7th Annual BMRP Investigator Meeting - Abstract

Scott M. Montgomery^1,a, Petter Malmborg² and Hans Hildebrand²

¹Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Karolinska Institute and ²Department of Women and Child Health, Astrid Lindgren Children’s Hospital (Stockholm, Sweden)

 

The pattern of microbial colonization in early life may be important for development of homeostasis between host and gut flora. If disrupted, this may influence Crohn’s disease risk as an inflammatory reaction to normal gut flora is implicated in the etiology. Supporting evidence includes a study of inpatient treatment indicating antibiotic use, which can disrupt bowel colonization). Pneumonia (particularly with otitis media) before but not after age five years was associated with subsequent pediatric and adult-onset Crohn’s disease. As colonization in the birth canal may be of particular importance in developing homeostasis, this study investigated birth by caesarean section and risk of pediatric Crohn’s disease among 431 male cases (4267 controls) and 315 female cases (3088 controls) born since 1990. Matching was by sex, week of birth and delivery unit. The analysis was stratified by sex as the preponderance of male patients in pediatric Crohn’s disease suggests sex-specific risks.   Birth by caesarean section was a risk for Crohn’s disease independent of mother’s age, maternal IBD, birth weight and gestational age. This association was more pronounced among boys. Pattern of perinatal bowel colonization may influence Crohn’s disease risk but associations differ by sex.

  

^aPrincipal Investigator