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Prevalence of Childhood Celiac Disease and Changes in Infant Feeding

Ivarsson, Anneli ; Myleus, Anna ; Norstrom, Fredrik ; vanderPals, Maria LU ; Rosen, Anna ; Hogberg, Lotta ; Danielsson, Lars ; Halvarsson, Britta ; Hammarroth, Solveig and Hernell, Olle , et al. (2013) In Pediatrics 131(3). p.687-694
Abstract
OBJECTIVES: Between 1984 and 1996, Sweden experienced an "epidemic" of clinical celiac disease in children <2 years of age, attributed partly to changes in infant feeding. Whether infant feeding affects disease occurrence and/or the clinical presentation remains unknown. We investigated and compared the total prevalence of celiac disease in 2 birth cohorts of 12-year-olds and related the findings to each cohort's ascertained infant feeding. METHODS: A 2-phase cross-sectional screening study was performed in which 13 279 children from 2 birth cohorts participated: children born during the epidemic (1993) and children born after the epidemic (1997). Previously diagnosed cases were reported and confirmed. Blood samples were analyzed for... (More)
OBJECTIVES: Between 1984 and 1996, Sweden experienced an "epidemic" of clinical celiac disease in children <2 years of age, attributed partly to changes in infant feeding. Whether infant feeding affects disease occurrence and/or the clinical presentation remains unknown. We investigated and compared the total prevalence of celiac disease in 2 birth cohorts of 12-year-olds and related the findings to each cohort's ascertained infant feeding. METHODS: A 2-phase cross-sectional screening study was performed in which 13 279 children from 2 birth cohorts participated: children born during the epidemic (1993) and children born after the epidemic (1997). Previously diagnosed cases were reported and confirmed. Blood samples were analyzed for serological markers and children with positive values were referred for small intestinal biopsy. Infant feeding practices in the cohorts were ascertained via questionnaires. Prevalence comparisons were expressed as prevalence ratios. RESULTS: The total prevalence of celiac disease was 29 in 1000 and 22 in 1000 for the 1993 and 1997 cohorts, respectively. Children born in 1997 had a significantly lower risk of having celiac disease compared with those born in 1993 (prevalence ratio: 0.75; 95% confidence interval: 0.60-0.93; P = .01). The cohorts differed in infant feeding (specifically, in the proportion of infants introduced to dietary gluten in small amounts during ongoing breastfeeding). CONCLUSIONS: A significantly reduced prevalence of celiac disease in 12-year-olds indicates an option for disease prevention. Our findings suggest that the present infant feeding recommendation to gradually introduce gluten-containing foods from 4 months of age, preferably during ongoing breastfeeding, is favorable. Pediatrics 2013;131:e687-e694 (Less)
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publication status
published
subject
keywords
celiac disease, prevalence, infant feeding
in
Pediatrics
volume
131
issue
3
pages
687 - 694
publisher
American Academy of Pediatrics
external identifiers
  • wos:000315587400004
  • scopus:84874601859
  • pmid:23420914
ISSN
1098-4275
DOI
10.1542/peds.2012-1015
language
English
LU publication?
yes
id
983b5191-870a-4673-8e71-4fcbfb42928d (old id 3657353)
date added to LUP
2016-04-01 15:07:08
date last changed
2020-08-26 02:57:59
@article{983b5191-870a-4673-8e71-4fcbfb42928d,
  abstract     = {OBJECTIVES: Between 1984 and 1996, Sweden experienced an "epidemic" of clinical celiac disease in children &lt;2 years of age, attributed partly to changes in infant feeding. Whether infant feeding affects disease occurrence and/or the clinical presentation remains unknown. We investigated and compared the total prevalence of celiac disease in 2 birth cohorts of 12-year-olds and related the findings to each cohort's ascertained infant feeding. METHODS: A 2-phase cross-sectional screening study was performed in which 13 279 children from 2 birth cohorts participated: children born during the epidemic (1993) and children born after the epidemic (1997). Previously diagnosed cases were reported and confirmed. Blood samples were analyzed for serological markers and children with positive values were referred for small intestinal biopsy. Infant feeding practices in the cohorts were ascertained via questionnaires. Prevalence comparisons were expressed as prevalence ratios. RESULTS: The total prevalence of celiac disease was 29 in 1000 and 22 in 1000 for the 1993 and 1997 cohorts, respectively. Children born in 1997 had a significantly lower risk of having celiac disease compared with those born in 1993 (prevalence ratio: 0.75; 95% confidence interval: 0.60-0.93; P = .01). The cohorts differed in infant feeding (specifically, in the proportion of infants introduced to dietary gluten in small amounts during ongoing breastfeeding). CONCLUSIONS: A significantly reduced prevalence of celiac disease in 12-year-olds indicates an option for disease prevention. Our findings suggest that the present infant feeding recommendation to gradually introduce gluten-containing foods from 4 months of age, preferably during ongoing breastfeeding, is favorable. Pediatrics 2013;131:e687-e694},
  author       = {Ivarsson, Anneli and Myleus, Anna and Norstrom, Fredrik and vanderPals, Maria and Rosen, Anna and Hogberg, Lotta and Danielsson, Lars and Halvarsson, Britta and Hammarroth, Solveig and Hernell, Olle and Karlsson, Eva and Stenhammar, Lars and Webb, Charlotta and Sandstrom, Olof and Carlsson, Annelie},
  issn         = {1098-4275},
  language     = {eng},
  number       = {3},
  pages        = {687--694},
  publisher    = {American Academy of Pediatrics},
  series       = {Pediatrics},
  title        = {Prevalence of Childhood Celiac Disease and Changes in Infant Feeding},
  url          = {http://dx.doi.org/10.1542/peds.2012-1015},
  doi          = {10.1542/peds.2012-1015},
  volume       = {131},
  year         = {2013},
}