{"rowid": 9, "title": "[\"Season and region of birth as risk factors for coeliac disease a key to the aetiology?\"]", "DOI": "10.1136/archdischild-2015-310122", "URL": "http://dx.doi.org/10.1136/archdischild-2015-310122", "created": "2016-08-16T01:13:27Z", "subject": "[\"Pediatrics, Perinatology, and Child Health\"]", "references-count": "39", "is-referenced-by-count": "11", "ISSN": "[\"0003-9888\", \"1468-2044\"]", "container-title": "Archives of Disease in Childhood", "abstract": "<jats:sec><jats:title>Background</jats:title><jats:p>Coeliac disease (CD) incidence has increased in recent decades, characterised by variations according to sex, age at diagnosis, year of birth, month of birth and region of birth. Genetic susceptibility and exposure to gluten are the necessary factors in CD aetiology, although several environmental factors are considered.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A nationwide prospective cohort longitudinal study was conducted consisting of 1\u2005912\u2005204 children aged 0\u201314.9\u2005years born in Sweden from 1991 to 2009. A total of 6569 children were diagnosed with biopsy-verified CD from 47 paediatric departments. Using Cox regression, we examined the association between CD diagnosis and season of birth, region of birth and year of birth.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Overall, CD risk was higher for children born during spring, summer and autumn as compared with children born during winter: adjusted HR for spring 1.08 (95% CI 1.01 to 1.16), summer 1.10 (95% CI 1.03 to 1.18) and autumn 1.10 (95% CI 1.02 to 1.18). Increased CD risk was highest if born in the south, followed by central Sweden when compared with children born in northern Sweden. Children diagnosed at &lt;2\u2005years had an increased CD risk if born in spring while those diagnosed at 2\u201314.9\u2005years the risk was increased for summer and autumn births. The birth cohort of 1991\u20131996 had increased CD risk if born during spring, for the 1997\u20132002 birth cohort the risk increased for summer and autumn births, while for the birth cohort of 2003\u20132009 the risk was increased if born during autumn.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Season of birth and region of birth are independently and jointly associated with increased risk of developing CD during the first 15\u2005years of life. Seasonal variation in infectious load is the likely explanation.</jats:p></jats:sec>", "author_number": "5", "orcids": "[]", "names": "[\"Fredinah Namatovu\", \"Marie Lindkvist\", \"Cecilia Olsson\", \"Anneli Ivarsson\", \"Olof Sandstr\\u00f6m\"]", "award_numbers": "[\"\"]", "funder_names": "[\"\"]", "funder_dois": "[\"\"]"}