Brief Article
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World J Gastroenterol. Feb 14, 2011; 17(6): 743-749
Published online Feb 14, 2011. doi: 10.3748/wjg.v17.i6.743
Perinatal and early life risk factors for inflammatory bowel disease
Stephen E Roberts, Clare J Wotton, John G Williams, Myfanwy Griffith, Michael J Goldacre
Stephen E Roberts, John G Williams, College of Medicine, Swansea University, Swansea SA2 8PP, United Kingdom
Clare J Wotton, Myfanwy Griffith, Michael J Goldacre, Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Oxford OX3 7LF, United Kingdom
Author contributions: Goldacre MJ and Roberts SE designed the study; Roberts SE and Goldacre MJ reviewed the literature; Wotton CJ and Griffith M undertook the analyses; Roberts SE, Goldacre MJ and Williams JG interpreted the study findings and wrote the manuscript.
Supported by (in part) National Institute for Health Research, England, Grant No. NCCRCD ZRC/002/002/026
Correspondence to: Michael J Goldacre, Professor, Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road, Oxford OX3 7LF, United Kingdom.
Telephone: +44-1865-289377 Fax: +44-1865-289379
Received: July 10, 2010
Revised: August 16, 2010
Accepted: August 23, 2010
Published online: February 14, 2011

AIM: To investigate associations between perinatal risk factors and subsequent inflammatory bowel disease (IBD) in children and young adults.

METHODS: Record linked abstracts of birth registrations, maternity, day case and inpatient admissions in a defined population of southern England. Investigation of 20 perinatal factors relating to the maternity or the birth: maternal age, Crohn’s disease (CD) or ulcerative colitis (UC) in the mother, maternal social class, marital status, smoking in pregnancy, ABO blood group and rhesus status, pre-eclampsia, parity, the infant’s presentation at birth, caesarean delivery, forceps delivery, sex, number of babies delivered, gestational age, birthweight, head circumference, breastfeeding and Apgar scores at one and five minutes.

RESULTS: Maternity records were present for 180 children who subsequently developed IBD. Univariate analysis showed increased risks of CD among children of mothers with CD (P = 0.011, based on two cases of CD in both mother and child) and children of mothers who smoked during pregnancy. Multivariate analysis confirmed increased risks of CD among children of mothers who smoked (odds ratio = 2.04, 95% CI = 1.06-3.92) and for older mothers aged 35+ years (4.81, 2.32-9.98). Multivariate analysis showed that there were no significant associations between CD and 17 other perinatal risk factors investigated. It also showed that, for UC, there were no significant associations with the perinatal factors studied.

CONCLUSION: This study shows an association between CD in mother and child; and elevated risks of CD in children of older mothers and of mothers who smoked.

Keywords: Crohn’s disease, Ulcerative colitis, Perinatal risk factors, Record linkage