Prevalence of Clinical Factors before Inflammatory Bowel Disease Diagnosis among 380,000 Girls Scheduled for Papillomavirus Vaccination: A Cohort Study

Background: As potentially auto-immune, human papillomavirus vaccination safety surveillance includes Inflammatory Bowel Disease (IBD). We aimed to assess other risk factors among girls scheduled to vaccinate during 2007-2016 Methods: Cohort study including girls aged 9-18 years using the Spanish Primary Care Database for Pharmacoepidemiological Research (BIFAP). Adjusted Hazard ratios (HR; reported in brackets) of IBD associated with (gastroenterological and others) clinical factors were estimated. Results: Out of 388,669 girls, 185 IBD cases occurred (43.78% Crohn’s disease, 37.84% Ulcerative colitis, 18.38% undetermined). IBD increased with age, IBD family history (HR: 10.64), thyroiditis (5.07), herpesvirus infection (4.96), asthenia (1.74), while decreased with inhaled budesonide (0.38) or meningococcus B-C vaccination (0.33). Abnormal bowel movement (25.26), lower gastrointestinal bleeding (8.74), dyspepsia (7.69), abdominal pain (1.49) and spasmolytic (3.89) or antisecretory drugs (2.43) were more recorded among cases. Contraceptives (3.07), fever (2.57), infectious gastroenteritis (2.48), growth problems (2.12), chronic diarrhoea (5.37) and coeliac disease (2.07) showed almost statistical increased risk while depression or allergy showed no risk. Conclusions: The relationship between potential immune diseases and IBD varied, being high for thyroiditis, just suggested for celiac disease and lacking for allergy. The important prevalence of family history, gastrointestinal or growth conditions on IBD was confirmed.