Perinatal and Antibiotic Exposures and the Risk of Developing Childhood-Onset Inflammatory Bowel Disease: A Nested Case-Control Study Based on a Population-Based Birth Cohort

Cristina Canova, Jonas F Ludvigsson, Riccardo Di Domenicantonio, Loris Zanier, Claudio Barbiellini Amidei and Fabiana Zingone
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Cristina Canova: Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy
Jonas F Ludvigsson: Department Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
Riccardo Di Domenicantonio: Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy
Loris Zanier: Epidemiological Service, Health Directorate, 35131 Udine, Italy
Claudio Barbiellini Amidei: Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy
Fabiana Zingone: Department of Surgery, Oncology and Gastroenterology, Gastroenterology Section, University Hospital of Padua, 33100 Padua, Italy

IJERPH, 2020, vol. 17, issue 7, 1-13

Abstract: The role of early-life environmental exposures on Inflammatory Bowel Disease (IBD) onset remains unclear. We aimed to quantify the impact of perinatal conditions and antibiotic use in the first 6 and 12 months of life, on the risk of childhood-onset IBD, in a birth cohort of the region Friuli-Venezia Giulia (Italy). A nested case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate Odds Ratios (OR) with 95% confidence intervals (CI) for all analyzed risk factors. We identified 164 individuals with IBD onset before the age of 18 years and 1640 controls. None of the considered perinatal conditions were associated with IBD. Analyses on antibiotic exposure were based on 70 cases and 700 controls. Risks were significantly higher for children with ≥4 antibiotic prescriptions in the first 6 and 12 months of life (OR = 6.34; 95%CI 1.68–24.02 and OR = 2.91; 95%CI 1.31–6.45, respectively). This association was present only among patients with Crohn’s disease and those with earlier IBD onset. We found that perinatal characteristics were not associated to IBD, while the frequent use of antibiotics during the first year of life was associated to an increased risk of developing subsequent childhood-onset IBD.

Keywords: pediatric IBD; VEO-IBD; Crohn disease; ulcerative colitis; birth cohort study; epidemiology; real-world data; record linkage; perinatal and postnatal exposure; pharmacoepidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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