妊娠期母体感染与后代患炎症性肠病风险之间的关系：两个斯堪的纳维亚出生队列的研究结果。

IF 4.5 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Inflammatory Bowel Diseases Pub Date : 2024-09-09 DOI:10.1093/ibd/izae209

Annie Guo, Johnny Ludvigsson, Tereza Lerchova, Henrik Imberg, Ketil Størdal, Karl Mårild

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引用次数: 0

摘要

背景：妊娠期感染和使用抗生素与后代患炎症性肠病（IBD）的风险之间的关系很少被研究。我们研究了孕期感染和抗生素使用与后代患 IBD 风险的关系：我们对瑞典东南部所有婴儿（ABIS）和挪威母子队列（MoBa）的参与者进行了跟踪调查，调查时间从出生（1997-2009 年）开始，直至 2020-2021 年。在国家登记册中，IBD 诊断被归类为≥2 条记录。通过问卷调查收集有关感染（任何感染、胃肠道感染和呼吸道感染）、感染时间（妊娠早期或晚期）以及孕期抗生素使用情况的信息。采用 Cox 比例危险回归和荟萃分析方法估算了 IBD 及其亚型的汇总调整危险比（aHRs），并对父母 IBD、母亲吸烟和教育程度进行了调整。敏感性分析考虑了0-12个月大时接触抗生素和感染的情况：我们对 117 493 名儿童进行了 2 024 299 人年的随访（在 ABIS 中随访 22.3 年，在 MoBa 中随访 16.4 年），其中包括 451 例 IBD 病例。妊娠期任何感染和呼吸道感染与后代 IBD 的 aHR 接近于 1（aHR = 0.99 [95% CI = 0.73-1.33] 和 aHR = 1.00 [95% CI = 0.81-1.23]）。然而，孕早期感染与否与 IBD 的发展有关（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]）。妊娠晚期发生任何胃肠道感染与未发生任何胃肠道感染均与后代的克罗恩病有关（aHR = 1.95 [95% CI = 1.34-2.84]）。妊娠期使用抗生素与孩子的 IBD 无关（aHR = 1.15 [95% CI = 0.93-1.44]）：在这项两国出生队列研究中，后代患 IBD 的风险因感染类型和时间而异，但与母亲在孕期使用抗生素无关。

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Association Between Maternal Infections in Pregnancy and the Risk of Inflammatory Bowel Disease in the Offspring: Findings From Two Scandinavian Birth Cohorts.

Background: 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.

Methods: 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.

Results: 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]).

Conclusions: 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.

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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.