Karl Mårild, Jonas Söderling, Olof Stephansson, Jordan Axelrad, Jonas Halfvarson, Gabriella Bröms, Jan Marsal, Martin Neovius, Björn Pasternak, Ola Olén, Jonas F Ludvigsson
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Adjusted risk ratios (aRRs) for overall and organ-specific mCAs were estimated using generalized linear models. These models adjusted for maternal sociodemographics, comorbidities, body mass index, and smoking.</p><p><strong>Results: </strong>There were 38.0 (n = 499) mCAs per 1,000 births to women with IBD vs 33.9 (n = 2,101) in matched comparators and a risk difference of 1 extra mCA per 246 births to women with IBD (aRR 1.11; 95% confidence interval [CI] 1.01-1.23). Risks of heart defects and mCAs of the urinary system partly drove estimates. The risk of mCAs was similar in children of women with ulcerative colitis and Crohn's disease. Periconceptional histological inflammation (vs remission) or clinically active (vs quiescent) IBD did not further influence the risk of mCA in the child (aRR 0.87 [95% CI 0.55-1.40] and aRR 1.04 [95% CI 0.85-1.27], respectively).</p><p><strong>Discussion: </strong>Children of women with IBD had a heightened susceptibility to mCAs, although absolute and relative risks were lower than previously reported. IBD activity was not linked to mCA risks, but those analyses included relatively few events.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2350-2360"},"PeriodicalIF":7.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234800/pdf/","citationCount":"0","resultStr":"{\"title\":\"Inflammatory Bowel Disease, Periconceptional Disease Activity, and Risk of Major Congenital Anomalies: A Nationwide Cohort Study.\",\"authors\":\"Karl Mårild, Jonas Söderling, Olof Stephansson, Jordan Axelrad, Jonas Halfvarson, Gabriella Bröms, Jan Marsal, Martin Neovius, Björn Pasternak, Ola Olén, Jonas F Ludvigsson\",\"doi\":\"10.14309/ajg.0000000000003306\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>It is uncertain whether the risk of major congenital anomalies (mCAs) is increased in children of women with inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>We aimed to determine the risk of mCAs in a Swedish nationwide cohort of 13,131 singleton live births from 1997 to 2020 to women with IBD and 61,909 matched children to women without IBD from the general population. 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引用次数: 0
摘要
目前尚不清楚炎症性肠病(IBD)女性的孩子发生重大先天性异常(mCAs)的风险是否会增加。方法:我们的目的是确定瑞典全国范围内1997年至2020年间13131例IBD女性单胎活产婴儿和61909例普通人群中无IBD女性匹配儿童的mCAs风险。我们还根据围孕期组织学炎症(对照缓解:分别为1124例和646例)或临床活动性IBD(对照静止:分别为3380例和6603例)检查了mca。使用广义线性模型估计整体和器官特异性mCAs的调整风险比(aRRs)。这些模型调整了产妇的社会人口统计、合并症、体重指数和吸烟。结果:IBD女性每1000个新生儿中有38.0 (n = 499)个mCA,而匹配比较组中有33.9 (n = 2101)个mCA, IBD女性每246个新生儿中有1个mCA的风险差异(aRR 1.11;95%置信区间[CI] 1.01-1.23)。心脏缺陷和泌尿系统mca的风险在一定程度上推动了这一估计。溃疡性结肠炎和克罗恩病妇女的孩子患mca的风险相似。围期组织学炎症(相对缓解)或临床活动性IBD(相对静止)并未进一步影响儿童mCA的风险(aRR分别为0.87 [95% CI 0.55-1.40]和1.04 [95% CI 0.85-1.27])。讨论:IBD女性的孩子对mCAs的易感性增加,尽管绝对和相对风险低于先前报道。IBD活动与mCA风险无关,但这些分析包括相对较少的事件。
Inflammatory Bowel Disease, Periconceptional Disease Activity, and Risk of Major Congenital Anomalies: A Nationwide Cohort Study.
Introduction: It is uncertain whether the risk of major congenital anomalies (mCAs) is increased in children of women with inflammatory bowel disease (IBD).
Methods: We aimed to determine the risk of mCAs in a Swedish nationwide cohort of 13,131 singleton live births from 1997 to 2020 to women with IBD and 61,909 matched children to women without IBD from the general population. We additionally examined mCAs according to periconceptional histological inflammation (vs remission: 1,124 and 646 births, respectively) or clinically active IBD (vs quiescent: 3,380 and 6,603 births, respectively). Adjusted risk ratios (aRRs) for overall and organ-specific mCAs were estimated using generalized linear models. These models adjusted for maternal sociodemographics, comorbidities, body mass index, and smoking.
Results: There were 38.0 (n = 499) mCAs per 1,000 births to women with IBD vs 33.9 (n = 2,101) in matched comparators and a risk difference of 1 extra mCA per 246 births to women with IBD (aRR 1.11; 95% confidence interval [CI] 1.01-1.23). Risks of heart defects and mCAs of the urinary system partly drove estimates. The risk of mCAs was similar in children of women with ulcerative colitis and Crohn's disease. Periconceptional histological inflammation (vs remission) or clinically active (vs quiescent) IBD did not further influence the risk of mCA in the child (aRR 0.87 [95% CI 0.55-1.40] and aRR 1.04 [95% CI 0.85-1.27], respectively).
Discussion: Children of women with IBD had a heightened susceptibility to mCAs, although absolute and relative risks were lower than previously reported. IBD activity was not linked to mCA risks, but those analyses included relatively few events.
期刊介绍:
Published on behalf of the American College of Gastroenterology (ACG), The American Journal of Gastroenterology (AJG) stands as the foremost clinical journal in the fields of gastroenterology and hepatology. AJG offers practical and professional support to clinicians addressing the most prevalent gastroenterological disorders in patients.