Revisiting the risk of celiac disease in children born small for gestational age: A sibling design perspective

Wingren, Carl Johan; Agardh, Daniel; Merlo, Juan

doi:10.3109/00365521.2012.661760

Cited by 13 publications

(23 citation statements)

References 54 publications

(82 reference statements)

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“…It is worth noting that this study found no increased risk for CD in children diagnosed after the age of two (Table S1) . Other studies have also reported weak associations between paediatric CD and summer birth , and a US study found an association between spring birth and CD in boys diagnosed before 15 years of age . However, other studies have not found a significant association between birth season and CD .…”

Section: Season Of Birthcontrasting

confidence: 54%

“…The mechanism underlying this association is unknown, and although it is conceivable, we are not aware of any clear evidence suggesting that the CD pathogenesis differs for children diagnosed before or after the age of two. Secondly, some of the studies are from partly overlapping study populations .…”

Section: Season Of Birthmentioning

confidence: 99%

“…Carlsson et al found no association between cord blood enterovirus antibodies and subsequent CD , and maternal urinary tract infections during pregnancy have not been associated with CD in offspring . Antibiotic treatment in pregnancy is a proxy for maternal infections, and it is also a likely cause of perturbation of the infant microbiota , which may play a pathogenic role in CD .…”

Section: Perinatal Infections and Antibiotic Exposure In Pregnancymentioning

confidence: 99%

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Current evidence on whether perinatal risk factors influence coeliac disease is circumstantial

2015

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Section: Season Of Birthcontrasting

confidence: 54%

Section: Season Of Birthmentioning

confidence: 99%

Section: Perinatal Infections and Antibiotic Exposure In Pregnancymentioning

confidence: 99%

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Current evidence on whether perinatal risk factors influence coeliac disease is circumstantial

2015

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“…Moreover, the standard design normally does not consider the existence of paired cases in the sample (e.g., siblings), which violate the assumption of independence of observations. In this context, family designs have been applied to population-based registries providing robust quasi-experimental analyses [25]–[30]. The idea behind family designs is to approximate a counterfactual situation by examining the effects of different exposures (for e.g.…”

Section: Introductionmentioning

confidence: 99%

Revisiting the Effect of Maternal Smoking during Pregnancy on Offspring Birthweight: A Quasi-Experimental Sibling Analysis in Sweden

Juárez

Merlo

2013

PLoS ONE

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Maternal smoking during pregnancy (SDP) seems associated with reduced birthweight in the offspring. This observation, however, is based on conventional epidemiological analyses, and it might be confounded by unobserved maternal characteristics related to both smoking habits and offspring birth weight. Therefore, we apply a quasi-experimental sibling analysis to revisit previous findings. Using the Swedish Medical Birth Register, we identified 677,922 singletons born between 2002 and 2010 from native Swedish mothers. From this population, we isolated 62,941 siblings from 28,768 mothers with discrepant habits of SDP. We applied conventional and mother-specific multilevel linear regression models to investigate the association between maternal SDP and offspring birthweight. Depending on the mother was light or heavy smoker and the timing of exposition during pregnancy (i.e., first or third trimester), the effect of smoking on birthweight reduction was between 6 and 78 g less marked in the sibling analysis than in the conventional analysis. Sibling analysis showed that continuous smoking reduces birthweight by 162 grams for mothers who were light smokers (1 to 9 cigarettes per day) and 226 g on average for those who were heavy smokers throughout the pregnancy in comparison to non-smoker mothers. Quitting smoking during pregnancy partly counteracted the smoking-related birthweight reduction by 1 to 29 g, and a subsequent smoking relapse during pregnancy reduced birthweight by 77 to 83 g. The sibling analysis provides strong evidence that maternal SDP reduces offspring birthweight, though this reduction was not as great as that observed in the conventional analysis. Our findings support public health interventions aimed to prevent SDP and to persuade those who already smoke to quit and not relapse throughout the pregnancy. Besides, further analyses are needed in order to explain the mechanisms through which smoking reduces birthweight and to identify other maternal characteristics that are common causes of both birthweight reduction and maternal smoking.

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“…This disorder has been associated with neonatal mortality and morbidities2 as well as with major medical problems across the life course, such as a higher risk of neurodevelopmental impairments,3 4 autism,5 schizophrenia,6 impaired cognitive function,7 coeliac disease in boys8 and reduced bone mass during early infancy,9 as well as Barrett's oesophagus and oesophagitis10 11 and others 12 13. Therefore, the identification of maternal and newborn characteristics (denominated as ‘risk factors’ in the rest of this work) associated with an increased risk for SGA is of obvious relevance in public health and preventive medicine.…”

Section: Introductionmentioning

confidence: 99%

Applying measures of discriminatory accuracy to revisit traditional risk factors for being small for gestational age in Sweden: a national cross-sectional study

2014

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ObjectivesSmall for gestational age (SGA) is considered as an indicator of intrauterine growth restriction, and multiple maternal and newborn characteristics have been identified as risk factors for SGA. This knowledge is mainly based on measures of average association (ie, OR) that quantify differences in average risk between exposed and unexposed groups. Nevertheless, average associations do not assess the discriminatory accuracy of the risk factors (ie, its ability to discriminate the babies who will develop SGA from those that will not). Therefore, applying measures of discriminatory accuracy rather than measures of association only, our study revisits known risk factors of SGA and discusses their role from a public health perspective.DesignCross-sectional study. We measured maternal (ie, smoking, hypertension, age, marital status, education) and delivery (ie, sex, gestational age, birth order) characteristics and performed logistic regression models to estimate both ORs and measures of discriminatory accuracy, like the area under the receiver operating characteristic curve (AU-ROC) and the net reclassification improvement.SettingData were obtained from the Swedish Medical Birth Registry.ParticipantsOur sample included 731 989 babies born during 1987–1993.ResultsWe replicated the expected associations. For instance, smoking (OR=2.57), having had a previous SGA baby (OR=5.48) and hypertension (OR=4.02) were strongly associated with SGA. However, they show a very small discriminatory accuracy (AU-ROC≈0.5). The discriminatory accuracy increased, but remained unsatisfactorily low (AU-ROC=0.6), when including all variables studied in the same model.ConclusionsTraditional risk factors for SGA alone or in combination have a low accuracy for discriminating babies with SGA from those without SGA. A proper understanding of these findings is of fundamental relevance to address future research and to design policymaking recommendations in a more informed way.

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Revisiting the risk of celiac disease in children born small for gestational age: A sibling design perspective

Abstract: Our results support a causal association between SGA and CD risk in boys but not in girls, although the mechanisms underlying this difference are still unclear.

Cited by 13 publications

References 54 publications

Current evidence on whether perinatal risk factors influence coeliac disease is circumstantial

Current evidence on whether perinatal risk factors influence coeliac disease is circumstantial

Revisiting the Effect of Maternal Smoking during Pregnancy on Offspring Birthweight: A Quasi-Experimental Sibling Analysis in Sweden

Applying measures of discriminatory accuracy to revisit traditional risk factors for being small for gestational age in Sweden: a national cross-sectional study

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