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Early life events in functional abdominal pain disorders in children
Amaranath Karunanayake1, Niranga Manjuri Devanarayana2, Shaman Rajindrajith3
1Department of Physiology, University of Ruhuna, Galle, Sri Lanka.
Insights
Adverse early life events like prenatal complications and assisted deliveries increase the risk of functional abdominal pain disorders (FAPDs) in children. Prolonged breastfeeding may reduce FAPD prevalence.
Area of Science:
- Pediatric Gastroenterology
- Neurogastroenterology
- Developmental Pediatrics
Background:
- Functional abdominal pain disorders (FAPDs) are prevalent in children and multifactorial in origin.
- Adverse early life events (ELE) may alter the central nervous system, predisposing children to FAPDs.
Purpose of the Study:
- To investigate the association between adverse early life events (ELE) and the development of functional abdominal pain disorders (FAPDs) in children.
Main Methods:
- A school-based survey of 1000 children was conducted.
- FAPDs were assessed using the Rome III questionnaire, and ELE were identified via parental questionnaires.
- Binary logistic regression analysis was employed to identify risk factors.
Main Results:
- 182 children (15.2%) were diagnosed with FAPDs.
- Risk factors identified include family history of abdominal or chronic pain, prenatal maternal complications, and interventional deliveries.
- Breastfeeding for over two years was associated with a reduced prevalence of FAPDs.
Conclusions:
- Prenatal maternal medical problems are linked to a higher prevalence of childhood FAPDs.
- Prolonged breastfeeding and normal vaginal delivery may reduce FAPD vulnerability.
- Preventive strategies could involve minimizing pregnancy complications, encouraging vaginal births, and promoting breastfeeding.
Objectives:
Functional abdominal pain disorders (FAPDs) are common gastrointestinal problems in children, and the pathophysiology is thought to be multifactorial. Adverse early life events (ELE) induce alterations in the central nervous system, perhaps predisposing individuals to develop FAPDs. We aimed to study the potential adverse ELE that are associated with FAPDs.
Methods:
We steered a school-based survey involving 1000 children from 4 randomly selected schools. FAPDs were assessed using the translated Rome III questionnaire, and ELE were identified using a pre-tested, parental questionnaire. FAPDs were diagnosed using the Rome III criteria.
Results:
Hundred and eighty-two (182) children had FAPDs (62.1% girls, mean age 8.5, SD 2.1). ELE of them were compared with 571 children without FAPDs (51.1% girls, mean age 8.8, SD 1.9). According to the binary logistic regression analysis, family members with abdominal pain, family member with chronic pain other than abdominal pain, prenatal maternal complications and interventional deliveries, were recognized as potential risk factors for the development of FAPDs. Breast feeding over two years has shown to reduce the prevalence of FAPDs.a.
Conclusions:
Prenatal maternal medical problems are associated a with higher prevalence of FAPDs later in life. Prolonged breastfeeding and normal vaginal delivery could be considered as factors that reduce the vulnerability of developing FAPDs in children. Therefore, minimizing pregnancy-related complications, encouraging vaginal deliveries, and encouraging breastfeeding are potentially valuable measures to prevent FAPDs during childhood.
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