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Childhood IBD risk not affected by maternal infections, antibiotic use during pregnancy
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Children born to mothers who acquired an infection requiring antibiotics during pregnancy do not have an increased risk for developing inflammatory bowel disease, according to the results of a Canadian population-based study.
This finding led investigators to suggest that other events affecting the gut microbiome later in childhood may have a more important impact on a child’s risk for IBD.
“One hypothesis as to why inflammatory bowel disease develops suggests that the intestinal microbiome changes at some point to an IBD favorable microbiome,” Charles N. Bernstein, MD, of the Inflammatory Bowel Disease Clinical and Research Center at the Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada, told Healio Gastroenterology. “This may be more likely to happen at a vulnerable time in the evolution of the human intestinal microbiome and the most vulnerable time is in the first year of life.”
Charles N. Bernstein
Bernstein and colleagues previously reported that, although children born by caesarean section have different intestinal microbiomes from children born by vaginal delivery in the first few months of life, there was no difference in the rates of C-section vs. vaginal delivery in people who develop IBD vs. controls.
Because maternal antibiotic use can also alter the nenonate’s intestinal microbiome, Bernstein and colleagues used records within the University of Manitoba IBD Epidemiology Database to identify all IBD patients born in Manitoba after 1970, their mothers, their siblings without IBD, and matched controls. They identified 973 patients with Crohn’s disease and 698 patients with ulcerative colitis for whom maternal health records were linked, as well as 1,615 families from which they identified 10,488 matched controls and 1,740 siblings without IBD.
They found that the rates of infections were comparable between mothers of children who developed IBD and mothers of controls within 9 months of birth (21.7% vs. 23.2%; OR = 0.96; 95% CI, 0.84-1.09), within 30 days of birth (11.4% vs. 12.4%; OR = 0.97; 95% CI, 0.82-1.14) and in the peripartum period (5.5% vs. 7.5%; OR = 0.86; 95% CI, 0.68-1.09). Moreover, they found no differences in the rates of maternal infections during pregnancy between IBD patients and their siblings without IBD.
Taken together, the data from this study and the prior study of the link between mode of delivery and IBD risk “suggests that changes to the neonatal microbiome are not sufficient to lead to IBD,” Bernstein said. “Hence other events in the first year of life may be more critical such as use of antibiotics by the child which has also been shown to be associated with a risk for IBD.” – by Adam Leitenberger
Disclosures: Bernstein reports he has consulted, served on advisory boards or speakers bureaus, and/or received educational grants from AbbVie Canada, Ferring Canada, Janssen Canada, Pfizer Canada, Shire Canada, Takeda Canada and Mylan Pharmaceuticals. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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