Courbette O, Girard-Bock C, Cloutier A, Luu TM, Nuyt AM, Faure C. Prematurity is a risk factor of disorders of gut-brain interaction in adults: A case-control study. World J Clin Pediatr 2025; 14(3): 103590 [DOI: 10.5409/wjcp.v14.i3.103590]
Corresponding Author of This Article
Olivier Courbette, MD, Department of Pediatric Gastroenterology, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte Ste Catherine, Montreal H3T1C5, Quebec, Canada. olivier.courbette@gmail.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Sep 9, 2025; 14(3): 103590 Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.103590
Prematurity is a risk factor of disorders of gut-brain interaction in adults: A case-control study
Olivier Courbette, Camille Girard-Bock, Anik Cloutier, Thuy Mai Luu, Anne Monique Nuyt, Christophe Faure
Olivier Courbette, Christophe Faure, Department of Pediatric Gastroenterology, Sainte-Justine University Hospital Center, Montreal H3T1C5, Quebec, Canada
Camille Girard-Bock, Anik Cloutier, Thuy Mai Luu, Anne Monique Nuyt, Department of Pediatrics, Sainte-Justine University Hospital Research Center, Montreal H3T1C5, Quebec, Canada
Author contributions: Courbette O performed the statistical analysis; Courbette O and Faure C contributed to the concept and design of the study and draft the article; Courbette O, Girard-Bock C, Cloutier A, Luu TM, Nuyt AM and Faure C contributed to the acquisition and analysis of the data; all authors have read and approve the final manuscript.
Supported by Sainte-Justine University Hospital Research Center excellence grant in 2020-2021.
Institutional review board statement: The study was reviewed and approved by the Sainte-Justine University Hospital Institutional Review Board (Approval No. 2019-1949).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at olivier.courbette@hpu.lenval.com on request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Olivier Courbette, MD, Department of Pediatric Gastroenterology, Sainte-Justine University Hospital Center, 3175 Chemin de la Côte Ste Catherine, Montreal H3T1C5, Quebec, Canada. olivier.courbette@gmail.com
Received: November 25, 2024 Revised: March 22, 2025 Accepted: April 15, 2025 Published online: September 9, 2025 Processing time: 204 Days and 12.4 Hours
Abstract
BACKGROUND
Disorders of gut-brain interaction (DGBI) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms. Early-life stressors have been implicated as possible contributing factors.
AIM
To determine if prematurity and neonatal factors influence the development of DGBI in adults.
METHODS
A case-control study was carried out at a tertiary referral center from July 2019 to July 2021. Cases (adults born with extremely premature < 29 weeks of gestation) were recruited from the Health of Adults Born Preterm Investigation cohort. Control subjects were recruited from the general population. All participants completed the Rome IV diagnostic questionnaire online. Cases completed anxiety and depression questionnaires (Patient-Reported Outcomes Measurement Information System-29 items, Generalized Anxiety Disorder-7 items, Patient Health Questionnaire-9 items). Neonatal data and sociodemographic status were collected.
RESULTS
A total of 79 cases and 124 controls were enrolled in the study. The group of adults born preterm exhibited a significantly higher prevalence of functional bowel disorders (P = 0.01) and a trend suggesting a higher prevalence of functional gastroduodenal disorders (P = 0.06). Among women born prematurely, the prevalence of functional gastroduodenal disorders, functional bowel disorders, and functional constipation was significantly higher compared to the female control group (P = 0.02 for all). The identified risk factors are categorized as directly linked to prematurity (e.g., chorioamnionitis), indirectly related to prematurity (e.g., anxiety, depression, and social skills as consequences of prematurity), or independent of prematurity (e.g., female sex).
CONCLUSION
This is the first case-control study reporting the prevalence of DGBI in a cohort of well-characterized adults born prematurely. We confirm that prematurity is a risk factor for developing a DGBI.
Core Tip: In this study, using the Rome IV questionnaire, we assessed the prevalence of different disorders of gut-brain interaction (DGBI) in two populations: (1) Full-term; and (2) Preterm adults. Subsequently, we compared the results between these two populations and analyzed the risk factors for DGBI in the population of adults born prematurely using regression analysis. The group of adults born prematurely has a higher frequency of functional bowel problems. Functional constipation and functional gastroduodenal problems are substantially more common in prematurely born women than in controls. Ultimately, we confirm that extreme prematurity is a risk factor for developing a DGBI.
