Prematurity is a risk factor of disorders of gut-brain interaction in adults: A case-control study.

Background: Disorders of gut-brain interaction (DGBI) are defined as a variable combination of chronic or recurrent gastrointestinal symptoms. Early-life stressors have been implicated as possible contributing factors.

Aim: To determine if prematurity and neonatal factors influence the development of DGBI in adults.

Methods: A case-control study was carried out at a tertiary referral center from July 2019 to July 2021. Cases (adults born with extremely premature < 29 weeks of gestation) were recruited from the Health of Adults Born Preterm Investigation cohort. Control subjects were recruited from the general population. All participants completed the Rome IV diagnostic questionnaire online. Cases completed anxiety and depression questionnaires (Patient-Reported Outcomes Measurement Information System-29 items, Generalized Anxiety Disorder-7 items, Patient Health Questionnaire-9 items). Neonatal data and sociodemographic status were collected.

Results: A total of 79 cases and 124 controls were enrolled in the study. The group of adults born preterm exhibited a significantly higher prevalence of functional bowel disorders (P = 0.01) and a trend suggesting a higher prevalence of functional gastroduodenal disorders (P = 0.06). Among women born prematurely, the prevalence of functional gastroduodenal disorders, functional bowel disorders, and functional constipation was significantly higher compared to the female control group (P = 0.02 for all). The identified risk factors are categorized as directly linked to prematurity (e.g., chorioamnionitis), indirectly related to prematurity (e.g., anxiety, depression, and social skills as consequences of prematurity), or independent of prematurity (e.g., female sex).

Conclusion: This is the first case-control study reporting the prevalence of DGBI in a cohort of well-characterized adults born prematurely. We confirm that prematurity is a risk factor for developing a DGBI.