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Celiac risk tied to season, region of birth may be explained by seasonal viral infections
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Swedish children born in the spring, summer and autumn have an increased risk for developing celiac disease in childhood compared with those born in the winter, especially if they were born in the southern region of the country, according to the results of a prospective cohort study.
These findings led researchers to conclude that exposure to seasonal viral infections during early immune development may explain these varying risks.
To examine how season of birth may affect the risk for developing celiac disease, researchers from Umeå University in Sweden used national registry data to perform a prospective, longitudinal cohort study involving 1,912,204 children aged younger than 15 years who were born in Sweden between 1991 and 2009. Among them, 6,569 were diagnosed with celiac disease.
The researchers performed Cox regression analyses to calculate hazard ratios for celiac disease diagnosis based on season, region and year of birth.
Compared with children born in the winter, those born in the spring (adjusted HR = 1.08; 95% CI, 1.01-1.16), summer (aHR = 1.1; 95% CI, 1.03-1.18) or autumn (aHR = 1.1; 95% CI, 1.02-1.18) had an overall higher risk for developing celiac disease.
This increased risk tied to season was highest for children born in the southern region of the country (HR = 1.59; 95% CI, 1.48-1.72), lower for those born in the central region (HR = 1.19; 95% CI, 1.1-1.29) and lowest for those born in the northern region.
Spring births were associated with an increased risk for developing celiac disease if diagnosed at less than 2 years of age (HR = 1.15; 95% CI, 1.02-1.31), while summer (HR = 1.14; 95% CI, 1.05-1.23) and autumn births (HR = 1.12; 95% CI, 1.03-1.22) were associated with an increased risk for developing celiac disease if diagnosed at greater than 2 years of age.
Children born between 1991 and 1996 had an increased risk for developing celiac disease if born in the spring, while those born between 1997 and 2002 had an increased risk if born in the summer or autumn, and those born between 2003 and 2009 had an increased risk if born in the autumn. The increased risk for celiac disease was more pronounced among girls across all seasons and birth years.
“We have confirmed a statistically significant effect of season of birth on the risk of being diagnosed with [celiac disease] during childhood with the highest [celiac disease] risk if born in south Sweden,” the researchers wrote. “Viral infections are the strongest possible risk factor in favor of our findings, although the role of vitamin D during pregnancy is still plausible.
“One of the limitations of this study is lack of data on infections and vitamin D level, thus at the moment inference on how these might influence seasonality and subsequently [celiac disease] risk remains speculative and calls for further investigation,” they noted. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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