Early determinants of inflammatory bowel disease: use of two national longitudinal birth cohorts

Objective To examine previously cited early risk factors for inflammatory b owel disease. Design The 1946 National Survey of Health & Development (NSHD) and the 1958 National Child Development Study (NCDS) are on-going, longitudinal birth c ohort studies. A nested case-control design was used combining data from bo th cohorts; eight controls per case, matched for gender and social class, w ere selected randomly. Methods Data concerning maternal infection in pregnancy (NCDS only), childh ood infection (measles, mumps and whooping cough), birth order, appendicect omy, breastfeeding and measures of poor housing conditions in childhood wer e analysed. In both cohorts, the member's hospital physician or medical rec ords were used to confirm the diagnosis. Results Twenty-six cases of Crohn's disease and 29 cases of ulcerative coli tis were identified. No significant association was found between the devel opment of Crohn's disease or ulcerative colitis and any of the studied fact ors. There was a trend that those with Crohn's disease were more likely not to have been breast-fed (OR 0.4, 95% CI 0.15-1.03) and not to have had an appendicectomy (OR < 1.00). The opposite was true of those with ulcerative colitis (OR 2.76, 95% CI 0.86-9.81 and OR 2.34, 95% CI 0.69 - 7.46, respect ively). The prevalence of inflammatory bowel disease was 5.12/1000 by the a ge of 43 years in NSHD and 2.02-2.54/1000 by the age of 33 years in NCDS. Conclusions The prevalence of inflammatory bowel disease in these cohorts i s among the highest recorded in Europe. Childhood factors may be different for those with Crohn's disease and ulcerative colitis. These cohorts will b e increasingly valuable data sources, (C) 2000 Lippincott Williams & Wilkin s.