Bonfils Linéa, Poulsen Gry, Agrawal Manasi, Julsgaard Mette, Torres Joana, Jess Tine, Allin Kristine Højgaard
Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark
Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark.
Gut. 2025 Jan 17;74(2):206-213. doi: 10.1136/gutjnl-2024-332885.
In utero exposure to maternal inflammation may impact immune system development and subsequent risk of disease. We investigated whether a maternal diagnosis of IBD before childbirth is linked to a higher risk of IBD in offspring compared with a diagnosis after childbirth. Further, we analysed paternal IBD status for comparison.
Using Danish health registers, we identified all individuals born in Denmark between 1997 and 2022 and their legal parents, as well as their IBD status. Cox proportional hazards regression analyses adjusted for calendar period and mode of delivery were used to estimate offspring IBD risk by maternal and paternal IBD status before and after childbirth.
Of 1 290 358 children, 10 041 (0.8%) had mothers with IBD diagnosis before childbirth and 9985 (0.8%) had mothers with IBD diagnosis after childbirth. Over 18 370 420 person-years, 3537 individuals were diagnosed with IBD. Offspring of mothers with IBD before childbirth had an adjusted HR of IBD of 6.27 (95% CI 5.21, 7.54) compared with those without maternal IBD, while offspring of mothers with IBD after childbirth had an adjusted HR of 3.88 (95% CI 3.27, 4.60). Corresponding adjusted HRs were 5.26 (95% CI 4.22, 6.56) among offspring with paternal IBD before childbirth and 3.73 (95% CI 3.10, 4.50) for paternal IBD after childbirth.
Offspring had a greater risk of IBD when either parent was diagnosed before childbirth rather than later, emphasising genetic predisposition and environmental risk factors rather than maternal inflammation in utero as risk factors for IBD.
子宫内暴露于母体炎症可能会影响免疫系统发育及后续疾病风险。我们调查了分娩前母亲被诊断为炎症性肠病（IBD）与分娩后诊断相比，其后代患IBD的风险是否更高。此外，我们分析了父亲的IBD状况以作比较。
利用丹麦健康登记系统，我们确定了1997年至2022年在丹麦出生的所有个体及其法定父母，以及他们的IBD状况。采用经日历期和分娩方式调整的Cox比例风险回归分析，以估计分娩前后母亲和父亲IBD状况下后代患IBD的风险。
在1290358名儿童中，10041名（0.8%）的母亲在分娩前被诊断为IBD，9985名（0.8%）的母亲在分娩后被诊断为IBD。在超过18370420人年的时间里，3537人被诊断为IBD。与母亲无IBD的后代相比，分娩前母亲患有IBD的后代患IBD的调整后风险比（HR）为6.27（95%置信区间5.21，7.54），而分娩后母亲患有IBD的后代调整后HR为3.88（95%置信区间3.27，4.60）。分娩前父亲患有IBD的后代相应的调整后HR为5.26（95%置信区间4.22，6.56），分娩后父亲患有IBD的调整后HR为3.73（95%置信区间3.10，4.50）。
当父母任何一方在分娩前而非之后被诊断为IBD时，其后代患IBD的风险更大，这强调了遗传易感性和环境风险因素而非子宫内母体炎症是IBD的风险因素。
