Waehrens Rasmus, Li Xinjun, Sundquist Jan, Sundquist Kristina, Zöller Bengt
a Center for Primary Health Care Research, Lund University/Region Skåne , Malmö , Sweden.
Scand J Gastroenterol. 2018 May;53(5):559-566. doi: 10.1080/00365521.2017.1398345. Epub 2017 Nov 10.
Studies of the importance of perinatal factors for the development of irritable bowel syndrome (IBS) are sparse. We conducted a large national cohort study to examine perinatal and familial risk factors for IBS.
A national cohort of 1,963,685 persons who were born in Sweden in 1973-1992 (identified from the Swedish Birth Registry) were followed up for adult (18 years and older) IBS incidence in the Swedish Patient Register through 2010 (maximum age 38 years). There were 24,633 IBS cases in 46,784,296 person-years of follow-up.
After adjusting for potential confounders, significant risk factors for IBS included caesarean (HR = 1.10, 95% confidence interval [CI] 1.05-1.11, p < .001), low birth weight (<2500g) (HR = 1.11, 95%CI 1.01-1.22, p = .02), being second in birth order (HR = 1.04, 95%CI 1.01-1.08, p = .01), foetal growth ≥1 SD (HR = 1.06, 95%CI 1.00-1.11, p = .05), young maternal age (<20 years) (HR= 1.09, 95%CI 1.02-1.17, p = .02), maternal marital status (divorced/widowed) (HR = 1.12, 95%CI 1.08-1.17, p < .001), maternal education of 10-11 years (HR = 1.04, 95%CI 1.01-1.08, p = .01), maternal education of 12-14 years (HR = 1.06, 95%CI 1.01-1.11, p = .03), parental history of IBS (HR = 1.54, 95%CI 1.42-1.66, p < .001), parental history of anxiety (HR = 1.21, 95%CI 1.17-1.26, p < .001) and parental history of depression (HR = 1.09, 95%CI 1.02-1.17, p = .02). Protective factors were male sex (HR = 0.36, 95%CI 0.35-0.37, p < .001) and old maternal at delivery (≥35 years) (HR = 0.95, 95%CI 0.90-1.00, p = .03).
In this large cohort study, several perinatal and familial factors were associated with an increased risk of IBS independently, suggesting that perinatal and familial factors may play an important long-term role in the aetiology of IBS.
关于围产期因素对肠易激综合征（IBS）发病影响的研究较少。我们开展了一项大型全国队列研究，以探究IBS的围产期及家族风险因素。
选取1973年至1992年在瑞典出生的1,963,685人组成全国队列（数据源自瑞典出生登记处），通过瑞典患者登记处对其进行随访，直至2010年（最大年龄38岁），以了解成人（18岁及以上）IBS发病率。在46,784,296人年的随访期内，共出现24,633例IBS病例。
在对潜在混杂因素进行校正后，IBS的显著风险因素包括剖宫产（HR = 1.10，95%置信区间[CI] 1.05 - 1.11，p <.001）、低出生体重（<2500g）（HR = 1.11，95%CI 1.01 - 1.22，p =.02）、出生顺序为第二（HR = 1.04，95%CI 1.01 - 1.08，p =.01）、胎儿生长≥1个标准差（HR = 1.06，95%CI 1.00 - 1.11，p =.05）、母亲年龄较小（<20岁）（HR = 1.09，95%CI 1.02 - 1.17，p =.02）、母亲婚姻状况（离婚/丧偶）（HR = 1.12，95%CI 1.08 - 1.17，p <.001）、母亲受教育年限为10 - 11年（HR = 1.04，95%CI 1.01 - 1.08，p =.01）、母亲受教育年限为12 - 14年（HR = 1.06，95%CI 1.01 - 1.11，p =.03）、父母有IBS病史（HR = 1.54，95%CI 1.42 - 1.66，p <.001）、父母有焦虑病史（HR = 1.21，95%CI 1.17 - 1.26，p <.00
