Early-life risk factors for both infant colic and excessive crying without colic.


Journal

Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714

Informations de publication

Date de publication:
06 Sep 2024
Historique:
received: 09 04 2024
accepted: 07 06 2024
revised: 13 05 2024
medline: 7 9 2024
pubmed: 7 9 2024
entrez: 6 9 2024
Statut: aheadofprint

Résumé

Infantile colic may represent gastrointestinal distress, yet most definitions emphasize excessive crying. Each may have distinct etiologies. In a pre-birth cohort, we used maternal reports of infant crying and apparent abdominal discomfort at 6mos to categorize infants as (1) unaffected (no excessive crying or colic), (2) excessive crying only, and (3) colic (abdominal discomfort +/- excessive crying). We examined associations of potential risk factors in separate models with excessive crying and colic (each vs. unaffected) using unadjusted multinomial logistic regression, and associations between count of risk factors and colic using logistic regression. Of 1403 infants, 140 (10%) had excessive crying, and 346 (25%) colic. Infants that were non-Hispanic white, low birthweight, firstborn, or had a maternal history of atopy, high postpartum depressive symptoms, or persistent prenatal nausea, had a 40-80% higher relative risk of colic. Preterm birth was associated with double the risk. Being firstborn, low birthweight, and preterm birth predicted excessive crying. Infants with ≥four (vs. 0-1) of the seven identified risk factors had 3.9 times (95% CI: 2.6, 6.1) higher odds of colic. Colic characterized by apparent abdominal discomfort can be phenotypically distinguished from excessive crying only. Multiple risk factors may further increase colic risk. Infant colic characterized by apparent gastrointestinal distress may be phenotypically distinct from excessive crying only. Literature that defines colic only based on crying behaviors may miss important predictors. Mother-reported colic and excessive crying appear to have overlapping risk factors, with additional risk factors identified for colic. The presence of multiple risk factors increases the risk of colic, supporting a multifactorial etiology.

Sections du résumé

BACKGROUND BACKGROUND
Infantile colic may represent gastrointestinal distress, yet most definitions emphasize excessive crying. Each may have distinct etiologies.
DESIGN/METHODS METHODS
In a pre-birth cohort, we used maternal reports of infant crying and apparent abdominal discomfort at 6mos to categorize infants as (1) unaffected (no excessive crying or colic), (2) excessive crying only, and (3) colic (abdominal discomfort +/- excessive crying). We examined associations of potential risk factors in separate models with excessive crying and colic (each vs. unaffected) using unadjusted multinomial logistic regression, and associations between count of risk factors and colic using logistic regression.
RESULTS RESULTS
Of 1403 infants, 140 (10%) had excessive crying, and 346 (25%) colic. Infants that were non-Hispanic white, low birthweight, firstborn, or had a maternal history of atopy, high postpartum depressive symptoms, or persistent prenatal nausea, had a 40-80% higher relative risk of colic. Preterm birth was associated with double the risk. Being firstborn, low birthweight, and preterm birth predicted excessive crying. Infants with ≥four (vs. 0-1) of the seven identified risk factors had 3.9 times (95% CI: 2.6, 6.1) higher odds of colic.
CONCLUSIONS CONCLUSIONS
Colic characterized by apparent abdominal discomfort can be phenotypically distinguished from excessive crying only. Multiple risk factors may further increase colic risk.
IMPACT CONCLUSIONS
Infant colic characterized by apparent gastrointestinal distress may be phenotypically distinct from excessive crying only. Literature that defines colic only based on crying behaviors may miss important predictors. Mother-reported colic and excessive crying appear to have overlapping risk factors, with additional risk factors identified for colic. The presence of multiple risk factors increases the risk of colic, supporting a multifactorial etiology.

Identifiants

pubmed: 39242932
doi: 10.1038/s41390-024-03518-4
pii: 10.1038/s41390-024-03518-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.

