Evaluation of potential early life risk factors for ulcerative colitis

Authors

Keywords:

ulcerative colitis, early life factors, breastfeeding, delivery

Abstract

Aim: It has been suggested that early life factors may affect the risk of inflammatory bowel disease by affecting the gut microbiome. Delivery type, breast milk, and parental smoking are the most important environmental factors. There are limited studies on the effects of these factors on the location of the disease and age at diagnosis. In addition, the effects of these factors on medical treatments and bowel involvement are unknown. We examined the relationship between potential early-life risk factors experienced in the first years of life and ulcerative colitis (UC). Material and Method: This study is a prospective case-control study. Sixty-nine UC patients were compared with 44 age- and sex-matched healthy controls (HC). We investigated delivery type, breastfeeding, maternal age at birth, and parents' smoking status, which may be potential early-life risk factors. Our analysis involved the relationship of these potential factors with the age at diagnosis and medical treatments in UC patients. Results: UC and HC groups were compared in terms of delivery type, breastfeeding, and parents' smoking status: There was no statistical difference between the groups. In terms of the duration of breastfeeding, we found that 6-12 months of breastfeeding was lower in the UC group (P=0.046). In addition, the age at diagnosis of the disease was lower in UC patients who were not breastfed and whose mothers smoked (P=0.031, P=0.016, respectively). Conclusions: The duration of breastfeeding is important for the development of UC. We recommend breastfeeding for longer than six months to prevent UC. Maternal smoking cessation has a protective role in the risk of early-onset UC.

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References

Abraham C, Cho JH. Inflammatory bowel disease. N Engl J Med. 2009;361:2066–78. doi: 10.1056/NEJMra0804647.

Hutfless S, Heyman MB, Bayless TM, Abramson O, Lisa J. Herrinton LJ. Prenatal and Perinatal Characteristics Associated with Pediatric-Onset Inflammatory Bowel Disease. Dig Dis Sci (2012) 57:2149–56. doi: 10.1007/s10620-012-2128-1.

Loftus EV Jr. Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology. 2004;126:1504–17. doi: 10.1053/j.gastro.2004.01.063.

Marshall JK, Hilsden RJ. Environment and epidemiology of inflammatory bowel diseases. In: Satsangi J, Sutherland RL, eds. Inflammatory bowel diseases. London: Churchill Livingston, 2003:17–28.

Metsala J, Kilkkinen A, Kaila M, Tapanainen H, Klaukka T, Gissler M, et al. Perinatal Factors and the Risk of Asthma in Childhood-A Population-based Register Study in Finland. Am J Epidemiol. 2008;168:170-8. doi: 10.1093/aje/kwn105.

Ievins R, Roberts SE, Goldacre MJ. Perinatal factors associated with subsequent diabetes mellitus in the child: record linkage study. Diabet Med. 2007;24(6):664-70. doi: 10.1111/j.1464-5491.2007.02147.x.

Klement E, Cohen RV, Boxman J, Joseph A, Reif S. Breastfeeding and risk of inflammatory bowel disease: a systematic review with meta-analysi. Am J Clin Nutr. 2004;80(5):1342-52. doi: 10.1093/ajcn/80.5.1342.

Fanaro S, Chierici R, Guerrini P, Vigi V. Intestinal microflora in early infancy: composition and development. Acta Paediatr Suppl. 2003;91(441):48–55. doi: 10.1111/j.1651-2227.2003.tb00646.x.

Midtvedt AC, Midtvedt T. Production of short chain fatty acids by the intestinal microflora during the first 2 years of human life. J Pediatr Gastroenterol Nutr. 1992;15:395–403. doi: 10.1097/00005176-199211000-00005.

Palmer C. Bik EM, Digiulio DB. Development of the human infant intestinal microbiota. PLoS Biol. 2007;5:e177. doi: 10.1371/journal.pbio.0050177.

Xu L, Lochhead P, Ko Y, Claggett B Leong RW, Ananthakrishnan AN, Systematic review with meta-analysis: Breastfeeding and the risk of Crohn’s disease and ulcerative colitis. Aliment Pharmacol Ther. 2017 Nov;46(9):780–9. doi: 10.1111/apt.14291.

