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Small size for gestational age at birth linked to Barrett’s esophagus
Infants born at a low weight for their gestational age are at increased risk for developing Barrett’s esophagus later in life, according to recent results.
In a population-based, case-control study, researchers compared 331 adult patients (232 men, 99 women) diagnosed with Barrett’s esophagus (BE) from January 1986 through December 2005 at two hospitals in Sweden with 852 matched controls. Perinatal characteristics, including birth weight and gestational age at birth, were compared between groups.
Birth year among participants ranged from 1921 to 1985. Weight between 3,000 g and 3,999 g was considered normal, while less than 2,500 g was considered low birth weight. Participants below the 3rd percentile for birth weight at gestational age were considered very small for gestational age (SGA); those between the 3rd and 10th percentiles were defined as moderately SGA.
Patients with low birth weight were at increased risk for BE (adjusted OR=8.22; 95% CI, 2.83-23.88) compared with those of normal birth weight. Investigators predominantly attributed this association to being SGA as opposed to gestational duration.
Participants who were very SGA had significantly increased BE risk compared with those born at a normal weight for gestational age (aOR=2.95; 95% CI, 1.35-6.44), as did moderately SGA participants (aOR=1.8; 95% CI, 1.04-3.09). Patients born at a larger weight for gestational age (90th to 97th percentiles) were at significantly reduced BE risk (aOR=0.51; 95% CI, 0.27-0.96), while those above the 97th percentile were not (aOR=1.62; 95% CI, 0.76-3.44).
“This study found that low birth weight and low birth weight for gestational age were associated with increased risk of adult BE,” the researchers concluded. “Although the biological interpretation is unclear, these findings indicate that impaired fetal growth is associated with an inflammatory reaction in the esophagus later in life. … Considering the premalignant nature of BE, these findings merit further studies. Also, the possible association between SGA and esophageal adenocarcinoma deserves further evaluation, as does the potential long-term consequences of gastroesophageal reflux in children.”