Références

Wessel, M. A., Cobb, J. C., Jackson, E. B., Harris, G. S. & Detwiler, A. C. Paroxysmal fussing in infancy, sometimes called colic. Pediatrics 14, 421–435 (1954).
doi: 10.1542/peds.14.5.421 pubmed: 13214956
Steutel, N. F., Benninga, M. A., Langendam, M. W., de Kruijff, I. & Tabbers, M. M. Reporting outcome measures in trials of infant colic. J. Pediatr. Gastroenterol. Nutr. 59, 341–346 (2014).
doi: 10.1097/MPG.0000000000000412 pubmed: 24796800
Zeevenhooven, J., Browne, P. D., L’Hoir, M. P., de Weerth, C. & Benninga, M. A. Infant colic: mechanisms and management. Nat. Rev. Gastroenterol. Hepatol. 15, 479–496 (2018).
doi: 10.1038/s41575-018-0008-7 pubmed: 29760502
Rome IV Criteria. Rome Foundation https://theromefoundation.org/rome-iv/rome-iv-criteria/ .
Zeevenhooven, J., Koppen, I. J. N. & Benninga, M. A. The New Rome IV Criteria for functional gastrointestinal disorders in infants and toddlers. Pediatr. Gastroenterol. Hepatol. Nutr. 20, 1–13 (2017).
doi: 10.5223/pghn.2017.20.1.1 pubmed: 28401050 pmcid: 5385301
Sarasu, J. M., Narang, M. & Shah, D. Infantile colic: An update. Indian Pediatr. 55, 979–987 (2018).
doi: 10.1007/s13312-018-1423-0 pubmed: 29941700
Indrio, F., Dargenio, V. N., Francavilla, R., Szajewska, H. & Vandenplas, Y. Infantile colic and long-term outcomes in childhood: a narrative synthesis of the evidence. Nutrients 15, 615 (2023).
doi: 10.3390/nu15030615 pubmed: 36771322 pmcid: 9921915
Vandenplas, Y. et al. Prevalence and health outcomes of functional gastrointestinal symptoms in infants from birth to 12 months of age. J. Pediatr. Gastroenterol. Nutr. 61, 531–537 (2015).
doi: 10.1097/MPG.0000000000000949 pubmed: 26308317 pmcid: 4631121
Savino, F. et al. A prospective 10-year study on children who had severe infantile colic. Acta Paediatr. Suppl. 94, 129–132 (2005).
doi: 10.1111/j.1651-2227.2005.tb02169.x pubmed: 16214780
Mai, T., Fatheree, N. Y., Gleason, W., Liu, Y. & Rhoads, J. M. Infantile colic: new insights into an old problem. Gastroenterol. Clin. North Am. 47, 829–844 (2018).
doi: 10.1016/j.gtc.2018.07.008 pubmed: 30337035 pmcid: 6659398
Zeevenhooven, J. et al. Functional gastrointestinal disorders, quality of life, and behaviour in adolescents with history of infant colic. Acta Paediatr. https://doi.org/10.1111/apa.17215 (2024).
Johnson, J. M. & Adams, E. D. The gastrointestinal microbiome in infant colic: a scoping review. MCN Am. J. Matern. Child Nurs. 47, 195–206 (2022).
doi: 10.1097/NMC.0000000000000832 pubmed: 35352686
Ouald Chaib, A., Levy, E. I., Ouald Chaib, M. & Vandenplas, Y. The influence of the gastrointestinal microbiome on infant colic. Expert Rev. Gastroenterol. Hepatol. 14, 919–932 (2020).
doi: 10.1080/17474124.2020.1791702 pubmed: 32633578
Hjern, A., Lindblom, K., Reuter, A. & Silfverdal, S.-A. A systematic review of prevention and treatment of infantile colic. Acta Paediatr. 109, 1733–1744 (2020).
doi: 10.1111/apa.15247 pubmed: 32150292
Tyrsin, O. Y. et al. Effect of Lactobacillus reuteri NCIMB 30351 drops on symptoms of infantile functional gastrointestinal disorders and gut microbiota in early infants: Results from a randomized, placebo-controlled clinical trial. Eur. J. Pediatr. 183, 2311–2324 (2024).
doi: 10.1007/s00431-024-05473-y pubmed: 38427038