Bernstein CN, Banerjee A, Targownik LE. Cesarean section delivery is not a risk factor for development of inflammatory bowel disease: a population-based Analysis. Clin Gastroenterol Hepatol. 2016;14:50–7. doi: 10.1016/j.cgh.2015.08.005.

Khalili H, Ananthakrishnan AN, Higuchi LM, Richter JM, Fuchs CS, Chan AT. Early Life Factors and Risk of Inflammatory Bowel Disease in Adulthood. Inflamm Bowel Dis. 2013 Mar;19(3):542-7. doi: 10.1097/MIB.0b013e31828132f8.

Wang Y-F, Ou-yang Q, Xia B, Liu L-N , Gu F, Zhou K-F, et al. Multicenter case-control study of the risk factors for ulcerative colitis in China. World J Gastroenterol. 2013 March 21;19(11):1827-33. doi: 10.3748/wjg.v19.i11.1827.

Gomes CF, Narula N, Morão B, Nicola P, Cravo M, Torres J. Mode of delivery does not afect the risk of infammatory bowel disease. Dig Dis Sci. 2020 Mar 21. doi: 10.1007/s10620-020-06204-7.

Gearry RB, Richardson AK, Frampton CM, Dodgshun AJ, Barclay ML. Population-based cases control study of inflammatory bowel disease risk factors. Journal of Gastroenterology and Hepatology. 2010;25:325-33. doi: 10.1111/j.1440-1746.2009.06140.x.

Barclay AR, Russell RK, Wilson ML, Gilmour WH, Satsangi J, Wilson DC. Systematic review: the role of breastfeeding in the development of pediatric inflammatory bowel disease. J Pediatr 2009 Sep;155(3):421-6. doi: 10.1016/j.jpeds.2009.03.017

Rigas A, Rigas B, Glassman M, Yen Y, Lan SJ, Petridou E, et al. Breast-feeding and maternal smoking in the etiology of Crohn's disease and ulcerative colitis in childhood. Ann Epidemiol. 1993 Jul;3(4):387-92.

Roberts SE, Clare J, Wotton CJ, Williams JG, Griffith M, Goldacre MJ. Perinatal and early life risk factors for inflammatory bowel disease. World J Gastroenterol. 2011 Feb 14;17(6):743-9. doi: 10.1016/1047-2797(93)90066-d.

Ley D, Desseyn JL, Mischke M, Knol J, Turck D, Gottrand F. Early-life origin of intestinal infammatory disorders. Nutr Rev. 2017;75:175–87. doi: 10.1093/nutrit/nuw061.

Bager P, Simonsen J, Nielsen NM, Frisch M. Cesarean section and ofspring’s risk of infammatory bowel disease: a national cohort study. Infamm Bowel Dis. 2012;18:857–62. doi: 10.1002/ibd.21805.

Benchimol EI, Kaplan GG, Otley AR, Nguyen GC, Underwood FE, Guttmann A. Rural and urban residence during early life is associated with risk of inflammatory bowel disease: a population-based inception and birth cohort study. Am J Gastroenterol. 2017;112:1412–22. doi: 10.1038/ajg.2017.208.

Kalyon S, Gökden Y, Oyman F. A new biological marker in inflammatory bowel disease: Pentraxin 3. J Surg Med. 2020;4(10):875-8.

Gökden Y, Hot S, Gönen C, Kalyon S, Çetinkaya ZA. The value of adenosine deaminase level in assessing activation of inflammatory bowel disease. J Surg Med. 2020;4(8):654-9. doi: 10.28982/josam.791156

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Published

2020-11-01

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Research Article

How to Cite

1.
Gökden Y, Ogutmen Koc D. Evaluation of potential early life risk factors for ulcerative colitis. J Surg Med [Internet]. 2020 Nov. 1 [cited 2022 Oct. 7];4(11):1013-7. Available from: https://jsurgmed.com/article/view/826501