Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy.
Department Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
Int J Environ Res Public Health. 2020 Apr 2;17(7):2409. doi: 10.3390/ijerph17072409.
The role of early-life environmental exposures on Inflammatory Bowel Disease (IBD) onset remains unclear. We aimed to quantify the impact of perinatal conditions and antibiotic use in the first 6 and 12 months of life, on the risk of childhood-onset IBD, in a birth cohort of the region Friuli-Venezia Giulia (Italy). A nested case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate Odds Ratios (OR) with 95% confidence intervals (CI) for all analyzed risk factors. We identified 164 individuals with IBD onset before the age of 18 years and 1640 controls. None of the considered perinatal conditions were associated with IBD. Analyses on antibiotic exposure were based on 70 cases and 700 controls. Risks were significantly higher for children with ≥4 antibiotic prescriptions in the first 6 and 12 months of life (OR = 6.34; 95%CI 1.68-24.02 and OR = 2.91; 95%CI 1.31-6.45, respectively). This association was present only among patients with Crohn's disease and those with earlier IBD onset. We found that perinatal characteristics were not associated to IBD, while the frequent use of antibiotics during the first year of life was associated to an increased risk of developing subsequent childhood-onset IBD.
生命早期环境暴露对炎症性肠病（IBD）发病的作用尚不清楚。我们旨在量化围产期和生命最初 6 个月和 12 个月使用抗生素对儿童发病的 IBD 风险的影响，这是在意大利弗留利-威尼斯朱利亚地区的一个出生队列中进行的。采用了一个 213515 名新生儿的纵向队列嵌套病例对照设计。使用条件二项式回归模型估计所有分析的危险因素的比值比（OR）及其 95%置信区间（CI）。我们确定了 164 名 18 岁以下发病的 IBD 患者和 1640 名对照者。没有考虑到的围产期条件与 IBD 相关。抗生素暴露的分析基于 70 例病例和 700 例对照。在生命最初 6 个月和 12 个月内使用≥4 种抗生素的儿童的风险明显更高（OR=6.34；95%CI 1.68-24.02 和 OR=2.91；95%CI 1.31-6.45）。这种关联仅存在于克罗恩病患者和发病较早的 IBD 患者中。我们发现围产期特征与 IBD 无关，而在生命的第一年频繁使用抗生素与随后发生儿童发病的 IBD 的风险增加有关。
