LONG TERM ADVERSE HEALTH OUTCOMES IN OFFSPRING FROM MOTHERS WITH INFLAMMATORY BOWEL DISEASE: A NATIONWIDE POPULATION BASED STUDY IN KOREA

Abstract

BACKGROUND: The research on reproductive women with inflammatory bowel disease (IBD) has focused on short-term outcomes and the studies on the long-term health outcomes of the children of parents with IBD are scarce. Therefore, there is a gap in understanding the influence of parental IBD on long-term outcomes especially in growth and development of their children. The objective of this study is to assess the long-term influence of maternal IBD on disease, growth and development of their offspring. METHODS: Using National Health Insurance Service (NHIS) which covers total population in Korea (n=50 million), we constructed a mother-child database to track healthcare utilization of their offspring. We linked National Health Screening for Infant and Children database which include growth and development information to NHIS data for subset of population. From the database, we identified IBD patients who had given live singleton births and their offspring by linking personal identification number, providing all children born alive in Korea between 2002 and 2018. Through follow-up until the age of 15, we investigated the association between maternal IBD and selected disease categories in the offspring that include neurodevelopmental disorders, metabolic, autoimmune and allergic conditions. We also assessed association to growth and development such as height and weight of the children up to 71 months of age. RESULTS: From study database of 3 million woman who gave birth during study periods, we identified 5191 women with IBD who had 7230 children, and 1:10 matched non-IBD control. Mortality rate between IBD and non-IBD offspring was not significantly different between two groups (p>0.05). We could confirm the higher risk of autoimmune diseases (risk ratio (RR); 1.5), but no significant increased risk was identified in neurodevelopmental disorders, and metabolic diseases in IBD offspring compared to non-IBD offspring. In multivariate analysis, children born to IBD mothers had an higher risk (RR: 8.1) of IBD development compared to children with non-IBD mother with but no increased risk was observed in other conditions including autism spectrum disorder, bronchial asthma, or juvenile rheumatoid arthritis. Growth failures defined as less than 3 percentiles in weight and height at 71 months of age were more prevalent in IBD offspring compared to non-IBD offspring (RR 1.53 in weight and 1.25 in height). Among IBD offspring, 5.14% and 4.25% children showed growth failure in weight and height, respectively, compared to 3.40% and 2.78% children in non-IBD offspring. CONCLUSIONS: From the largest study that ever researched on the health offspring of IBD parents, we found the evidence of poor long-term morbidity regarding autoimmune diseases, but not in neurodevelopmental disorders. Offspring have a higher risk of developing IBD and growth failure up to age of 6.