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Systematic review with meta‐analysis: breastfeeding and the risk of Crohn's disease and ulcerative colitis
Author(s) -
Xu L.,
Lochhead P.,
Ko Y.,
Claggett B.,
Leong R. W.,
Ananthakrishnan A. N.
Publication year - 2017
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14291
Subject(s) - medicine , breastfeeding , ulcerative colitis , meta analysis , relative risk , crohn's disease , disease , inflammatory bowel disease , breast feeding , medline , gastroenterology , pediatrics , confidence interval , political science , law
Summary 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.