Impact of Environmental and Familial Factors in a Cohort of Pediatric Patients With Inflammatory Bowel Disease.
The primary role of environment on inflammatory bowel disease (IBD) onset has been recently stressed. We aimed to investigate the effect of environmental factors in an IBD pediatric cohort.



A total of 467 subjects (264 IBD and 203 controls) were enrolled. All patients underwent a questionnaire including 5 different groups of environmental risk factors: family history of IBD and autoimmune diseases, perinatal period, home amenities and domestic hygiene, childhood diseases and vaccinations, and diet.



In a multivariate model, mother's degree (odds ratio [OR]: 5.5; 2.5-11.6), duration of breast feeding >3rd month (OR: 4.3; 1.6-10.5), father's employment (OR: 3.7; 1.2-8.7), gluten introduction <6th month (OR: 2.8; 1.5-5), number of siblings <2 (OR: 2.8; 1.5-5.3), and family history of autoimmune diseases (OR: 2.7; 1.4-5.3) were significant risk factors for Crohn disease. Low adherence to Mediterranean diet (OR: 2.3; 1.2-4.5), gluten introduction <6th month (OR: 2.8; 1.6-4.9), and number of siblings <2 (OR: 2; 1.1-3.6) were significant risk factors for ulcerative colitis. Owning pets (OR: 0.3; 0.1-0.7) and bed sharing (OR: 0.2; 0.1-0.6) were protective factors for Crohn disease, whereas owning pets (OR: 0.4; 0.2-0.8) and family parasitosis (OR: 0.07; 0.01-0.4) were protective factors for ulcerative colitis.



Our study confirms that environmental factors are closely linked to IBD onset and may partly explain IBD rise in developed countries.
*Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples †Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy.
Caterina
C
Strisciuglio
Francesca
F
Giugliano
Massimo
M
Martinelli
Sabrina
S
Cenni
Luigi
L
Greco
Annamaria
A
Staiano
Erasmo
E
Miele
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000209:etiology* / Q000517:prevention & control; D003424:Crohn Disease / Q000209:etiology* / Q000517:prevention & control; D019049:Developed Countries; D038441:Diet, Mediterranean; D004777:Environment; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D065840:Protective Factors; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires