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早期生活因素与成年后功能性肠症状负担之间的可能关联。

A possible association between early life factors and burden of functional bowel symptoms in adulthood.

机构信息

Department of Clinical Sciences, Lund University, Lund, Sweden.

Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.

出版信息

Scand J Prim Health Care. 2021 Dec;39(4):506-514. doi: 10.1080/02813432.2021.2004823. Epub 2021 Nov 22.

Abstract

OBJECTIVE

The studies of early life factors and development of functional bowel diseases show inconsistent results. We therefore examined associations between certain early life factors and functional bowel symptoms in adulthood.

DESIGN

Population-based cross-sectional study.

SETTING

Weight and height were measured and questionnaires were completed at the time point of enrollment in MOS.

SUBJECTS

1013 participants in the Malmö Offspring Study (MOS) without organic bowel disease with data available from the Swedish Medical Birth Registry.

MAIN OUTCOME MEASURES

Associations were calculated between gestational age, birth weight, small-for-gestational-age and Apgar score from the Birth Registry, and symptoms according to the visual analog scale for irritable bowel syndrome (VAS-IBS) (abdominal pain, diarrhea, constipation, bloating and flatulence, vomiting and nausea, and symptoms' influence on daily life) or self-reported IBS using logistic regression.

RESULTS

In all, 253 (25.0%) participants reported bowel symptoms during the past 2 weeks and 179 (17.7%) self-reported IBS; conditions which were strongly associated ( < 0.001). Female sex and chronic stress were two independent factors more common among participants with bowel symptoms compared with asymptomatic participants ( < 0.001). Early life factors were not associated with presence of overall bowel symptoms ( = 0.080), any specific bowel symptoms or self-reported IBS. Lower birth weight ( = 0.038) and being born small for gestational age ( = 0.043) were associated with severe influence of intestinal symptoms on daily life in adulthood.

CONCLUSIONS

Lower birth weight and small for gestational age are not associated with the presence of overall bowel symptoms but with more pronounced influence of such symptoms on daily adult life.Key pointsLower gestational age tended to be associated with functional bowel symptoms in adulthood.Lower birth weight and being small for gestational age are associated with increased negative influences of symptoms on daily life in adulthood.Patients born preterm or with low birth weights may be at increased risk to develop functional bowel symptoms later in life.

摘要

目的

早期生活因素与功能性肠病发展的研究结果并不一致。因此,我们研究了成年后某些早期生活因素与功能性肠病症状之间的关系。

设计

基于人群的横断面研究。

地点

在 MOS 入组时测量体重和身高并完成问卷调查。

对象

1013 名无器质性肠病的莫索尔夫裔研究(MOS)参与者,且数据可从瑞典医学出生登记处获得。

主要观察指标

出生登记处的胎龄、出生体重、小于胎龄儿和阿普加评分与根据视觉模拟量表(VAS-IBS)(腹痛、腹泻、便秘、腹胀、气胀、呕吐和恶心,以及症状对日常生活的影响)或自我报告的 IBS 症状之间的关联,采用逻辑回归进行计算。

结果

共有 253 名(25.0%)参与者报告过去 2 周内有肠道症状,179 名(17.7%)自我报告 IBS;这两种情况具有很强的相关性( < 0.001)。与无症状参与者相比,有肠道症状的参与者中女性( < 0.001)和慢性压力( < 0.001)更为常见。早期生活因素与总体肠道症状( = 0.080)、任何特定的肠道症状或自我报告的 IBS 无关。出生体重较低( = 0.038)和出生时小于胎龄( = 0.043)与成年后肠道症状对日常生活的严重影响有关。

结论

出生体重较低和小于胎龄与总体肠道症状无关,但与症状对成年日常生活的负面影响更为显著。出生时胎龄较低的婴儿可能更容易在以后的生活中出现功能性肠病症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd5b/8725981/223fd94a8e40/IPRI_A_2004823_F0001_B.jpg

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