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Prenatal and Perinatal Characteristics Associated with Pediatric-Onset Inflammatory Bowel Disease

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Abstract

Background

The majority of studies that report early life risk factors for pediatric-onset inflammatory bowel disease (IBD) do not account for potential confounding, which can lead to spurious associations and incorrect inferences.

Aims

To assess the relationship between prenatal and perinatal characteristics and the risk of pediatric-onset IBD accounting for potential confounding.

Methods

We conducted a nested case–control study of 189 cases aged ≤18 years and 3,080 age- and membership-matched controls born at a Kaiser Permanente Northern California facility between 1984 and 2006. The cases were diagnosed with IBD between 1996 and 2006 and diagnosis was confirmed by chart review. We obtained prenatal and perinatal characteristics from the electronic clinical records of the mother and child. Conditional logistic regression was used to assess the associations between these factors and risk of incident IBD, Crohn’s disease, and ulcerative colitis.

Results

In analyses accounting for confounding, maternal IBD (odds ratio [OR] 5.1, 95 % confidence interval [CI] 2.0–12.9) and white race (OR 2.3, 95 % CI 1.6–3.2) were the only factors statistically associated with pediatric-onset IBD. Maternal respiratory infection during pregnancy (OR 2.0, 95 % CI 1.0–4.0), age < 20 years (OR 2.0, 95 % CI 0.8–4.7) and gestational hypertension (OR 1.7, 95 % CI 1.0–2.7) were associated with pediatric-onset IBD, but did not achieve statistical significance.

Conclusions

Maternal history of IBD and race were the only characteristics of those that we examined that were associated with the development of pediatric IBD in this well-documented population of cases and matched controls.

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Acknowledgments

This study was funded by grant R40 MC 11266, through the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program (Herrinton); American Gastroenterology Association Graduate Student Research Award, Charlotte Ferencz Scholarship in Epidemiology and the Meyerhoff, Rosenwald and Weinman Family Funds (Hutfless); and NIH–NIDDK K24 DK060617 (Heyman). The funding sources did not play a role in the study design, collection, analysis, or interpretation of the data, nor in the writing of the report.

Conflict of interest

The authors have no potential competing interests.

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Johns Hopkins University, 600 N. Wolfe St., Blalock Building 449, Baltimore, MD, 21287, USA

    Susan Hutfless & Theodore M. Bayless

  2. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    De-Kun Li & Lisa J. Herrinton

  3. Department of Pediatrics, University of California, San Francisco, CA, USA

    Melvin B. Heyman

  4. Department of Pediatrics, Kaiser Permanente Medical Center, Santa Clara, CA, USA

    Oren Abramson

Authors
  1. Susan Hutfless
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  2. De-Kun Li
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  3. Melvin B. Heyman
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  4. Theodore M. Bayless
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  5. Oren Abramson
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  6. Lisa J. Herrinton
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Corresponding author

Correspondence to Susan Hutfless.

Appendix

Appendix

See Table 4.

Table 4 Specific infections of mothers during the prenatal period to 1 week after birth
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Hutfless, S., Li, DK., Heyman, M.B. et al. Prenatal and Perinatal Characteristics Associated with Pediatric-Onset Inflammatory Bowel Disease. Dig Dis Sci 57, 2149–2156 (2012). https://doi.org/10.1007/s10620-012-2128-1

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  • DOI: https://doi.org/10.1007/s10620-012-2128-1

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