Childhood Socioeconomic Characteristics and Risk of Inflammatory Bowel Disease: A Scandinavian Birth Cohort Study.

IF 4.5 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Inflammatory Bowel Diseases Pub Date : 2024-10-03 DOI:10.1093/ibd/izad220

Ida Sigvardsson, Ketil Størdal, Malin Östensson, Annie Guo, Johnny Ludvigsson, Karl Mårild

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Abstract

Background: Ecological observations suggest a negative relationship between childhood socioeconomic status (SES) and inflammatory bowel disease (IBD) risk. Individual-level analyses have been inconsistent and mostly lacked refined assessments of SES. We aimed to comprehensively study the association between early-life SES and later IBD.

Methods: This study included 117 493 participants from the Norwegian Mother, Father and Child cohort and Swedish All Babies in Southeast Sweden cohorts. Participants were followed from birth (1997-2009) through 2021. IBD was identified through national patient registers. Questionnaire and register data were used to define parental educational level, employment, and household income level. Cox regression estimated adjusted hazard ratios (aHRs), accounting for other SES exposures and covariates (eg, parental IBD). Cohort-specific estimates were pooled using a random-effects model.

Results: During 2 024 299 person-years of follow-up, 451 participants were diagnosed with IBD (All Babies in Southeast Sweden cohort, n = 113 and Norwegian Mother, Father and Child cohort, n = 338). Early-life maternal, but not paternal, educational level was associated with later IBD (low vs high educational level; pooled aHR, 1.81; 95% confidence interval [CI], 1.16-2.82; and pooled aHR, 1.20; 95% CI, 0.80-1.80; respectively). Having a nonworking mother or father was not significantly associated with IBD (pooled aHR, 0.69; 95% CI, 0.47-1.02; pooled aHR, 0.79; 95% CI, 0.45-1.37). High vs low household income level yielded a pooled aHR of 1.33 (95% CI, 0.94-1.89). Overall, results were largely consistent across cohorts.

Conclusions: In this prospective Scandinavian cohort study, low maternal educational level was, independent of other SES and covariates, significantly associated with later IBD in her child. Further research is needed to elucidate factors that may mediate this relationship.

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儿童社会经济特征与炎症性肠病风险：斯堪的纳维亚出生队列研究。

背景：生态学观察表明，儿童社会经济地位（SES）与炎症性肠病（IBD）风险之间存在负相关关系。个人层面的分析不一致，大多缺乏对SES的精细评估。我们旨在全面研究早期社会经济地位与晚期IBD之间的关系。方法：本研究包括117493名来自挪威母亲、父亲和儿童队列和瑞典东南部所有婴儿队列的参与者。参与者从出生（1997-2009）到2021年进行了随访。IBD是通过国家患者登记确定的。问卷和登记数据用于确定父母的教育水平、就业和家庭收入水平。Cox回归估计了调整后的风险比（aHR），考虑了其他SES暴露和协变量（如父母IBD）。使用随机效应模型对特定队列的估计进行汇总。结果：在2 024 299人年的随访中，451名参与者被诊断为IBD（瑞典东南部的所有婴儿队列 = 113和挪威母亲、父亲和儿童队列，n = 338）。早期母亲而非父亲的教育水平与后期IBD相关（教育水平低与高；合并aHR，1.81；95%置信区间[CI]，1.16-2.82；合并aHR1.20；95%CI0.80-1.80；分别）。母亲或父亲不工作与IBD没有显著相关性（合并aHR，0.69；95%置信区间，0.47-1.02；合并aHR为0.79；95%可信区间，0.45-1.37）。高家庭收入水平与低家庭收入水平的合并aHR分别为1.33（95%置信区间为0.94-1.89）。总体而言，各队列的结果基本一致。结论：在这项斯堪的纳维亚前瞻性队列研究中，母亲受教育水平低，独立于其他社会经济地位和协变量，与她孩子的后期IBD显著相关。需要进一步的研究来阐明可能介导这种关系的因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammatory Bowel Diseases 医学-胃肠肝病学

CiteScore

9.70

自引率

6.10%

发文量

462

审稿时长

1 months

期刊介绍： Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.