Guo Annie, Ludvigsson Johnny, Lerchova Tereza, Imberg Henrik, Størdal Ketil, Mårild Karl
Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Crown Princess Victoria Children's Hospital, Region Östergötland, Linköping, Sweden.
Inflamm Bowel Dis. 2024 Sep 9. doi: 10.1093/ibd/izae209.
The association of infections and antibiotic use in pregnancy and the risk of inflammatory bowel disease (IBD) development in the offspring have been scarcely investigated. We examined infection and antibiotic use in pregnancy and the risk of IBD in offspring.
We followed participants from the All Babies in Southeast Sweden (ABIS) and the Norwegian mother father and child cohort (MoBa) from birth (1997-2009) until 2020-2021. IBD diagnosis was classified as ≥2 records in national registers. Information on infections (any, gastrointestinal, and respiratory), their timing (early or late in pregnancy), and antibiotic use in pregnancy were collected from questionnaires. Cox proportional-hazard regression and meta-analytic methods were used to estimate pooled adjusted hazard ratios (aHRs) for IBD and its subtypes, adjusted for parental IBD, maternal smoking, and education. Sensitivity analyses accounted for exposure to antibiotics and infections 0-12 months of age.
We followed 117 493 children for 2 024 299 person-years (follow-up 22.3 years in ABIS and 16.4 years in MoBa), including 451 IBD cases. The aHRs for any infection and respiratory infections in pregnancy and offspring IBD were close to one (aHR = 0.99 [95% CI = 0.73-1.33] and aHR = 1.00 [95% CI = 0.81-1.23], respectively). However, any versus no infection in early pregnancy was associated with IBD development (aHR = 1.26 [95% CI = 1.02-1.55]), particularly Crohn's disease (CD; aHR = 1.40 [95% CI = 1.01-1.93]). Any versus no gastrointestinal infection in late pregnancy was associated with offspring CD (aHR = 1.95 [95% CI = 1.34-2.84]). Antibiotic use in pregnancy was not associated with IBD in the child (aHR = 1.15 [95% CI = 0.93-1.44]).
In this binational birth cohort study, the risk of offspring IBD varied by infection type and timing but not with maternal antibiotic use in pregnancy.
孕期感染及抗生素使用与后代患炎症性肠病（IBD）风险之间的关联鲜有研究。我们研究了孕期感染及抗生素使用情况与后代患IBD的风险。
我们对瑞典东南部所有婴儿（ABIS）和挪威母婴队列（MoBa）的参与者从出生（1997 - 2009年）开始随访至2020 - 2021年。IBD诊断依据国家登记册中≥2条记录确定。通过问卷收集感染（任何感染、胃肠道感染和呼吸道感染）情况、感染发生时间（孕期早期或晚期）以及孕期抗生素使用情况。采用Cox比例风险回归和荟萃分析方法，在对父母IBD、母亲吸烟情况和教育程度进行校正后，估计IBD及其亚型的合并校正风险比（aHRs）。敏感性分析考虑了0 - 12个月龄时接触抗生素和感染的情况。
我们对117493名儿童进行了2024299人年的随访（ABIS随访22.3年，MoBa随访16.4年），其中包括451例IBD病例。孕期任何感染和呼吸道感染与后代患IBD的aHR接近1（分别为aHR = 0.99 [95%CI = 0.73 - 1.33]和aHR = 1.00 [95%CI = 0.81 - 1.23]）。然而，孕早期有感染与无感染相比，与IBD发病相关（aHR = 1.26 [95%CI = 1.02 - 1.55]），尤其是克罗恩病（CD；aHR = 1.40 [95%CI = 1.01 - 1.93]）。孕晚期有胃肠道感染与无感染相比，与后代患CD相关（aHR = 1.95 [95%CI = 1.34 - 2.84]）。孕期使用抗生素与儿童患IBD无关（aHR = 1.15 [95%CI = 0.93 - 1.44]）。
在这项两国出生队列研究中
