Early life events and factors, such as having a mother with inflammatory bowel disease or having an infection within the first year of life, are associated with higher risk for developing inflammatory bowel disease later in life, according to results of a population-based study.
Charles N. Bernstein, MD, of the University of Manitoba Inflammatory Bowel Disease Clinical and Research Center, and colleagues wrote that the first two years of life could be and important period for the development of IBD because it is when the composition of the gut microbiota starts to stabilize.
“Events which promote alterations in the composition of the gut microbiome in the first year of life may have important effects on its more permanent composition,” they wrote. “This in turn may impact on the ultimate development of IBD. Infections which impact on the gut microbiome and antibiotic use in the first year of life through their effects on the gut microbiome may, therefore, impact on the ultimate development of IBD.”
Researchers aimed to explore if there is an increased risk for IBD among individuals who experience critical events at birth and within the first year of life. They used the University of Manitoba IBD Epidemiology Database and collected data on infections, failure to thrive and hospital readmissions, as well as sociodemographic factors for patients diagnosed with IBD from 1979 to 2010. Their analysis included data from 825 IBD cases and 5,999 matched controls.
Investigators found that a maternal diagnosis of IBD was the greatest risk factor for IBD in offspring (OR = 4.53; 95% CI, 3.08–6.67).
“This might reflect either an important genetic effect or an important environmental effect or a combination of both,” Bernstein and colleagues wrote. “Children share a close environment with their mothers especially in their developing years and it has been shown that the gut microbiome of children increasingly mirrors that of their parents’ gut microbiome from the second through the sixth month of life.”
Being in the highest socioeconomic quintile at birth and infections also increased the risk for developing IBD at any age (OR = 1.39; 95% CI, 1.09–1.79). Infection in the first year of life was associated with diagnosis of IBD before age 10 years (OR = 3.06; 95% CI, 1.07–8.78) and before age 20 years (OR = 1.63; 95% CI, 1.18–2.24).
Bernstein and colleagues wrote that more research is needed to determine exactly how infections increase risk for IBD and the role of antibiotics.
“If it is increasingly accepted that antibiotics in the first year of life truly pose a risk for later chronic immune disease like IBD, then research is warranted to determine exactly what antibiotic intake does to infant gut microflora or intestinal or systemic immune responses,” they wrote. “Studies should explore the infant gut microbiome before and for several months after infections and/or antibiotic use to determine what changes occur that might promote the development of IBD later.” – by Alex Young
Disclosures: Bernstein reports serving on advisory boards for AbbVie Canada, Ferring Canada, Janssen Canada, Napo Pharmaceuticals, Pfizer Canada, Shire Canada and Takeda Canada. He reports consulting for 4D Pharma and Mylan Pharmaceuticals. He also reports receiving educational grants from AbbVie Canada, Janssen Canada, Pfizer Canada, Shire Canada and Takeda Canada. He reports being on the speakers’ panel for Ferring Canada and Shire Canada. Please see the full study for all other authors’ relevant financial disclosures.