JPGN Journal Club November 2026: Predicting Paediatric IBD: Two Birth Cohort Studies Compared
To start today, a few opportunities to consider, with details on the ESPGHAN website: in Rome, from 25 to 28 November 2026, the annual Young Investigator Forum; in Cluj-Napoca / Kolozsvár / Klausenburg, from 28 to 30 January 2027, a Monothematic Conference on Wilson’s disease in children. Everyone can put her or his finger on the map to point out Rome – I am ignoring the people whose fingers are on Napoli / Naples; you got Italy right, and that’s already something! – but Cluj? Well, it’s the capital of Transylvania, also known as Erdély, a very multicultural city. To get there, you go to the eastern edge of Hungary and hop across the border. I’ve visited Cluj, simply as part of getting to know Europe; I liked the town and enjoyed my long weekend there. So I recommend the venue, and of course the conference will be grand.
Now to Journal Club.
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Who will develop inflammatory bowel disease (IBD)?
An important question. Prognostication, intervention… if the question can be answered, then, as with diabetes, populations at risk can be defined, screened, helped. That topic is what Dr Jake Mann wants to discuss in today’s ESPGHAN Journal Club of 2026, and who am I to deny him what he wants? Jake, as always, it’s good to be Zooming with you.
Full bibliographic details for Jake’s choices are available in the documentation that accompanies this podcast – you can find it on the ESPGHAN website – so I’ll just give necessarily incomplete summaries.
Work from teams at the universities of Aalborg and Aarhus, in Denmark, and at the Mount Sinai Medical Center, in Manhattan (Agrawal M et al. Prediction of inflammatory bowel disease based on early life risk factors in a population-based cohort. Clin Gastroenterol Hepatol) used data from a Danish registry that encompassed 96,817 children born between 1996 and 2002; 50,592 study participants were selected whose mothers, resident in Denmark, took part in all four interviews during pregnancy and the first two postnatal years. In approximately 21 years of follow-up, 310 offspring were diagnosed with IBD. Of these, 129 were diagnosed before the age of 17 and 43 before the age of 13; 5 had developed very-early-onset IBD, before the age of 6. A wide range of circumstances was screened for association with IBD development. The study concluded that parental IBD was a risk factor, as were early-life illness and antibiotic use (perhaps by disrupting immune-system maturation and enterobiome composition).
Work from a grab-bag of Swedish and Norwegian institutions (Sigvardsson I et al. Early-life adverse events and risk of inflammatory bowel disease: a Scandinavian birth cohort study. J Pediatr Gastroenterol Nutr) enrolled twice as many children – 111,293 – with follow-up for approximately 20 years, and found a proportionately similar incidence of IBD – 697 cases. Their subjects were screened for associations between “adverse events” and later IBD. They found no evidence that such events put children at increased risk.
Presented with only these summaries, one would think that the studies’ results are in diametric opposition. Identified risk; no identified risk. Clues to follow up; dead end, cul-de-sac. Is that your take-home message for us, Jake? Or do my summaries misrepresent the work done?
I think the disparities arise from differences between the “adverse events” selected for study. The New Yorkers and Danes chose events impairing the body; the northern Scandinavians chose events impairing the soul. Is that your assessment, too?
Literature
Agrawal M, et al. Prediction of inflammatory bowel disease based on early life risk factors in a population-based cohort. Clin Gastroenterol Hepatol. 2026 Sep;24(9):2551–2559. doi:10.1016/j.cgh.2026.01.034. Epub 2026 Feb 3. PMID: 41643799. PMCID: PMC12893764 (available from 2027-02-03).
Sigvardsson I, et al. Early-life adverse events and risk of inflammatory bowel disease: a Scandinavian birth cohort study. J Pediatr Gastroenterol Nutr. 2026 Aug 21. doi:10.1002/jpn3.70537. Online ahead of print. PMID: 42626830.