Switkowski Karen M, Oken Emily, Simonin Elisabeth M, Nadeau Kari C, Rifas-Shiman Sheryl L, Lightdale Jenifer R
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Pediatr Res. 2025 Apr;97(5):1537-1545. doi: 10.1038/s41390-024-03518-4. Epub 2024 Sep 6.
Infantile colic may represent gastrointestinal distress, yet most definitions emphasize excessive crying. Each may have distinct etiologies.
DESIGN/METHODS: In a pre-birth cohort, we used maternal reports of infant crying and apparent abdominal discomfort at 6mos to categorize infants as (1) unaffected (no excessive crying or colic), (2) excessive crying only, and (3) colic (abdominal discomfort +/- excessive crying). We examined associations of potential risk factors in separate models with excessive crying and colic (each vs. unaffected) using unadjusted multinomial logistic regression, and associations between count of risk factors and colic using logistic regression.
Of 1403 infants, 140 (10%) had excessive crying, and 346 (25%) colic. Infants that were non-Hispanic white, low birthweight, firstborn, or had a maternal history of atopy, high postpartum depressive symptoms, or persistent prenatal nausea, had a 40-80% higher relative risk of colic. Preterm birth was associated with double the risk. Being firstborn, low birthweight, and preterm birth predicted excessive crying. Infants with ≥four (vs. 0-1) of the seven identified risk factors had 3.9 times (95% CI: 2.6, 6.1) higher odds of colic.
Colic characterized by apparent abdominal discomfort can be phenotypically distinguished from excessive crying only. Multiple risk factors may further increase colic risk.
Infant colic characterized by apparent gastrointestinal distress may be phenotypically distinct from excessive crying only. Literature that defines colic only based on crying behaviors may miss important predictors. Mother-reported colic and excessive crying appear to have overlapping risk factors, with additional risk factors identified for colic. The presence of multiple risk factors increases the risk of colic, supporting a multifactorial etiology.
婴儿腹绞痛可能表现为胃肠道不适，但大多数定义强调过度哭闹。每种情况可能有不同的病因。
设计/方法：在一个产前队列中，我们使用母亲报告的婴儿在6个月时的哭闹情况和明显的腹部不适，将婴儿分为：（1）未受影响（无过度哭闹或腹绞痛），（2）仅过度哭闹，（3）腹绞痛（腹部不适伴/不伴过度哭闹）。我们在单独的模型中使用未调整的多项逻辑回归分析了潜在风险因素与过度哭闹和腹绞痛（各自与未受影响组相比）之间的关联，并使用逻辑回归分析了风险因素数量与腹绞痛之间的关联。
在1403名婴儿中，140名（10%）有过度哭闹，346名（25%）有腹绞痛。非西班牙裔白人、低出生体重、头胎或母亲有特应性病史、产后抑郁症状高或孕期持续恶心的婴儿，患腹绞痛的相对风险高40 - 80%。早产与两倍的风险相关。头胎、低出生体重和早产预示着过度哭闹。有七个已确定风险因素中≥四个（与0 - 1个相比）的婴儿患腹绞痛的几率高3.9倍（95%可信区间：2.6，6.1）。
以明显腹部不适为特征的腹绞痛在表型上可与仅过度哭闹相区分。多种风险因素可能进一步增加腹绞痛风险。
以明显胃肠道不适为特征的婴儿腹绞痛在表型上可能与仅过度哭闹不同。仅基于哭闹行为定义腹绞痛的文献可能会遗漏重要的预测因素。母亲报告的腹绞痛和过度哭闹似乎有重叠的风险因素，同时也确定了腹绞痛的其他风险因素。多种风险因素的存在增加了腹绞痛的风险，支持多因素病因。
