Infection in the First Year of Life Increases IBD Risk in the Long Term

Having an infection in the first year of life increases one’s risk of developing inflammatory bowel disease (IBD) later in life, according to findings from a population-based study.

To analyze the relationship between critical events in the first year of life and the development of IBD, the researchers studied data from the University of Manitoba IBD Epidemiology Database of individuals from Manitoba, Canada, in whom IBD had been diagnosed from 1984 through 2010, as well as their healthy counterparts.

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All health care visits or hospitalizations during the neonatal and postnatal periods from 1970 through 2010 were also reviewed to determine the incidence of infections, gastrointestinal illnesses, failure to thrive, and hospital readmission in the first year of life, as well as the sociodemographic factors at birth.

Overall, the researchers evaluated data dating back to 1979 on 825 participants with IBD and 5999 healthy counterparts.

A maternal diagnosis of IBD was the greatest risk factor for IBD later in life (odds ratio [OR], 4.53; 95% CI, 3.08-6.67).

Having had an infection within the first year was associated with IBD development before age 10 years (OR, 3.06; 95% CI, 1.07-8.78) and before age 20 years (OR, 1.63; 95% CI, 1.18-2.24).

According to the study authors, the association between infection and IBD diagnosis could be attributed to antibiotics use or a physiologic defect during gut microbiome development.

“Limiting antibiotic usage in the management of routine infections could be desirable; however, it would be difficult to curb antibiotic use for many of the infections as serious as the ones we assessed,” the authors wrote. “If it is increasingly accepted that antibiotics in the first year of life truly pose a risk for later chronic immune disease like IBD, then research is warranted to determine exactly what antibiotic intake does to infant gut microflora or intestinal or systemic immune responses.”

Individuals in the highest socioeconomic quintile at birth had an increased likelihood of developing IBD later in life. For events within the first year, participants being in the highest socioeconomic quintile at birth and having had infections had an increased risk of developing IBD at any age. 

Gastrointestinal infections, gastrointestinal disease, or abdominal pain experienced within the first year of life did not impact risk of IBD later in life.

—Colleen Murphy

Reference:

Bernstein CN, Burchill C, Targownik LE, Singh H, Roos LL. Events within the first year of life, but not the neonatal period, affect risk for later development of inflammatory bowel diseases. Gastroenterology. 2019;156(8):2190-2197. doi:10.1053/j.gastro.2019.02.004.