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

Canova, Cristina; Ludvigsson, Jonas F.; Domenicantonio, Riccardo Di; Zanier, Loris; Amidei, Claudio Barbiellini; Zingone, Fabiana

doi:10.3390/ijerph17072409

Cited by 30 publications

(21 citation statements)

References 42 publications

(50 reference statements)

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“…The included studies were published between 2010 and 2020 (tables 1A-D): 11 cohort studies 22-32 and 11 case-control studies. [33][34][35][36][37][38][39][40][41][42][43] The studies were performed in Sweden (n=4), 27 30 35 36 the USA (n=5), 33 34 37 41 42 Italy (n=4), 22 29 32 43 Denmark (n=2), 23 31 Canada (n=2) 38 39 and one in the UK, 25 the Netherlands 26 and Finland. 40 There were two international studies, one in Denmark and Norway, 28 and another in Finland, Germany, Sweden and the USA.…”

Section: Study Characteristicsmentioning

confidence: 99%

Early life antibiotics and childhood gastrointestinal disorders: a systematic review

Kamphorst

Daele

Vlieger

et al. 2021

bmjpo

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BackgroundIn adults, there is increasing evidence for an association between antibiotic use and gastrointestinal (GI) disorders but in children, the evidence is scarce.ObjectiveAssess the association between exposure to antibiotics in the first 2 years of life in term born children and the presence of chronic GI disorders later in childhood.DesignFor this systematic review the MEDLINE, Embase, WHO trial register and Web of Science were systematically searched from inception to 8 June 2020. Title and abstract screening (n=12 219), full-text screening (n=132) as well as the quality assessment with the Newcastle-Ottawa Scale were independently performed by two researchers.Main outcome measuresThe association between antibiotics and inflammatory bowel disease (IBD) (n=6), eosinophilic oesophagitis (EoE) (n=5), coeliac disease (CeD) (n=6), infantile colics (n=3), functional constipation (n=2), recurrent abdominal pain, regurgitation, functional diarrhoea and infant dyschezia were examined.ResultsTwenty-two studies were included, 11 cohort and 11 case–control studies. A best evidence synthesis showed strong evidence for an association between antibiotic exposure in the first 2 years of life and the presence of IBD, and CeD during childhood. Moderate evidence was found for an association with EoE and no association with functional constipation in the first year of life. There was insufficient evidence for the other studied disorders.ConclusionsThe use of antibiotics in early life may increase the risk of GI disorders later in life. Further studies are necessary to unravel the underlying mechanisms and determine potential preventive measures. Meanwhile judicious use of antibiotics in early childhood is highly warranted.PROSPERO registration numberPROSPERO CRD42019132631.

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Section: Study Characteristicsmentioning

confidence: 99%

Early life antibiotics and childhood gastrointestinal disorders: a systematic review

Kamphorst

Daele

Vlieger

et al. 2021

bmjpo

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“…Given recent evidence suggesting that antibiotic exposure in the first year of life is associated with both IBD [9,40] and asthma [42,43], a sensitivity analysis adjusted for this exposure was performed on 70 IBD cases and 700 references (analyses restricted to children born after 1994). Antibiotic exposure in the first year of life showed a non-significant increased risk of asthma at 3 years (OR 1.62 95% CI 0.91-2.69).…”

Section: Resultsmentioning

confidence: 99%

“…On the basis of the age at IBD diagnosis, childhood onset IBD was categorized in three groups: pediatric IBD between 10 and 17 years (Paris classification A1b), EO-IBD between 0 and 9 years (Paris classification A1a), and VEO-IBD between 0 and 5 years [8,40].…”

Section: Ibd Definitionmentioning

confidence: 99%

Risk of Prevalent Asthma among Children Affected by Inflammatory Bowel Disease: A Population-Based Birth Cohort Study

