Department of Internal Medicine, Institute of Clinical Medicine, University of Oulu, Oulu, Finland.
Terveystalo Oulu, Medical Center, Oulu, Finland.
BMC Public Health. 2024 Apr 15;24(1):1038. doi: 10.1186/s12889-024-18549-z.
The pathogenesis of inflammatory bowel disease (IBD) has not been fully elucidated. The aim of this study was to analyze the pregnancy period, perinatal period, and infancy period risk factors for IBD in a well-characterized birth cohort from Northern Finland.
The Northern Finland Birth Cohort 1966 (NFBC1966) population comprises mothers living in the two northernmost provinces of Finland, Oulu, and Lapland, with dates of delivery between Jan 1st and Dec 31st, 1966 (12 055 mothers, 12 058 live-born children, 96.3% of all births during 1966). IBD patients were identified using hospital registries (from 1966 to 2020) and Social Insurance Institution (SII) registry reimbursement data for IBD drugs (from 1978 to 2016). The data were analyzed by Fisher's exact test and logistic regression.
In total, 6972 individuals provided informed consent for the use of combined SII and hospital registry data. Of those, 154 (2.1%) had IBD (113 [1.6%] had ulcerative colitis (UC), and 41 (0.6%) had Crohn's disease (CD)). According to multivariate analysis, maternal smoking > 10 cigarettes/day during pregnancy was associated with a nearly 6-fold increased risk of CD in the offspring (OR 5.78, 95% CI 1.70-17.3). Breastfeeding (OR = 0.18, 95% CI 0.08-0.44) and iron supplementation during the first year of life (OR = 0.43, 95% CI 0.21-0.89) were negatively associated with CD.
Smoking during pregnancy was associated with the risk of CD while Breastfeeding and oral iron supplementation at infancy were negatively associated with the risk of CD later in life.
炎症性肠病（IBD）的发病机制尚未完全阐明。本研究的目的是在芬兰北部一个特征明确的出生队列中分析 IBD 的妊娠、围产期和婴儿期危险因素。
北芬兰出生队列 1966 年（NFBC1966）人群包括居住在芬兰最北部省份奥卢和拉普兰的母亲，分娩日期为 1966 年 1 月 1 日至 12 月 31 日（12055 名母亲，12058 名活产儿，占 1966 年所有分娩的 96.3%）。IBD 患者通过医院登记册（1966 年至 2020 年）和社会保险机构（SII）IBD 药物报销数据（1978 年至 2016 年）进行识别。数据分析采用 Fisher 精确检验和逻辑回归。
共有 6972 人同意使用 SII 和医院登记册数据的组合。其中，154 人（2.1%）患有 IBD（113 人[1.6%]患有溃疡性结肠炎，41 人[0.6%]患有克罗恩病）。根据多变量分析，母亲在怀孕期间每天吸烟超过 10 支香烟与后代患 CD 的风险几乎增加 6 倍相关（OR 5.78，95%CI 1.70-17.3）。母乳喂养（OR=0.18，95%CI 0.08-0.44）和婴儿期第一年的铁补充剂（OR=0.43，95%CI 0.21-0.89）与 CD 呈负相关。
怀孕期间吸烟与 CD 的风险相关，而婴儿期母乳喂养和口服铁补充与以后生活中 CD 的风险呈负相关。
