Kenny Walter

Familial history for inflammatory bowel disease should be considered for disease screening programs, according to new data from a Swedish cohort.

A team, led by Jonas F. Halfvarson, MD, Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, estimated the prevalence of familial aggregation of IBD.

“A family history of IBD is a proxy for an individual’s genetic and, in part, environmental risk of developing the disease and has long been recognized as the strongest risk factor for IBD,” the authors wrote. “Therefore, family history is routinely assessed as part of the clinical work-up at diagnosis.”

In the past, several studies have focused on familial clustering of IBD. However, the majority of these studies are based on smaller patient populations without including control groups.

In the nationwide, case-control study, the investigators compared patients with IBD (n = 50,667) to a control group (n = 506,720) between 2003-2017 and examined the odds of having a first-degree relative with IBD by age of diagnosis, type of family history, and IBD subtype. They also assessed the incidence of future IBD in relatives of patients with incident IBD.

Of the patients with IBD, 14,927 had Crohn’s disease and 27,221 had ulcerative colitis, while 8519 had unclassified IBD.

Each patient with IBD was identified from Swedish national registers.

The team calculated odds ratios as estimates of relative risk for IBD in first-degree relatives using logistic regression. They also estimated incidence rates of an incident diagnosis of IBD in first-degree relatives of patients with IBDand in first-degree relatives of matched reference individuals from the general population as the number of events per 1000 person-years.

The investigators found patients with IBD more often had a mother (3.0% vs 0.9%; OR, 3.5; 95% CI, 3.3–3.7), father (2.9% vs 0.8%; OR, 3.5; 95% CI, 3.3–3.7), full sibling (5.3% vs 1.5%; OR, 3.6; 95% CI, 3.4–3.8), and child (2.4% vs 0.9%; OR, 2.6; 95% CI, 2.4–2.8) with IBD.

The overall strength of association was directly related to the number of affected first-degree relatives. This strength was also modified by subtype of IBD and age of diagnosis.

The highest odds ratios were seen in pediatric patients with IBD among a subset of pediatric patients with Crohn’s disease (OR, 10.6; 95% CI, 8.2–13.5) and pediatric-onset ulcerative colitis (OR, 8.4; 95% CI, 6.4–10.9) cases.

The 10-year cumulative incidence of disease for full-siblings was 1.7% of incident patients with IBD, compared to 0.4% among full-siblings of reference individuals.

“The variations in the strength of familial IBD and future risk of IBD in [first-degree relatives] support differences in genetic predisposition and call for targeted approaches in potential screening programs,” the authors wrote.

Age determines the risk of familial inflammatory bowel disease—A nationwide study

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The overall strength of association was directly related to the number of affected first-degree relatives and was modified by IBD subtype and age of diagnosis.



Family history should be taken into account for IBD screenings

 can have a lasting impact on behavioral problems for children at age 10-11 years, according to new research.

In the study, Ariel A. Williamson, PhD, and colleagues, identified whether distinct sleep problem trajectories from infancy through middle childhood were linked to multiple aspects of child well-being at ages 10-11 years.

Williamson et al used data from the first 6 waves of the Longitudinal Study of Australian Children—Birth Cohort, which involved 5107 children recruited at birth.

Each caregiver included in the study reported on sleep problems for the children at each time point; the investigator indexed child well-being outcomes at ages 10-11 years using a combination of caregiver-reported, teacher-reported, and child-completed tasks. The outcomes included emotional and behavioral functioning such as internalizing and externalizing symptoms and self-control, health-related quality of life, cognitive skills, and academic achievement.

The authors identified 5 distinct sleep problem trajectories over time using a latent class analysis. The problems were persistent sleep problems through middle childhood (7.7% of the sample), limited infant or preschool sleep problems (9.0%), increased middle childhood sleep problems (17.0%), mild sleep problems over time (14.4%), and no sleep problems (51.9%).

The results showed children with persistent sleep problems had the greatest impairments across the different outcomes, other than cognitive skills (perceptual reasoning), with moderate to large effect sizes.


On the other hand, children with increased middle childhood sleep problems also experienced greater internalizing and externalizing symptoms with a worse quality of life.However, there were few academic impairments in this subgroup of patients.

In addition, the participants with limited infant or preschool sleep problems and mild increases over time trajectories also showed internalizing concerns and worse caregiver-reported quality of life. These effects were smaller than the other sleep trajectories.

“The linkages between sleep problems and negative child outcomes across domains underscore the importance of early identification and targeted intervention to address sleep problems and promote child well-being,” the authors wrote.

“[F]ew studies have examined the continuity of sleep concerns and their association with developmental outcomes from infancy, when behavioral sleep problems are the most prevalent,” Williamson and colleagues noted. “More research is needed that assesses the impact of sleep problems from infancy through middle childhood, particularly as the first 10–11 years of life is a period of important child development, with the acquisition of foundational psychosocial and cognitive/academic skills and the transition to a formal school setting.”

A version of this article was originally published by our sister publication

1. Williamson AA, Mindell JA, Hiscock H, Quach J. 

Longitudinal sleep problem trajectories are associated with multiple impairments in child well-being

Researchers highlight the need for early interventions.

Kenny Walter

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Family history should be taken into account for IBD screenings

Link noted between early sleep disturbances and later behavioral problems