The association between gastroesophageal reflux and esophageal adenocarcinoma is likely to be mediated by inflammation.
Reflux is common in infancy.
The esophageal mucosa of infants born preterm or small for gestational age small for gestational age could be particularly vulnerable.
Dr Lina Forssell and colleagues from Sweden investigated the association between preterm or small for gestational age birth and risk of esophagitis early in life.
The research team analyzed data from the Swedish birth register, and the Swedish patient register to identify birth characteristics of individuals with endoscopically verified esophagitis from 1973 to 2007, and to determine their outcomes.
The team selected 5 controls randomly and matched with each case.
|The odds ratio for prematurity was 6.8 in individuals with esophagitis|
|Clinical Gastroenterology & Hepatology|
Multivariable conditional logistic regression models were used to provide odds ratios odds ratio and 95% confidence intervals, adjusted for potential confounding.
The researchers found that the risk of esophagitis was increased among individuals born preterm or small for gestational age.
When data were stratified by age at diagnosis and by sex, different risk patterns appeared.
Among individuals diagnosed with esophagitis 9 years of age and younger, the odds ratio for prematurity was 6.8, and the odds ratio for small for gestational age at birth was 1.2.
The team reported that furthermore, the association with preterm birth was stronger among males than females, whereas the association with small for gestational age was stronger among females than males.
The risk of being diagnosed with esophagitis at age 20 or younger was not associated with preterm birth, but was associated with being small for gestational age at birth.
Dr Forsell's team concludes that "Preterm birth is associated with esophagitis only during childhood, whereas small for gestational age birth is associated with esophagitis during adolescence as well."
"The associations appear to differ between sexes."