Ellwood, J., Draper-Rodi, J. & Carnes, D. Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines. BMJ Open 10, e035405 (2020).
doi: 10.1136/bmjopen-2019-035405 pubmed: 32102827 pmcid: 7202698
Bell, G., Hiscock, H., Tobin, S., Cook, F. & Sung, V. Behavioral outcomes of infant colic in toddlerhood: a longitudinal study. J. Pediatr. 201, 154–159 (2018).
doi: 10.1016/j.jpeds.2018.05.010 pubmed: 29887386
Oken, E. et al. Cohort profile: project viva. Int. J. Epidemiol. 44, 37–48 (2015).
doi: 10.1093/ije/dyu008 pubmed: 24639442
Wadhwa, P. D., Sandman, C. A., Porto, M., Dunkel-Schetter, C. & Garite, T. J. The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am. J. Obstet. Gynecol. 169, 858–865 (1993).
doi: 10.1016/0002-9378(93)90016-C pubmed: 8238139
Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines. (National Academies Press (US), Washington (DC), 2009).
Oken, E. et al. Sex-specific associations of maternal gestational glycemia with hormones in umbilical cord blood at delivery. Am. J. Perinatol. 33, 1273–1281 (2016).
doi: 10.1055/s-0036-1586509 pubmed: 27490771 pmcid: 5080532
Oken, E., Kleinman, K. P., Rich-Edwards, J. & Gillman, M. W. A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatr. 3, 6 (2003).
doi: 10.1186/1471-2431-3-6 pubmed: 12848901 pmcid: 169185
Turner, R. J., Grindstaff, C. F. & Phillips, N. Social support and outcome in teenage pregnancy. J. Health Soc. Behav. 31, 43–57 (1990).
doi: 10.2307/2137044 pubmed: 2313076
Faleschini, S. et al. Women’s perceived social support: associations with postpartum weight retention, health behaviors and depressive symptoms. BMC Women’s Health 19, 143 (2019).
doi: 10.1186/s12905-019-0839-6 pubmed: 31752823 pmcid: 6873672
Cheng, E. R. et al. The influence of antenatal partner support on pregnancy outcomes. J. Women’s Health 25, 672–679 (2016).
doi: 10.1089/jwh.2015.5462
Cox, J. L., Holden, J. M. & Sagovsky, R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br. J. Psychiatry 150, 782–786 (1987).
doi: 10.1192/bjp.150.6.782 pubmed: 3651732
Matthey, S., Henshaw, C., Elliott, S. & Barnett, B. Variability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale: implications for clinical and research practice. Arch. Women’s Ment. Health 9, 309–315 (2006).
doi: 10.1007/s00737-006-0152-x
Evans, J., Heron, J., Francomb, H., Oke, S. & Golding, J. Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323, 257–260 (2001).
doi: 10.1136/bmj.323.7307.257 pubmed: 11485953 pmcid: 35345
Levis, B. et al. Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ 371, m4022 (2020).
doi: 10.1136/bmj.m4022 pubmed: 33177069 pmcid: 7656313
Despriee, Å. W. et al. Prevalence and perinatal risk factors of parent-reported colic, abdominal pain and other pain or discomforts in infants until 3 months of age - A prospective cohort study in PreventADALL. J. Clin. Nurs. 31, 2784–2796 (2022).
doi: 10.1111/jocn.16097 pubmed: 34704296
Phelan, A. L., DiBenedetto, M. R., Paul, I. M., Zhu, J. & Kjerulff, K. H. Psychosocial stress during first pregnancy predicts infant health outcomes in the first postnatal year. Matern Child Health J. 19, 2587–2597 (2015).
doi: 10.1007/s10995-015-1777-z pubmed: 26152890 pmcid: 6042965
