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Early-Life Hygiene-Related Factors and Risk of Inflammatory Bowel Disease: A Scandinavian Birth Cohort Study
Univ Gothenburg, Sweden; Inst Clin Sci, Sweden.
Univ Gothenburg, Sweden.
Univ Oslo, Norway; Oslo Univ Hosp, Norway.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.ORCID iD: 0000-0003-1695-5234
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2023 (English)In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background We aimed to investigate whether early-life hygiene-related factors influenced the risk of inflammatory bowel disease (IBD) in a Scandinavian population and test the associations consistency across cohorts.Methods This study followed 117 493 participants in the All Babies in Southeast Sweden study and the Norwegian Mother, Father, and Child Cohort Study. IBD diagnoses were defined by national registers. Comprehensive data on hygiene-related exposures, such as having pets, rural living, daycare attendance, and siblings, were retrieved from questionnaires administered from pregnancy until childs age of 36 months. A multivariable Cox regression model yielded adjusted hazard ratios (aHRs) for IBD accounting for socioeconomic status and perinatal factors. Cohort-specific estimates were pooled using a random-effects model.Results In over 2 024 299 person-years of follow-up 451 participants developed IBD. In pooled estimates children attending daycare up to 36 months of life vs not attending daycare were less likely to develop Crohns disease (aHR, 0.60; 95% confidence interval [CI], 0.37- 0.98). Children having 1 or more siblings had a modestly increased risk of IBD (aHR, 1.17; 95% CI, 0.96-1.42; aHR for each sibling, 1.12; 95% CI, 1.01-1.24). The other hygiene factors were not significantly linked to later IBD. In the Norwegian Mother, Father, and Child Cohort Study cohort, bed sharing was associated with an increased risk of IBD, most notably for ulcerative colitis (aHR, 1.67; 95% CI, 1.01-2.78).Conclusions In this birth cohort study from 2 high-income Scandinavian countries, some early-life hygiene-related exposures were associated with IBD risk. The generalizability of these results to countries of other socioeconomic level is unknown. Exposure to some hygiene factors during early childhood seems to be associated with the risk of later inflammatory bowel disease. The direction and magnitude of the associations need to be further studied before any clinical implications.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS INC , 2023.
Keywords [en]
Inflammatory bowel disease; hygiene factors; epidemiology; early life
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-199104DOI: 10.1093/ibd/izad257ISI: 001092509100001PubMedID: 37921331OAI: oai:DiVA.org:liu-199104DiVA, id: diva2:1811918
Note

Funding Agencies|The authors are grateful to all the families in Sweden and Norway who participated in these ongoing cohort studies. In addition, they acknowledge Leslie Shaps, PhD, at Proofreading, Editing amp; Translation Global Services for language editing.

Available from: 2023-11-14 Created: 2023-11-14 Last updated: 2024-08-13

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Division of Children's and Women's HealthFaculty of Medicine and Health SciencesH.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus
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