversely related to the age of IBD onset.
- Enhanced monitoring for respiratory symptoms is advised for male children with IBD and those with VEO-IBD.
Abstract:
Literature on the risk of asthma among children with inflammatory bowel disease (IBD) is limited and has reported discording results. To the best of our knowledge, no previous study has evaluated the association between asthma and childhood onset IBD, focusing on pediatric IBD with onset between 10 and 17 years, early-onset IBD (EO-IBD) between 0 and 9 years, and very early-onset IBD (VEO-IBD) between 0 and 5 years, all conditions characterized by different clinical progressions. A nested matched case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) of asthma among children with IBD compared with controls. We found 162 children with IBD and 1620 controls. Overall, childhood onset IBD was associated with increased risks of being affected by asthma (OR: 1.49 95% CI 1.05-2.12), although a significant risk was only present among males (OR: 1.60 95% CI 1.02-2.51). Children with Crohn's disease and ulcerative colitis had similarly increased risks, although they failed to attain statistical significance. Risks of asthma based on age at IBD onset were inversely related to age, with the lowest non-significant risks for pediatric IBD and EO-IBD, while children affected by VEO-IBD had the highest risk of asthma (OR: 2.75 95% CI 1.26-6.02). Our study suggests the presence of a higher prevalence of asthma among both male children with IBD and children with VEO-IBD. It could be advisable to pay greater attention to possible respiratory symptoms among these categories at higher risk.
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