Velasco-Benitez Carlos A, Axelrod Cara H, Gutierrez Susan, Saps Miguel
Department of Pediatrics, Universidad del Valle, Cali, Colombia.
Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain.
J Pediatr Gastroenterol Nutr. 2020 Feb;70(2):e37-e40. doi: 10.1097/MPG.0000000000002543.
The pathogenesis of functional gastrointestinal disorders (FGIDs) remains unknown. Early life events including method of delivery and length of gestation may be risk factors for FGIDs. Data from studies on early life events and the development of FGIDs are scarce and contradictory.
The aim of the study was to assess the association between mode of delivery, length of gestation, and FGIDs in children. We hypothesized that delivery via Cesarean section and prematurity would be associated with an increased prevalence of FGIDs.
Questionnaires were mailed to families from 3 cities in Colombia. Parents provided information on mode of delivery, demographics, and medical history. School children completed the Spanish version of the Questionnaire of Pediatric Gastrointestinal Symptoms Rome IV. Categorical data were analyzed using Fisher exact tests. Calculation of odds ratio with 95% confidence interval was performed.
A total of 1497 children (535 preadolescents 10-12 years, 962 adolescents 13-18 years) participated. For participants born via Cesarean delivery, there was no significant increase in prevalence of any of the Rome IV FGIDs compared with vaginal delivery. There was a significant association between prematurity and FGIDs for those born between 28 and 32 weeks (confidence interval 0.99-3.37; P = 0.03). In this group, functional nausea was the only category of FGID to reach significance (0.16-112.23) (P = 0.02). However, statistical significance was lost when gestational ages were grouped together with multivariate analysis.
Our findings provide evidence that Cesarean delivery and prematurity are not risk factors for the development of FGIDs. Future studies are indicated to further evaluate the relationship between early life events and FGIDs.
功能性胃肠病(FGIDs)的发病机制尚不清楚。包括分娩方式和妊娠时长在内的早期生活事件可能是FGIDs的危险因素。关于早期生活事件与FGIDs发生发展的研究数据稀少且相互矛盾。
本研究旨在评估儿童分娩方式、妊娠时长与FGIDs之间的关联。我们假设剖宫产和早产与FGIDs患病率增加有关。
向哥伦比亚3个城市的家庭邮寄问卷。父母提供分娩方式、人口统计学和病史信息。在校儿童完成西班牙语版的《罗马IV小儿胃肠症状问卷》。使用Fisher精确检验分析分类数据。计算比值比及其95%置信区间。
共有1497名儿童(535名10 - 12岁的青春期前儿童,962名13 - 18岁的青少年)参与。与阴道分娩相比,剖宫产出生的参与者中,任何一种罗马IV型FGIDs的患病率均未显著增加。妊娠28至32周出生的儿童中,早产与FGIDs之间存在显著关联(置信区间0.99 - 3.37;P = 0.03)。在这一组中,功能性恶心是唯一达到显著水平的FGID类别(0.16 - 112.23)(P = 0.02)。然而,在多变量分析中将胎龄分组后,统计学显著性消失。
我们的研究结果表明,剖宫产和早产不是FGIDs发生发展的危险因素。未来研究需进一步评估早期生活事件与FGIDs之间的关系。