School of Medicine, Swansea University, Swansea, UK.
Aliment Pharmacol Ther. 2009 Jan;29(2):222-31. doi: 10.1111/j.1365-2036.2008.03871.x. Epub 2008 Oct 13.
Little is known about perinatal risk factors and coeliac disease.
To investigate the relationship between perinatal risk factors and subsequent coeliac disease among offspring.
Record linked abstracts of birth registrations, maternity, in-patient and day case records in a defined population of southern England.
Using univariate analysis, coeliac disease in the child was associated with maternal coeliac disease (odds ratio = 20.6; 95% CI = 5.04-84.0; based on two cases in both mother and child) and with social class, year of birth, maternal smoking and parity. Multivariate analysis confirmed an increased risk of coeliac disease of 3.79 (95% CI = 1.85-7.79) for classes IV and V compared with I and II, an increased risk of 1.92 (1.06-3.49) for births during 1975-1979 compared with 1970-1974 and an increased risk of 1.80 (1.05-3.09) for 'subsequent' compared with 'first' births. Smoking during pregnancy was no longer associated with coeliac disease. Because numbers were small, maternal coeliac disease was excluded from the multivariate analysis.
This study shows increased risks of coeliac disease for manual social classes, births during the late 1970s and 'subsequent' births. Overall, perinatal risk factors seem to have a limited role in the aetiology of coeliac disease in children and young adults.
围产期风险因素与乳糜泻之间的关系知之甚少。
调查围产期风险因素与后代乳糜泻之间的关系。
记录英国南部一个特定人群的出生登记、产妇、住院和日间病例记录的相关摘要。
使用单变量分析,儿童的乳糜泻与母亲的乳糜泻(比值比=20.6;95%置信区间=5.04-84.0;基于母亲和孩子各有两例)以及社会阶层、出生年份、母亲吸烟和产次有关。多变量分析证实,与 I 和 II 级相比,IV 和 V 级的乳糜泻风险增加 3.79(95%置信区间=1.85-7.79),与 1970-1974 年相比,1975-1979 年出生的乳糜泻风险增加 1.92(1.06-3.49),与“后续”出生相比,“首次”出生的乳糜泻风险增加 1.80(1.05-3.09)。怀孕期间吸烟与乳糜泻不再相关。由于数量较少,乳糜泻的母亲被排除在多变量分析之外。
本研究表明,乳糜泻的风险在体力劳动社会阶层、20 世纪 70 年代末出生和“后续”出生中增加。总的来说,围产期的风险因素在儿童和青年乳糜泻的发病机制中似乎作用有限。