Premature birth and being born small for gestational age increased the likelihood of developing esophagitis during childhood, according to recent results.
Researchers assessed data on 7,358 patients with esophagitis collected from the Swedish birth and patient registries between 1973 and 2007, along with 34,094 matched controls. Birth characteristics and outcomes were recorded, and potential associations between risk for esophagitis and birth conditions were evaluated.
Patients who were born preterm (32 weeks or less) were at increased risk for developing esophagitis (OR=2.74; 95% CI, 2.15-3.49). Elevated risk for esophagitis also was observed in patients who were born small for their gestational age (SGA) — defined in grams that were 2 or more standard deviations less than mean birth weight (OR=1.49; 95% CI, 1.32-1.68).
Patients aged 9 years or younger when diagnosed with esophagitis were significantly more likely to have been born prematurely (n=1,907 cases and n=8,808 controls; OR=6.82, 4.65-10.03) or SGA (OR=1.98, 1.55-2.52). The association with premature birth was stronger in males than females (OR=9.88, 5.93-16.45 among males vs. OR=3.41, 1.81-6.41 among females), while the reverse was observed for the association with SGA (OR=2.50, 1.76-3.55 among females; OR=1.64, 1.16-2.30 among males) (95% CI for all).
Among patients who received esophagitis diagnoses between ages 10 and 19 years, the likelihood of both preterm birth (OR=2.09, 1.18-3.70) and SGA (OR=1.46, 1.10-1.94) was increased, but less pronounced than in those with earlier diagnoses. No association was observed between esophagitis diagnosed at age 20 years or older and premature birth (OR=1.02, 0.64-1.63), but the association between SGA at birth and esophagitis remained (OR=1.31, 1.11-1.54) (95% CI for all).
“We found a strong association between preterm birth, impaired fetal growth and risk of esophagitis,” the researchers wrote. “The results merit further investigation of GERD among preterm infants and children. Furthermore, a valid assessment of the subsequent risk of esophageal adenocarcinoma development among individuals born preterm is merited. Given that reflux of gastric content is a major risk factor for esophageal adenocarcinomas, individuals with GERD in early life, and thus a potential long period of exposure, may be particularly vulnerable to esophageal adenocarcinoma development.”