Irritable bowel syndrome and the perinatal period: lower birth weight increases the risk

Raslau D1, Herrick LM2,3, Locke GR2, Schleck CD4, Zinsmeister AR4, Almazar A2, Talley NJ2,5, Saito YA2. Neurogastroenterol Motil. 2016 May 18. doi: 10.1111/nmo.12849. [Epub ahead of print]
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1Department of Medicine, Mayo Clinic, Rochester, MN, USA. 2Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. 3College of Nursing, South Dakota State University, Brookings, SD, USA. 4Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA. 5University of Newcastle, Callaghan, NSW, Australia.


BACKGROUND: Early life events have been found to be associated with irritable bowel syndrome (IBS) suggesting a role in development of functional disorders. The study aim was to identify potential perinatal risk factors for adult IBS.

METHODS: Utilizing a population-based nested case-control design, cases who met modified Rome III criteria for IBS and age- and-gender matched controls were identified using responses from prior mailed surveys to a random sample of Olmsted County residents. Medical records of eligible respondents were reviewed for perinatal events of interest. The association of early life events with subsequent case status was assessed using conditional logistic regression.

KEY RESULTS: Of 3 417 respondents, 513 were born in Olmsted County and 108 met criteria for IBS. Due to missing records, 89 pairs were included in the final analyses. Logistic regression revealed only birth weight as a predictor of IBS. Lower birth weight increased the odds for IBS (OR = 1.54 [95% CI = (1.12, 2.08), p = 0.008]). Median birth weight was 3.35 kg (range: 1.96-5.24) and 3.57 kg (range: 2.18-4.59) for cases and controls, respectively. Maternal age, delivery method, and antibiotic exposure were not associated with IBS status but this study was only powered to detect large odds ratios.

CONCLUSIONS AND INFERENCES: Lower birth weight was observed as a risk factor for IBS. It is not clear if in utero developmental delays directly lead to IBS or if low birth weight is a prospective marker for subsequent early life problems leading to IBS.

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