Breastfeeding may prevent development of JSpA in infants

Infant factors affecting the microbiome appears to influence the occurrence of juvenile spondyloarthritis (JSpA), suggests a study, noting a link between exclusive breastfeeding and lower odds of JSpA.

Children with JSpA were matched 1:1 to control participants by age and sex in this single-centre retrospective case-control study. Subsequently, the authors assessed the association of infant factors with occurrence of JSpA, including infant nutrition and form of delivery, using univariable and multivariable conditional logistic regression modelling.

The association of JSpA disease activity (JSpA Disease Activity Index with 6 elements [JSpADA6]) at presentation with breastfeeding exposure, form of delivery, and antibiotic exposure was also explored using linear regression.

A total of 195 case-control matched pairs (mean age 13.0 years, 47.7 percent female) were included in the analysis. Majority of the controls (88.7 percent) and infants with JSpA (69.2 percent) had exposure to breastfeeding of any duration (p<0.001).

Multivariate analysis revealed an independent and significant association of exclusive breastfeeding >6 months with a lower chance of developing JSpA (odds ratio, 0.47, 95 percent confidence interval [CI], 0.30‒0.72; p<0.001).

In addition, the median JSpADA6 showed no significant association with breastfeeding for >6 months. Vaginal delivery, however, significantly correlated with a lower JSpADA6 (B, ‒0.65, 95 percent CI, ‒1.13 to ‒0.17; p=0.008).

These findings suggest “that infant factors that affect the microbiome may be associated with the occurrence and disease activity of JSpA at presentation,” the authors said.