基于挪威母婴前瞻性队列研究的儿童乳糜泻发病围产期危险因素。
Perinatal risk factors for development of celiac disease in children, based on the prospective Norwegian Mother and Child Cohort Study.
作者信息
Emilsson Louise, Magnus Maria Christine, Størdal Ketil
机构信息
Primary Care Research Unit, Vårdcentralen Värmlands Nysäter, County Council of Värmland, Sweden; Department of Health Management and Health Economy, Institute of Health and Society, University of Oslo, Oslo, Norway.
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
出版信息
Clin Gastroenterol Hepatol. 2015 May;13(5):921-7. doi: 10.1016/j.cgh.2014.10.012. Epub 2014 Oct 18.
BACKGROUND & AIMS: There have been inconsistent reports of prenatal and perinatal factors that affect risk for development of celiac disease. We assessed the association of fetal growth, birth weight, and mode of delivery with development of celiac disease within the Norwegian Mother and Child (MoBa) Cohort Study.
METHODS
The MoBa cohort contains pregnancy information on 95,200 women and data on their 114,500 children, which were collected in Norway from 1999 through 2008; it is linked to the Medical Birth Registry. Women and children with celiac disease were identified from the National Patient Registry and from women's responses to MoBa questionnaires. We calculated odds ratios (ORs) for celiac disease by using a multivariable logistic regression model, adjusting for maternal celiac disease, sex of children, and children's age (model 1); in a second model, we adjusted for age of gluten introduction and duration of breastfeeding (model 2).
RESULTS
We identified 650 children with celiac disease and 107,828 controls in the MoBa database. We found no association between birth weight or height with celiac disease (born small for gestational age was not associated). Celiac disease was not associated with mode of delivery (cesarean section, model 1: OR, 0.84; 95% confidence interval [CI], 0.65-1.09, and model 2: OR, 0.83; 95% CI, 0.63-1.09). Maternal celiac disease, adjusted for age and sex of the children (OR, 12.45; 95% CI, 8.29-18.71) and type 1 diabetes (model 1: OR, 2.58; 95% CI, 1.19-5.53, and model 2: OR, 2.61; 95% CI, 1.14-5.98) were associated with development of celiac disease in children, whereas maternal type 2 diabetes and gestational diabetes were not.
CONCLUSIONS
On the basis of analysis of the Norwegian MoBa cohort, development of celiac disease in children is significantly associated with sex of the child, maternal celiac disease, and type 1 diabetes but not with intrauterine growth.
背景与目的
关于影响乳糜泻发生风险的产前和围产期因素，已有不一致的报道。我们在挪威母婴队列研究（MoBa）中评估了胎儿生长、出生体重和分娩方式与乳糜泻发生之间的关联。
方法
MoBa队列包含1999年至2008年在挪威收集的95200名女性的妊娠信息及其114500名子女的数据；该队列与医疗出生登记处相关联。通过国家患者登记处和女性对MoBa问卷的回答来确定患有乳糜泻的女性和儿童。我们使用多变量逻辑回归模型计算乳糜泻的比值比（OR），并对母亲的乳糜泻、孩子的性别和孩子的年龄进行校正（模型1）；在第二个模型中，我们对麸质引入年龄和母乳喂养持续时间进行校正（模型2）。
结果
我们在MoBa数据库中确定了650名患有乳糜泻的儿童和107828名对照。我们发现出生体重或身高与乳糜泻之间无关联（小于胎龄儿无关联）。乳糜泻与分娩方式无关（剖宫产，模型1：OR为0.84；95%置信区间[CI]为0.65 - 1.09，模型2：OR为0.83；95%CI为0.63 - 1.09）。校正孩子的年龄和性别后，母亲的乳糜泻（OR为12.45；95%CI为8.29 - 18.71）和1型糖尿病（模型1：OR为2.58；95%CI为1.19 - 5.53，模型2：OR为2.61；95%CI为1.14 - 5.98）与儿童乳糜泻的发生相关，而母亲的2型糖尿病和妊娠期糖尿病则无关。
结论
基于对挪威MoBa队列的分析，儿童乳糜泻的发生与孩子的性别、母亲的乳糜泻和1型糖尿病显著相关，但与子宫内生长无关。
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