L Xu1,2, P Lochhead1, Y Ko3, B Claggett2,4, R W Leong3, A N Ananthakrishnan1,2. 1. Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA. 2. Harvard Medical School, Boston, MA, USA. 3. Gastroenterology and Liver Services, Concord Hospital, Sydney, NSW, Australia. 4. Cardiac Imaging Core Laboratory and Clinical Trials Endpoints Center, Brigham and Women's Hospital, Boston, MA, USA.
Abstract
BACKGROUND: Breastfeeding is a modifiable factor that may influence development of inflammatory bowel diseases. However, literature on this has been inconsistent and not accounted for heterogeneity in populations and exposure. AIM: To conduct a meta-analysis to examine the association between breastfeeding in infancy and risk of Crohn's disease (CD) and ulcerative colitis (UC). METHODS: A systematic search of Medline/PubMed and Embase was performed for full text, English-language literature through November 2016. Studies were included if they described breastfeeding in infancy in patients with CD or UC, and healthy controls. Data were pooled using a random effects model for analysis. RESULTS: A total of 35 studies were included in the final analysis, comprising 7536 individuals with CD, 7353 with UC and 330 222 controls. Ever being breastfed was associated with a lower risk of CD (OR 0.71, 95% CI 0.59-0.85) and UC (OR 0.78, 95% CI 0.67-0.91). While this inverse association was observed in all ethnicity groups, the magnitude of protection was significantly greater among Asians (OR 0.31, 95% CI 0.20-0.48) compared to Caucasians (OR 0.78, 95% CI 0.66-0.93; P = .0001) in CD. Breastfeeding duration showed a dose-dependent association, with strongest decrease in risk when breastfed for at least 12 months for CD (OR 0.20, 95% CI 0.08-0.50) and UC (OR 0.21, 95% CI 0.10-0.43) as compared to 3 or 6 months. CONCLUSION: Breastfeeding in infancy protects against the development of CD and ulcerative colitis.
BACKGROUND: Breastfeeding is a modifiable factor that may influence development of inflammatory bowel diseases. However, literature on this has been inconsistent and not accounted for heterogeneity in populations and exposure. AIM: To conduct a meta-analysis to examine the association between breastfeeding in infancy and risk of Crohn's disease (CD) and ulcerative colitis (UC). METHODS: A systematic search of Medline/PubMed and Embase was performed for full text, English-language literature through November 2016. Studies were included if they described breastfeeding in infancy in patients with CD or UC, and healthy controls. Data were pooled using a random effects model for analysis. RESULTS: A total of 35 studies were included in the final analysis, comprising 7536 individuals with CD, 7353 with UC and 330 222 controls. Ever being breastfed was associated with a lower risk of CD (OR 0.71, 95% CI 0.59-0.85) and UC (OR 0.78, 95% CI 0.67-0.91). While this inverse association was observed in all ethnicity groups, the magnitude of protection was significantly greater among Asians (OR 0.31, 95% CI 0.20-0.48) compared to Caucasians (OR 0.78, 95% CI 0.66-0.93; P = .0001) in CD. Breastfeeding duration showed a dose-dependent association, with strongest decrease in risk when breastfed for at least 12 months for CD (OR 0.20, 95% CI 0.08-0.50) and UC (OR 0.21, 95% CI 0.10-0.43) as compared to 3 or 6 months. CONCLUSION: Breastfeeding in infancy protects against the development of CD and ulcerative colitis.
Authors: Yanna Ko; Viraj Kariyawasam; Mohamad Karnib; Rhys Butcher; Douglas Samuel; Ahmad Alrubaie; Nabil Rahme; Charles McDonald; James Cowlishaw; Peter Katelaris; Gavin Barr; Brian Jones; Susan Connor; Gokulan Paven; Grace Chapman; Gordon Park; Richard Gearry; Rupert W Leong Journal: Clin Gastroenterol Hepatol Date: 2015-03-11 Impact factor: 11.382
Authors: John Penders; Carel Thijs; Cornelis Vink; Foekje F Stelma; Bianca Snijders; Ischa Kummeling; Piet A van den Brandt; Ellen E Stobberingh Journal: Pediatrics Date: 2006-08 Impact factor: 7.124
Authors: A Rigas; B Rigas; M Glassman; Y Y Yen; S J Lan; E Petridou; C C Hsieh; D Trichopoulos Journal: Ann Epidemiol Date: 1993-07 Impact factor: 3.797
Authors: Frederika A van Nimwegen; John Penders; Ellen E Stobberingh; Dirkje S Postma; Gerard H Koppelman; Marjan Kerkhof; Naomi E Reijmerink; Edward Dompeling; Piet A van den Brandt; Isabel Ferreira; Monique Mommers; Carel Thijs Journal: J Allergy Clin Immunol Date: 2011-08-27 Impact factor: 10.793
Authors: Ryan Ungaro; Charles N Bernstein; Richard Gearry; Anders Hviid; Kaija-Leena Kolho; Matthew P Kronman; Souradet Shaw; Herbert Van Kruiningen; Jean-Frédéric Colombel; Ashish Atreja Journal: Am J Gastroenterol Date: 2014-09-16 Impact factor: 10.864
Authors: Severin A Lautenschlager; Nicolas Fournier; Luc Biedermann; Valerie Pittet; Philipp Schreiner; Benjamin Misselwitz; Michael Scharl; Gerhard Rogler; Alexander R Siebenhüner Journal: Inflamm Intest Dis Date: 2020-08-26