Søndergaard, C. et al. Psychosocial distress during pregnancy and the risk of infantile colic: a follow-up study. Acta Paediatr. 92, 811–816 (2003).
doi: 10.1111/j.1651-2227.2003.tb02538.x pubmed: 12892160
van den Berg, M. P. et al. Paternal depressive symptoms during pregnancy are related to excessive infant crying. Pediatrics 124, e96–e103 (2009).
doi: 10.1542/peds.2008-3100 pubmed: 19564275
Korja, R. et al. Preterm infant’s early crying associated with child’s behavioral problems and parents’ stress. Pediatrics 133, e339–e345 (2014).
doi: 10.1542/peds.2013-1204 pubmed: 24394685
Gardner, F. C., Adkins, C. S., Hart, S. E., Travagli, R. A. & Doheny, K. K. Preterm stress behaviors, autonomic indices, and maternal perceptions of infant colic. Adv. Neonatal Care 18, 49–57 (2018).
doi: 10.1097/ANC.0000000000000451 pubmed: 29261561 pmcid: 5786477
Pärtty, A., Kalliomäki, M., Salminen, S. & Isolauri, E. Infantile colic is associated with low-grade systemic inflammation. J. Pediatr. Gastroenterol. Nutr. 64, 691–695 (2017).
doi: 10.1097/MPG.0000000000001340 pubmed: 27478897
Brett, B. E., Vacaru, S., Beijers, R. & de Weerth, C. Infant colic and HPA axis development across childhood. Psychoneuroendocrinology 164, 106965 (2024).
doi: 10.1016/j.psyneuen.2024.106965 pubmed: 38493596
Baldassarre, M. E. et al. Birth weight and the development of functional gastrointestinal disorders in infants. Pediatr. Gastroenterol. Hepatol. Nutr. 23, 366–376 (2020).
doi: 10.5223/pghn.2020.23.4.366 pubmed: 32704497 pmcid: 7354866
Salvatore, S. et al. Neonatal antibiotics and prematurity are associated with an increased risk of functional gastrointestinal disorders in the first year of life. J. Pediatr. 212, 44–51 (2019).
doi: 10.1016/j.jpeds.2019.04.061 pubmed: 31201028
Aydemir, Y. et al. Screening for functional gastrointestinal disorders in preterm infants up to 12 months of corrected age: a prospective cohort study. Eur. J. Pediatr. 183, 2091–2099 (2024).
doi: 10.1007/s00431-024-05451-4 pubmed: 38347262 pmcid: 11035472
Castro-Rodríguez, J. A. et al. Relation between infantile colic and asthma/atopy: a prospective study in an unselected population. Pediatrics 108, 878–882 (2001).
doi: 10.1542/peds.108.4.878 pubmed: 11581439
Talachian, E., Bidari, A. & Rezaie, M. H. Incidence and risk factors for infantile colic in Iranian infants. World J. Gastroenterol. 14, 4662–4666 (2008).
doi: 10.3748/wjg.14.4662 pubmed: 18698680 pmcid: 2738790
Crowcroft, N. S. & Strachan, D. P. The social origins of infantile colic: questionnaire study covering 76,747 infants. BMJ 314, 1325–1328 (1997).
doi: 10.1136/bmj.314.7090.1325 pubmed: 9158470 pmcid: 2126574
Fazil, M. Prevalence and risk factors for infantile colic in District Mansehra. J. Ayub. Med. Coll. Abbottabad 23, 115–117 (2011).

Auteurs

Karen M Switkowski (KM)

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. karen_switkowski@hphci.harvard.edu.

Emily Oken (E)

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Elisabeth M Simonin (EM)

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Kari C Nadeau (KC)

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Sheryl L Rifas-Shiman (SL)

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.

Jenifer R Lightdale (JR)

Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, MA, USA.

Classifications MeSH