Maternal Infections That Would Warrant Antibiotic Use Antepartum or Peripartum Are Not a Risk Factor for the Development of IBD: A Population-Based Analysis

Abstract

Background: We aimed to determine whether maternal antenatal or perinatal infections (and thereby use of antibiotics) increase the risk of developing inflammatory bowel disease (IBD) in their offspring.

Methods: The University of Manitoba IBD Epidemiology Database contains records of all Manitobans diagnosed with IBD from 1984 to 2010. Each individual with IBD is matched to 10 controls. Subjects' medical system contacts are identified using a unique deidentified personal health identification number. Individuals born in 1970 and later are linkable to their mothers through a 6-digit family health registration number and cross referencing of mothers' personal health identification number with the child's birth record. We assessed antenatal (30 days and 9 months before delivery) and peripartum (in hospital) maternal infections identified by ICD-8 and ICD-9 codes as a proxy for antibiotic use.

Results: Of the 2487 IBD cases born after 1970, 1758 were born in Manitoba, of which 1671 were linkable to mothers (Crohn's disease = 973 and ulcerative colitis = 698). From 1615 families, 10488 matched controls and 1740 siblings were identified. Maternal infections occurred with equal rates in mothers of IBD cases and mothers of controls: within 9 months antepartum, 21.7% versus 23.2% (odds ratio = 0.96 [0.84-1.09]); within 30 days antepartum 11.4% versus 12.4% (odds ratio = 0.97, 0.82-1.14); peripartum 5.5% versus 7.5% (odds ratio = 0.86, 0.68-1.09). There was also no difference in the occurrence of antepartum or peripartum infections among mothers of IBD cases versus unaffected siblings.

Conclusions: Maternal infections (and therefore antibiotic use) in the antepartum and peripartum periods do not affect the risk of development of IBD in offspring.