Maternal Infections, Antibiotics and Paracetamol in Pregnancy and Offspring Celiac Disease: A Cohort Study.

Objectives: Infections in pregnancy are common, may affect fetal development and have been linked to offspring autoimmunity. We aimed to determine whether maternal infections, the use of antibiotics and paracetamol in pregnancy are associated with the risk of offspring celiac disease (CD). Methods: The nationwide Norwegian Mother and Child Cohort Study includes 84,274 children born in 2000-2009 with prospectively collected questionnaire data on maternal infections and medication use in pregnancy. CD was identified through questionnaires and the Norwegian Patient Register. Logistic regression yielded odds ratios adjusted for age and sex (aORs). Results: During a median follow-up of 8.5 years, 617 children (0.7%) were diagnosed with CD. The aOR for offspring CD per increase in number of maternal infections was 1.07 (95% confidence interval [CI] = 1.01-1.13), but not significantly increased for categories one infection (1.01 [95%CI = 0.82-1.25]) and >= two infections (1.22 [95%CI = 1.00-1.49]) vs. no infection. We found the same pattern for respiratory tract infections, but not for gastrointestinal infections. The aORs were broadly consistent across pregnancy-periods of exposure. The use of antibiotics and paracetamol was, compared with no use, not associated with offspring CD (aOR = 1.16 [95%CI = 0.94-1.43] and aOR = 1.13 [95%CI = 0.96-1.33], respectively; P-values for trend>0.2). Conclusions: In this large pregnancy cohort we found no clear association between maternal infections in pregnancy and offspring CD, but considering the marginal significance in some of our results maternal infections cannot be ruled out as a risk factor. Reassuringly for both parents-to-be and clinicians, the use of antibiotics and paracetamol in pregnancy were not significant risk factors. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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