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Pre- and Perinatal Factors Predicting Inflammatory Bowel Disease: A Population-Based Study with Fifty Years of
Monica Velosa1, Hagit Hochner2, Baruch Yerushalmi3
1The Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel.
Insights
Pre- and perinatal factors influence inflammatory bowel disease (IBD) risk. Low birth weight appears protective, while being the firstborn increases Crohn
Area of Science:
- Gastroenterology
- Epidemiology
- Perinatal Medicine
Background:
- Pre- and perinatal events are potential risk factors for inflammatory bowel disease (IBD).
- Longitudinal population-based studies are crucial for understanding IBD etiology.
- Investigating early-life factors may reveal novel insights into IBD development.
Purpose of the Study:
- To examine the association between pre- and perinatal factors and the risk of developing IBD.
- To identify specific early-life exposures that predict IBD incidence.
- To inform potential early diagnosis and intervention strategies for IBD.
Main Methods:
- Nested case-control study design.
- Utilized the Jerusalem Perinatal Study (JPS) cohort (n=90,079) with 50-year follow-up.
- Linked JPS data with the Israeli IBD Research Nucleus (epi-IIRN) database for IBD case identification and matched controls.
Main Results:
- Identified 746 IBD cases (405 Crohn's disease [CD], 341 ulcerative colitis [UC]) and 2043 controls.
- Non-western family origin was associated with decreased odds of CD and UC.
- Low birth weight (≤2500g) showed a protective effect, particularly for UC.
- Being the firstborn was linked to increased CD risk, while more older siblings decreased CD risk.
- High socioeconomic status was associated with CD, but not UC.
Conclusions:
- Several pre- and perinatal variables are significant predictors of IBD development.
- Findings may aid in developing early diagnosis and family follow-up protocols for IBD.
- This study highlights the importance of early-life factors in IBD pathogenesis.
Background:
Pre- and perinatal events may be associated with an increased risk of inflammatory bowel disease [IBD]. We aimed to investigate the role of pre- and perinatal factors as potential risk factors for the development of IBD in a population with a follow-up of 50 years.
Methods:
We conducted a nested case-control study, reporting IBD incidence among individuals born in 1964-76, for whom pre- and perinatal exposures were reported as part of the Jerusalem Perinatal Study [JPS], by linking them to the database of the epidemiology group of the Israeli IBD Research Nucleus [epi-IIRN], including all IBD patients in Israel since 2005 and their matched controls.
Results:
We identified 2789 individuals within the epi-IIRN cohort who were also included in the JPS cohort [n = 90 079]: 746 IBD patients (405 with Crohn's disease [CD] and 341 with ulcerative colitis [UC]) and 2043 non-IBD controls. Those with a 'Non-western' family origin had decreased odds of developing CD and UC. High socioeconomic status was associated with CD but not UC. Low birth weight [≤2500 g] occurred less frequently in IBD cases compared to controls, especially in UC patients, showing a protective effect. Being the first born was associated with CD, and having older siblings lowered the odds of developing CD, decreasing 7% with each additional sibling. Smoking and breastfeeding data were available for a subset of individuals, but neither was associated with IBD development.
Conclusion:
This population-based study identifies several pre- and perinatal variables as predictors of IBD development. This information may be helpful to facilitate implementation of early diagnosis interventions and family follow-up protocols.
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