Investigating the hygiene hypothesis as a risk factor in pediatric onset Crohn's disease: A case-control study

Devendra K. Amre, Philippe Lambrette, Liliane Law, Alfreda Krupoves, Virginie Chotard, Florin Costea, Guy Grimard, David Israel, David Mack, Ernest G. Seidman

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVES: Evidence for the hygiene hypothesis in the etiology of Crohn's disease (CD) is unclear. We investigated the relationship between infection-related exposures and risk for CD in children. METHODS: A hospital-based case-control was carried out. Newly-diagnosed cases of CD (n = 194), less than 20 yr of age were recruited from the gastroenterology clinic of a large-pediatric inflammatory bowel disease (IBD) center in Montreal, Canada. Orthopedic patients pair-matched (n = 194) for timing of diagnosis and area of residence were recruited as controls. Information on infection-related exposures between birth and disease diagnosis was ascertained by administering a structured questionnaire to the mother and the index subject. The relationship between the frequency and timing of infection-related exposures with CD was studied. RESULTS: The mean age (SD) at diagnosis was 12.3 (5.1). CD was more common after 10 yr of age. Gender distribution was similar between comparison groups. In multivariate conditional logistic regression, family history of IBD (odds ratio (OR) = 4.6; 95% confidence interval (CI) = 1.6-13.3), age (OR = 1.2; 95% CI = 1.1-1.3), and owning a pet (OR = 2.0; 95% CI = 0.9-4.5) were associated with risk for CD, whereas regular use of a personal towel (OR = 0.5; 95% CI = 0.2-0.9) and lesser crowding in homes (OR = 0.3; 95% CI = 0.1-0.8) were protective. Day-care attendance during the first 6 months of life and "physician-diagnosed infections" between 5 and 10 yr of age were associated with increased risks for CD. CONCLUSIONS: Infection-related exposures seem to enhance risk for CD in children. The timing of these exposures during early childhood may be relevant to the etiology of pediatric CD.

Original languageEnglish (US)
Pages (from-to)1005-1011
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume101
Issue number5
DOIs
StatePublished - May 2006
Externally publishedYes

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Hygiene Hypothesis
Crohn Disease
Case-Control Studies
Odds Ratio
Confidence Intervals
Infection
Inflammatory Bowel Diseases
Crowding
Pediatric Crohn's disease
Pets
Gastroenterology
Canada
Orthopedics
Logistic Models
Mothers
Parturition
Pediatrics
Physicians

ASJC Scopus subject areas

  • Gastroenterology

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Investigating the hygiene hypothesis as a risk factor in pediatric onset Crohn's disease : A case-control study. / Amre, Devendra K.; Lambrette, Philippe; Law, Liliane; Krupoves, Alfreda; Chotard, Virginie; Costea, Florin; Grimard, Guy; Israel, David; Mack, David; Seidman, Ernest G.

In: American Journal of Gastroenterology, Vol. 101, No. 5, 05.2006, p. 1005-1011.

Research output: Contribution to journalArticle

Amre, DK, Lambrette, P, Law, L, Krupoves, A, Chotard, V, Costea, F, Grimard, G, Israel, D, Mack, D & Seidman, EG 2006, 'Investigating the hygiene hypothesis as a risk factor in pediatric onset Crohn's disease: A case-control study', American Journal of Gastroenterology, vol. 101, no. 5, pp. 1005-1011. https://doi.org/10.1111/j.1572-0241.2006.00526.x
Amre, Devendra K. ; Lambrette, Philippe ; Law, Liliane ; Krupoves, Alfreda ; Chotard, Virginie ; Costea, Florin ; Grimard, Guy ; Israel, David ; Mack, David ; Seidman, Ernest G. / Investigating the hygiene hypothesis as a risk factor in pediatric onset Crohn's disease : A case-control study. In: American Journal of Gastroenterology. 2006 ; Vol. 101, No. 5. pp. 1005-1011.
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AU - Amre, Devendra K.

AU - Lambrette, Philippe

AU - Law, Liliane

AU - Krupoves, Alfreda

AU - Chotard, Virginie

AU - Costea, Florin

AU - Grimard, Guy

AU - Israel, David

AU - Mack, David

AU - Seidman, Ernest G.

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