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Pediatric inflammatory bowel disease: Increasing incidence, decreasing surgery rate, and compromised nutritional status: A prospective population‐based cohort study 2007–2009

Jakobsen, Christian MD1,*; Paerregaard, Anders MD1; Munkholm, Pia MD2; Faerk, Jan MD3; Lange, Aksel MD4; Andersen, Jesper MD5; Jakobsen, Marianne MD6; Kramer, Iza MD7; Czernia‐Mazurkiewicz, Janina MD8; Wewer, Vibeke MD1

doi: 10.1002/ibd.21654
Original Article

Background:: The aim was to evaluate the incidence, treatment, surgery rate, and anthropometry at diagnosis of children with inflammatory bowel disease (IBD).

Methods:: Patients diagnosed between January 1, 2007 to December 31, 2009 in Eastern Denmark, Funen, and Aarhus were included from a background population of 668,056 children <15 years of age. For evaluation of incidence, treatment, and surgery rate, a subcohort from Eastern Denmark was extracted for comparison with a previously published population‐based cohort from the same geographical area (1998–2006).

Results:: In all, 130 children with IBD: 65 with Crohn's disease (CD), 62 with ulcerative colitis (UC), and three with IBD unclassified (IBDU) were included. The mean incidence rates per 106 in 2007–2009 were: IBD: 6.4 (95% confidence interval [CI]: 5.4–7.7), CD: 3.2 (2.5–4.1), UC: 3.1 (2.4–4.0) and IBDU: 0.2 (0.05–0.5). Comparing the two cohorts from Eastern Denmark we found higher incidence rates for IBD (5.0 and 7.2 in 1998–2000 and 2007–2009, respectively, P = 0.02) and CD (2.3 versus 3.3, P = 0.04). Furthermore, we found a significant decrease in surgery rates (15.8/100 person‐years versus 4.2, P = 0.02) and an increase in the rate of initiating immunomodulators (IM) within the first year (29.0/100 person‐years versus 69.2, P < 0.001). IM use was associated with a trend towards a decreased surgery risk (relative risk [RR] 0.38; 0.15–1.0). Children with CD had poor nutritional status at diagnosis compared with the general pediatric population.

Conclusions:: Over the past 12 years we found an increase in the incidence of IBD in children, an increasing use of IM, and decreasing 1‐year surgery rates. CD patients had poor nutritional status.

1 Department of Pediatrics, Hvidovre University Hospital, Copenhagen, Denmark

2 Department of Gastroenterology, Medical section, Herlev University Hospital, Copenhagen, Denmark

3 Department of Pediatrics, Holbaek Hospital, Holbaek, Denmark

4 Department of Pediatrics, Skejby University Hospital, Aarhus, Denmark

5 Department of Pediatrics, Hilleroed Hospital, Hilleroed, Denmark

6 Department of Pediatrics, Odense University Hospital, Odense, Denmark

7 Department of Pediatrics, Roskilde Hospital, Roskilde, Denmark

8 Department of Pediatrics, Nykoebing Falster Hospital, Nykoebing Falster, Denmark

*Reprints: Hvidovre University Hospital, Kettegaard Alle 30, 2650 Hvidovre, Denmark


Received 13 December 2010; Accepted 23 December 2010

Published online 4 March 2011 in Wiley Online Library (

Grant sponsor: Copenhagen University; Grant sponsor: Augustinus Foundation; Grant sponsor: Ville Heise Foundation; Grant sponsor: Sigrid Morans Foundation; Grant sponsor: Vibeke Binder and Poul Riis Foundation.

Supported by grants from Copenhagen University, the Augustinus Foundation, Ville Heise Foundation, Sigrid Morans Foundation, and the Vibeke Binder and Poul Riis Foundation.

© Crohn's & Colitis Foundation of America, Inc.
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