Health-care utilization of children born to women with and without inflammatory bowel disease in the first five years of life: a population-cohort study

Background — Children born to women with inflammatory bowel disease (IBD) may have increased healthcare utilization in early life due to genetic susceptibilities and exposure to inflammation in utero, though this has not been robustly evaluated. We aimed to characterize healthcare use between these groups.

Methods — We accessed province-wide health administrative databases to identify children born to women with and without IBD between 2002-2019. Differences in hospitalizations, emergency department (ED) visits, ambulatory visits, and endoscopy visits in the first 5 years of life were characterized. We further assessed differences in mental-health related healthcare utilization between groups. Multivariable negative binomial regression was performed to calculate adjusted incidence rate ratios (IRR) with 95% confidence intervals (95% CI).

Results — We included 17,447 and 1,832,334 children born to women with and without IBD respectively. Compared to those born to women without IBD, children born to women with IBD appeared to have an increased rate of all-cause hospitalizations (IRR 1.06, 95% CI, 1.03-1.10), all-cause ED visits (IRR 1.08, 95% CI, 1.05-1.10), ambulatory visits (IRR 1.06, 95% CI, 1.05-1.07), and endoscopic visits (IRR 2.14, 95% CI, 1.70-2.69). Children born to women with IBD also appeared to have increased mental-health related ambulatory visits (IRR 1.93, 95% CI, 1.01-3.76), with the most common reasons coded for these visits being neurodevelopmental/behavioral and developmental delay concerns.

Conclusion — Children born to women with IBD may have increased healthcare utilization compared to those born to women without IBD.