Division of Gastroenterology, Hepatology, and Endoscopy, Department of Medicine, Brigham and Women's Hospital, Boston, MA, and Harvard Medical School, Boston, MA, USA.
Center for Clinical Epidemiology, Odense University Hospital, and Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
J Crohns Colitis. 2020 Dec 2;14(12):1709-1716. doi: 10.1093/ecco-jcc/jjaa106.
Research on long-term outcomes of children exposed to inflammatory bowel disease [IBD] in utero is lacking. Maternal inflammation, IBD medications, or other factors may increase the risk of developmental disabilities in the offspring.
We used the Danish National Birth Cohort, an ongoing prospective study that includes 100 419 pregnancies of 92 274 women, in conjunction with the Danish National Registries, to evaluate cognitive and motor development of the children of women with and without IBD. We analysed basic measures of childhood development at 6-month and 18-month interviews with the mother and with validated questionnaires filled out by the parents when the child was 7 years old. We adjusted for multiple confounders, including preterm birth.
At 6 months, we included 484 children of women with IBD and 69 571 unexposed children; at 18 months, 471 exposed and 66 018 unexposed; at 7 years, 391 exposed and 54 356 unexposed. At 18 months, exposed children were significantly less likely to 'use word-like sounds' but there was no difference between use of 'sentences of 2 words'. At 6 and 18 months, there were no other obvious differences in language and motor development. At 7 years, cognitive scores [emotional, conduct, hyperactivity, peer, and social scores] and motor development [gross/fine motor skills and general coordination] were similar between the two groups.
Children exposed to IBD in utero and unexposed children scored similarly on survey-based tools assessing basic measures of neurodevelopment over 7 years. These results are reassuring for current and future parents with IBD.
研究宫内暴露于炎症性肠病(IBD)的儿童的长期结局的研究很少。母体炎症、IBD 药物或其他因素可能会增加后代发育障碍的风险。
我们使用丹麦全国出生队列,这是一项正在进行的前瞻性研究,包括 92274 名妇女的 100419 次妊娠,结合丹麦全国登记处,评估患有和不患有 IBD 的妇女的子女的认知和运动发育。我们分析了在母亲的 6 个月和 18 个月访谈中以及在孩子 7 岁时由父母填写的经过验证的问卷中儿童的基本发育指标。我们调整了多种混杂因素,包括早产。
在 6 个月时,我们纳入了 484 名患有 IBD 的妇女的子女和 69571 名未暴露的儿童;在 18 个月时,纳入了 471 名暴露儿童和 66018 名未暴露的儿童;在 7 岁时,纳入了 391 名暴露儿童和 54356 名未暴露的儿童。在 18 个月时,暴露组的儿童明显不太可能使用“类似单词的声音”,但在使用“2 个单词的句子”方面没有差异。在 6 个月和 18 个月时,语言和运动发育没有其他明显差异。在 7 岁时,两组之间的认知评分(情绪、行为、多动、同伴和社会评分)和运动发育(粗大/精细运动技能和一般协调能力)相似。
在宫内暴露于 IBD 的儿童和未暴露的儿童在 7 年以上的基于调查的工具评估基本神经发育指标方面得分相似。这些结果为当前和未来患有 IBD 的父母提供了安慰。