IJE Advance Access published online on September 28, 2007
International Journal of Epidemiology, doi:10.1093/ije/dym201
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Effect of sibling number in the household and birth order on prevalence of Helicobacter pylori: a cross-sectional study
1Centre for Digestive Diseases, Leeds General Infirmary, Great George Street, Leeds, UK.
2Centre for Epidemiology and Biostatistics, Medical School, Leeds University, Leeds, UK.
3Department of Medicine and School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
4Gastroenterology Division, McMaster University, Health Sciences Centre, Hamilton, Ontario, Canada.
* Corresponding author. Room 7.23, Department of Academic Medicine, Clinical Sciences Building, St. James's University Hospital, Leeds, LS9 7TF, England, UK. E-mail: alexf12399{at}yahoo.com
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Abstract |
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Background Infection with Helicobacter pylori (H. pylori) is acquired mainly in childhood, with studies demonstrating this is related to living conditions. Effects of sibling number and birth order on prevalence of infection have not been extensively studied.
Methods The authors performed a cross-sectional survey of adults, aged between 50 and 59 years, previously involved in a community-screening programme for H. pylori in Leeds and Bradford, UK. Prevalence of H. pylori was assessed at baseline with urea breath test. All individuals who were alive, and could be traced, were contacted by postal questionnaire in 2003 obtaining information on number of siblings and birth order. Data concerning childhood socioeconomic conditions were stored on file from the original study.
Results 3928 (47%) of 8407 original participants provided data. Prevalence of infection increased according to sibling number (20% in those with none vs 63% with eight or more). Controlling for childhood socioeconomic conditions and birth order using multivariate logistic regression, infection odds were substantially increased with three siblings compared with none [odds ratio (OR) 1.51; 95% confidence interval (CI) 1.06–2.15], and a gradient of effect continued up to eight or more siblings (OR 5.70; 95% CI 2.92–11.14). Odds of infection also increased substantially with birth order, but the positive gradient disappeared on adjustment for sibling number and childhood socioeconomic conditions.
Conclusions: In this cross section of UK adults, aged 50–59 years, sibling number in the household, but not birth order, was independently associated with prevalence of H. pylori infection.
Keywords Birth order, Helicobacter pylori, prevalence, siblings
Accepted 29 August 2007
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