Mo1993 The Prevalence of Stressful Life Events Including Sexual Child Abuse in Children With Functional Defecation Disorders: A Systematic Review

Abstract

Background: Early life exposure to antibiotics might alter the development of the host microbiome and influence Crohn's disease (CD) risk. Although this association has been suggested by a few recent studies, larger studies with longer duration of follow-up and more rigorous control of confounding are needed. We sought to further evaluate the association between antibiotic use during the first year of life and subsequent CD by performing a nationwide birth cohort study in Denmark.Methods: All children born in Denmark between 1995 and 2007 were identified in the Danish Medical Birth Registry, and followed until death, emigration, or end of study (January 1, 2011). Outpatient antibiotic use was identified using the National Prescription Registry. Cases of CD were identified using the Danish National Patient Registry; a subset was confirmed by linkage to the National Pathology Registry. As a negative control, we analyzed exposure to systemic adrenergic agents, the second most commonly prescribed class of medications in the first year of life. Relative risk was determined by Cox proportional hazards models, after adjusting for route of delivery, birth order, gender, birth year, and family history of CD.Results: The birth cohort consisted of 850,962 children followed for a mean of 8.5 years (7,206,533 person-years of follow up). Of these, 51.3% were male, 17.5% were born by c-section, 1.0% had a family history of CD and 41.1% had ≥ 1 filled antibiotic prescription in the first year of life. 291 cases of CD were observed during follow-up. A positive association between antibiotic use and CD did not reach statistical significance (adjusted HR 1.2, 95% CI 0.9-1.5). Results of a subanalysis of confirmed cases were similar (adjusted HR 1.4, 95% CI 0.9-2.2). As expected, there was a positive association with family history of CD (adjusted HR 16.4, 95% CI 8.631.1). There was no association between use of systemic adrenergic drugs and CD (adjusted HR 1.0, 95% CI 0.5-1.8).Discussion: We found a non-significant trend for the association between early-life antibiotic exposure and risk of CD. No association was observed in our negative control group. Our findings are consistent with previously observed associations between antibiotic use and CD.