title: Gastric suction at birth associated with long-term risk for functional intestinal disorders in later life.
abstract: OBJECTIVE
  To test the hypothesis that noxious stimulation at birth may increase the long-term risk for developing psychosomatic or functional disorders during later life.
  
  
  METHODS
  Matched case-control study using sibling controls. The birth records were retrieved for the offspring of 494 mothers who, after uncomplicated pregnancies, had delivered two or more children with birth weights at least 2500 g, if at least one child was exposed to a perinatal complication or birth asphyxia. Among their offspring (N=1110), the 108 cases hospitalized for functional intestinal symptoms were identified from nationwide hospital discharge records. Of these, 96 cases were compared with 116 unaffected sibling controls.
  
  
  RESULTS
  Functional intestinal symptoms occurred more commonly among the 1110 subjects (9.5%) than in the general population (3.4%, chi(2)=124, P<10(-6)). Gastric suction at birth occurred more frequently among the cases compared with their siblings (22.9% vs 11.2%). There were no differences in the number of cases and controls exposed to perinatal trauma or birth asphyxia. Multivariate logistic regression analyses showed that gastric suction at birth was associated with functional intestinal disorders during later life (odds ratio, 2.99; 95% confidence interval, 1.32-6.79; P=.009), whereas maternal, perinatal, or other confounding variables were not significant.
  
  
  CONCLUSIONS
  Noxious stimulation caused by gastric suction at birth may promote the development of long-term visceral hypersensitivity and cognitive hypervigilance, leading to an increased prevalence of functional intestinal disorders in later life.
authors.affiliation: Department of Critical Care Medicine, University of Arkansas for Medical Sciences, and Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202, USA. anandsunny@exchange.uams.edu
authors.forename: K J S
authors.initials: KJ
authors.lastname: Anand
authors.forename: Bo
authors.initials: B
authors.lastname: Runeson
authors.forename: Bertil
authors.initials: B
authors.lastname: Jacobson
mesh_terms: D000293:Adolescent; D000328:Adult; D001238:Asphyxia Neonatorum / Q000453:epidemiology / Q000628:therapy; D001719:Birth Certificates; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D012306:Risk; D035781:Siblings; D013270:Stomach; D013396:Suction / Q000009:adverse effects*; D013548:Sweden / Q000453:epidemiology; D013995:Time