Amidei

Zingone

Zanier³

et al. 2020

IJERPH

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Literature on the risk of asthma among children with inflammatory bowel disease (IBD) is limited and has reported discording results. To the best of our knowledge, no previous study has evaluated the association between asthma and childhood onset IBD, focusing on pediatric IBD with onset between 10 and 17 years, early-onset IBD (EO-IBD) between 0 and 9 years, and very early-onset IBD (VEO-IBD) between 0 and 5 years, all conditions characterized by different clinical progressions. A nested matched case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) of asthma among children with IBD compared with controls. We found 162 children with IBD and 1620 controls. Overall, childhood onset IBD was associated with increased risks of being affected by asthma (OR: 1.49 95% CI 1.05–2.12), although a significant risk was only present among males (OR: 1.60 95% CI 1.02–2.51). Children with Crohn’s disease and ulcerative colitis had similarly increased risks, although they failed to attain statistical significance. Risks of asthma based on age at IBD onset were inversely related to age, with the lowest non-significant risks for pediatric IBD and EO-IBD, while children affected by VEO-IBD had the highest risk of asthma (OR: 2.75 95% CI 1.26–6.02). Our study suggests the presence of a higher prevalence of asthma among both male children with IBD and children with VEO-IBD. It could be advisable to pay greater attention to possible respiratory symptoms among these categories at higher risk.

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“…This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on perinatal and postnatal exposures and adverse pregnancy, maternal, fetal and neonatal outcomes through population-based birth cohort studies, with a specific focus on real-word data. The 12 accepted articles covered a wide range of themes that can be addressed specifically through birth cohort study design; however, only three were based on real word data with record-linkage to HADs [ 10 , 11 , 12 ].…”

mentioning

confidence: 99%

“…Two papers focused on inflammatory bowel diseases, both as an outcome of perinatal and antibiotic exposure in early life and as a condition associated with asthma, among children identified in a birth cohort [ 11 , 12 ]. Both exposures and comorbidities were assessed by means of HADs, using a matched case-control design nested in a population-based birth cohort of more than 213,000 individuals born between 1989 and 2012, and resident in the Region of Friuli-Venezia Giulia (Italy).…”

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confidence: 99%

Population-Based Birth Cohort Studies in Epidemiology

Canova

Cantarutti

2020

IJERPH

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Birth cohort studies are the most appropriate type of design to determine the causal relationship between potential risk factors during the prenatal or postnatal period and the health status of the newborn up to childhood and potentially adulthood. To date, there has been a growth in interest regarding observational population-based studies which are performed to provide answers to specific research questions for defined populations, for instance, assessing the exposure to environmental pollutants or drugs on the risk of developing a disease. Birth cohorts based on the recruitment and active follow-up of mothers and children allow the collection of biological material, and specific clinical and genetic information. However, they require a considerable amount of time and resources and, besides being usually of limited size, they are exposed to the risk of the loss of subjects to follow-up, with decreased statistical power and possible selection bias. For these reasons, linking the medical birth register with administrative health records for mothers and babies is increasingly being used in countries with a universal healthcare system, allowing researchers to identify large and unselected populations from birth, and to reconstruct relevant traits and care pathways of mothers and newborns. This Special Issue of the International Journal of Environmental Research and Public Health focuses on the current state of knowledge on perinatal and postnatal exposures and adverse pregnancy, maternal, fetal and neonatal outcomes through population-based birth cohort studies, with a specific focus on real-word data. The 12 accepted articles covered a wide range of themes that can be addressed specifically through birth cohort study design; however, only three were based on real word data with record-linkage to health administrative databases. In particular, two papers have addressed the topic of socioeconomic status considering several indicators both at the individual and contextual level. Two papers focused on inflammatory bowel diseases, both as an outcome of perinatal and antibiotic exposure in early life and as a condition associated with asthma, among children identified in a birth cohort based on a Regional Medical Birth Register. Three articles focused on medication use during pregnancy and its impact on maternal and fetal health. The effect of exposure to prenatal environmental risk factors on perinatal and childhood outcomes has been considered in two papers. Two papers analyzed ad hoc nationwide prospective birth cohorts set in Japan and UK. Finally, we included a systematic review with meta-analysis to evaluate the relation between growth restriction at birth and congenital heart defects. We think that this Special Issue may contribute to enriching the discussion of future challenges, opportunities, strengths and limitations for all research topics that can be investigated using a population-based birth cohort study design.

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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

Cited by 30 publications

References 42 publications

Early life antibiotics and childhood gastrointestinal disorders: a systematic review

Early life antibiotics and childhood gastrointestinal disorders: a systematic review

Risk of Prevalent Asthma among Children Affected by Inflammatory Bowel Disease: A Population-Based Birth Cohort Study

Population-Based Birth Cohort Studies in Epidemiology

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