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Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses

2021-05-15Journal article Open access
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dc.contributor.authorAgrawal, Manasi
dc.contributor.authorSabino, João
dc.contributor.authorFrias-Gomes, Catarina
dc.contributor.authorHillenbrand, Christen M.
dc.contributor.authorSoudant, Celine
dc.contributor.authorAxelrad, Jordan E.
dc.contributor.authorShah, Shailja C.
dc.contributor.authorRibeiro-Mourão, Francisco
dc.contributor.authorLambin, Thomas
dc.contributor.authorPeter, Inga
dc.contributor.authorColombel, Jean-Frederic
dc.contributor.authorNarula, Neeraj
dc.contributor.authorTorres, Joana
dc.date.accessioned2022-11-10T10:10:01Z
dc.date.available2022-11-10T10:10:01Z
dc.date.issued2021-05-15
dc.description.abstractBackground: Early life exposures impact immune system development and therefore the risk of immune-mediated diseases, including inflammatory bowel disease (IBD). We systematically reviewed the impact of pre-, peri‑, and postnatal exposures up to the age of five years on subsequent IBD diagnosis. Methods: We identified case-control and cohort studies reporting on the association between early life environmental factors and Crohn's disease (CD), ulcerative colitis (UC), or IBD overall. Databases were search from their inception until May 24th, 2019 until July 14th, 2020. We conducted meta-analyses for quantitative review of relevant risk factors that were comparable across studies and qualitative synthesis of the literature for a wide range of early life exposures, including maternal health and exposures during pregnancy, perinatal factors, birth month and related-factors, breastfeeding, hygiene-related factors and social factors, immigration, antibiotics, offspring health, including infections, and passive smoking. PROSPERO registration: CRD42019134980. Findings: Prenatal exposure to antibiotics (OR 1.8; 95% CI 1.2-2.5) and tobacco smoke (OR 1.5; 95% CI 1.2-1.9), and early life otitis media (OR 2.1; 95% CI 1.2-3.6) were associated with IBD. There was a trend towards an association between exposure to antibiotics in infancy and IBD (OR: 1.7, 95% CI 0.97, 2.9), supported by positive data on population-based data. Breastfeeding was protective against IBD. Other early life risk factors had no association with IBD, but data were limited and heterogenous. Interpretation: Early life is an important period of susceptibility for IBD development later in life. Tobacco smoke, infections and antibiotics were associated positively, and breastfeeding was associated negatively with IBD. Our findings offer an opportunity to develop primary prevention strategies.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAgrawal M, Sabino J, Frias-Gomes C, et al. Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses. EClinicalMedicine. 2021;36:100884. doi:10.1016/j.eclinm.2021.100884pt_PT
dc.identifier.doi10.1016/j.eclinm.2021.100884pt_PT
dc.identifier.issn2589-5370
dc.identifier.urihttp://hdl.handle.net/10400.16/2741
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherThe Lancetpt_PT
dc.relation.publisherversionhttps://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00164-4/fulltextpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectCrohn's diseasept_PT
dc.subjectEarly lifept_PT
dc.subjectEnvironmental exposurept_PT
dc.subjectEpidemiologypt_PT
dc.subjectInflammatory bowel diseasept_PT
dc.subjectNon-geneticpt_PT
dc.subjectRisk factorspt_PT
dc.subjectUlcerative colitispt_PT
dc.titleEarly life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analysespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceEnglandpt_PT
oaire.citation.startPage100884pt_PT
oaire.citation.titleEClinicalMedicinept_PT
oaire.citation.volume36pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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