Maternal and perinatal conditions and the risk of developing celiac disease during childhood.
Celiac disease (CD) is increasing worldwide, which might be due to the changing environmental and lifestyle exposures. We aimed to explore how conditions related to maternity, delivery and the neonatal period influence CD onset during childhood.



Using Sweden's national registers we had access to information on 1 912 204 children born between 1991 and 2009, 6 596 of whom developed CD before 15 years of age. Logistic regression analyses were performed to determine how CD is associated with maternity, delivery and the neonatal period.



Regardless of sex, a reduction in CD risk was observed in children born to mothers aged ≥35 years (odds ratio [OR] 0.8; 95 % confidence interval [CI] 0.7-0.9) and with high maternal income (OR 0.9; 95 % CI 0.8-0.9). Being a second-born child, however, was positively associated with CD. Among boys, elective caesarean delivery increased the risk of CD (OR 1.2; 95 % CI 1.0-1.4), while maternal overweight (OR 0.9; 95 % CI 0.8-0.9), premature rupture of the membrane (OR 0.4; 95 % CI 0.2-0.8) and low birth weight showed a negative association. Girls had an increased CD risk compared to boys and in girls the risk was increased by repeated maternal urinary tract infections (OR 1.1; 95 % CI 1.0-1.2).



Elective caesarean delivery and repeated maternal urinary tract infections during pregnancy are associated with increased risk of CD onset during childhood, suggesting the role of dysbiosis during early life. High maternal age and high income reduced the risk of CD, which might be due to infant-feeding practices and life style.
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden. fredinah.namatovu@epiph.umu.se.
Fredinah
F
Namatovu
Department of Food and Nutrition, Umeå University, Umeå, Sweden.
Cecilia
C
Olsson
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden.
Marie
M
Lindkvist
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden.
Anna
A
Myléus
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden.|Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Uppsala, Sweden.
Ulf
U
Högberg
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden.
Anneli
A
Ivarsson
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Olof
O
Sandström
D000293:Adolescent; D002446:Celiac Disease / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
Caesarean; Celiac disease; Children; Delivery; Elective; Income; Infections; Perinatal; Pregnancy; Register