title: Prenatal and perinatal characteristics associated with pediatric-onset inflammatory bowel disease.
abstract: BACKGROUND
  The majority of studies that report early life risk factors for pediatric-onset inflammatory bowel disease (IBD) do not account for potential confounding, which can lead to spurious associations and incorrect inferences.
  
  
  OBJECTIVE
  To assess the relationship between prenatal and perinatal characteristics and the risk of pediatric-onset IBD accounting for potential confounding.
  
  
  METHODS
  We conducted a nested case-control study of 189 cases aged ≤18 years and 3,080 age- and membership-matched controls born at a Kaiser Permanente Northern California facility between 1984 and 2006. The cases were diagnosed with IBD between 1996 and 2006 and diagnosis was confirmed by chart review. We obtained prenatal and perinatal characteristics from the electronic clinical records of the mother and child. Conditional logistic regression was used to assess the associations between these factors and risk of incident IBD, Crohn's disease, and ulcerative colitis.
  
  
  RESULTS
  In analyses accounting for confounding, maternal IBD (odds ratio [OR] 5.1, 95 % confidence interval [CI] 2.0-12.9) and white race (OR 2.3, 95 % CI 1.6-3.2) were the only factors statistically associated with pediatric-onset IBD. Maternal respiratory infection during pregnancy (OR 2.0, 95 % CI 1.0-4.0), age < 20 years (OR 2.0, 95 % CI 0.8-4.7) and gestational hypertension (OR 1.7, 95 % CI 1.0-2.7) were associated with pediatric-onset IBD, but did not achieve statistical significance.
  
  
  CONCLUSIONS
  Maternal history of IBD and race were the only characteristics of those that we examined that were associated with the development of pediatric IBD in this well-documented population of cases and matched controls.
authors.affiliation: Division of Gastroenterology and Hepatology, Johns Hopkins University, 600 N. Wolfe St., Blalock Building 449, Baltimore, MD 21287, USA. shutfle1@jhmi.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Hutfless
authors.forename: De-Kun
authors.initials: DK
authors.lastname: Li
authors.forename: Melvin B
authors.initials: MB
authors.lastname: Heyman
authors.forename: Theodore M
authors.initials: TM
authors.lastname: Bayless
authors.forename: Oren
authors.initials: O
authors.lastname: Abramson
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Herrinton
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012189:Retrospective Studies; D044465:White People; D055815:Young Adult