Perinatal and childhood risk factors for inflammatory bowel disease: a case-control study

To determine whether exposure to a measles epidemic in utero or in infancy is a risk factor for the development of Crohn's disease, and to determine whether such an association can be found in individuals with subacute sclerosing panencephalitis (SSPE), a condition in which early infection with measles is known to be of aetiological importance.

A postal questionnaire was sent to 16,875 members of two national inflammatory bowel disease patient support groups. A control group was composed of friends or neighbours. Birth data were compared with the dates of measles epidemics and six possible periods of susceptibility were examined. Birth data from a national register of patients with SSPE were analysed similarly. Previously identified risk factors were also examined.

The answers from 2522 members and 2379 controls were analysed. We found no evidence of an association between the development of Crohn's disease and exposure to a measles epidemic. The birth dates of both groups were distributed normally throughout the year. No other early risk factor for the development of inflammatory bowel disease was detected. Exposure to a measles epidemic before the age of 1 year did not emerge as a risk factor for SSPE.

These data contradict reports from a recent study in central Sweden, but relatively early exposure to measles in childhood may still be a risk factor for the development of Crohn's disease.