Season of birth in a nationwide cohort of coeliac disease patients

Lebwohl, Benjamin; Green, Peter H. R.; Murray, Joseph A.; Ludvigsson, Jonas F.

doi:10.1136/archdischild-2012-302360

Cited by 48 publications

(32 citation statements)

References 27 publications

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“…The first study followed children up to 1997, and found summer to be associated with increased risk in children diagnosed before the age of 2 years 8. Lebwohl et al using Swedish pathology data showed a slightly increased risk in adults born during summer 9. Lewy et al reported increased CD risk in girls born during summer and in children diagnosed before 2 years of age but not in boys or in older children 10.…”

Section: Discussionmentioning

confidence: 99%

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

et al. 2016

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BackgroundCoeliac disease (CD) incidence has increased in recent decades, characterised by variations according to sex, age at diagnosis, year of birth, month of birth and region of birth. Genetic susceptibility and exposure to gluten are the necessary factors in CD aetiology, although several environmental factors are considered.MethodsA nationwide prospective cohort longitudinal study was conducted consisting of 1 912 204 children aged 0–14.9 years born in Sweden from 1991 to 2009. A total of 6569 children were diagnosed with biopsy-verified CD from 47 paediatric departments. Using Cox regression, we examined the association between CD diagnosis and season of birth, region of birth and year of birth.ResultsOverall, CD risk was higher for children born during spring, summer and autumn as compared with children born during winter: adjusted HR for spring 1.08 (95% CI 1.01 to 1.16), summer 1.10 (95% CI 1.03 to 1.18) and autumn 1.10 (95% CI 1.02 to 1.18). Increased CD risk was highest if born in the south, followed by central Sweden when compared with children born in northern Sweden. Children diagnosed at <2 years had an increased CD risk if born in spring while those diagnosed at 2–14.9 years the risk was increased for summer and autumn births. The birth cohort of 1991–1996 had increased CD risk if born during spring, for the 1997–2002 birth cohort the risk increased for summer and autumn births, while for the birth cohort of 2003–2009 the risk was increased if born during autumn.ConclusionsSeason of birth and region of birth are independently and jointly associated with increased risk of developing CD during the first 15 years of life. Seasonal variation in infectious load is the likely explanation.

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Section: Discussionmentioning

confidence: 99%

Season and region of birth as risk factors for coeliac disease a key to the aetiology?

et al. 2016

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“…Evidence, however, is not clear. Some studies have found infections at the time of gluten introduction not to be associated with increased risk of CD [46,47] .…”

Section: Other Environmental Factorsmentioning

confidence: 99%

Primary Prevention of Celiac Disease: Environmental Factors with a Focus on Early Nutrition

et al. 2015

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Celiac disease (CD) is a common autoimmune disorder caused by ingestion of gluten. When diagnosed, it should be treated with a lifelong, strict gluten-free diet. Early infant feeding practices have been suggested as a means of preventing CD. In the last few decades, observational data have suggested that breastfeeding, especially at the time of introducing gluten into the infant's diet, as well as the time and mode of gluten first being given to a child could prevent or delay the occurrence of CD. As a result, recommendations advised that it is prudent to avoid both early (<4 months) and late (>7 months) introduction of gluten, and to introduce gluten gradually while the infant is still being breastfed, as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy. Recently, the results of two large randomized trials have shown that breastfeeding in general, breastfeeding during gluten introduction, and early or delayed gluten introduction do not influence the total risk of CD in genetically predisposed individuals. Introducing gluten at 4 versus 6 months in very small amounts, or at 6 versus 12 months, resulted in similar rates of CD in these children. Thus, early feeding practices seem to have no impact on the risk of developing CD during childhood. In children without the genetic predisposition, the age and mode of gluten introduction do not influence the risk anyway.

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“…To date, there have been two published studies on the season of birth-CD association in North America [33], three in Northern Europe [13,16], and one in Israel [18].…”

Section: Introductionmentioning

confidence: 99%