title: Premature Birth and Large for Gestational Age Are Associated with Risk of Barrett's Esophagus in Adults.
abstract: BACKGROUND
  Birth characteristics, including weight and gestational age, may be associated with risk of Barrett's esophagus (BE), the only known precursor for esophageal adenocarcinoma; however, data are limited.
  
  
  OBJECTIVE
  To examine associations between various birth characteristics and BE, and whether these associations are mediated by known risk factors for BE.
  
  
  METHODS
  Data were obtained from a cross-sectional study among eligible Veterans Affairs patients scheduled for an upper endoscopy, and a sample identified from primary care clinics. Participants underwent an esophagogastroduodenoscopy and completed a survey that captured information on sociodemographic and clinical factors, as well as birth information. We compared 263 patients with histologically confirmed BE to 1416 controls without BE on endoscopy. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using multivariate logistic regression.
  
  
  RESULTS
  Premature birth was independently associated with risk of BE after adjusted by age, sex, race, and other birth characteristics (OR 3.28, 95 % CI 1.22-8.79). On the other hand, large for gestational age was inversely associated with risk of BE (OR 0.46, 95 % CI 0.21-0.98). These effects were stronger for patients with long-segment BE than with short-segment BE. The associations were not mediated by gastroesophageal reflux disease symptoms, use of proton pump inhibitors, Helicobacter Pylori infection, waist-hip-ratio, height or the presence of hiatus hernia.
  
  
  CONCLUSIONS
  Premature birth and large for gestational age may be associated with risk of BE in adults. These associations do not appear to be mediated through known risk factors for BE; however, additional studies are required to confirm our findings.
authors.affiliation: Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX, 77030, USA.|Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Seiji
authors.initials: S
authors.lastname: Shiota
authors.affiliation: Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX, 77030, USA.|Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.|Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, 2002 Holcombe Blvd, Houston, TX, 77030, USA.
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
authors.affiliation: Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. Aaron.Thrift@bcm.edu.|Dan L. Duncan Cancer Center, Baylor College of Medicine, One Baylor Plaza, MS: BCM305, Houston, TX, 77030, USA. Aaron.Thrift@bcm.edu.
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Thrift
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000453:epidemiology*; D001724:Birth Weight; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D047928:Premature Birth; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology
keywords: Barrett’s esophagus; Birth weight for gestational age; Premature birth; Risk factors