Inflamm Bowel Dis. 2025 Oct 1;31(Supplement_2):S27-S40. doi: 10.1093/ibd/izaf205.
ABSTRACT
The rising incidence of pediatric-onset inflammatory bowel disease (IBD) has intensified focus on the early-life period as a critical window for prevention. Accumulating observational evidence links prenatal, perinatal, and early childhood exposures to later IBD risk. Several mechanisms underpin this relationship, including gut microbiome development, immune system maturation, epigenetic modulation, and metabolic and endocrine programming. Building on this framework, this review outlines potential intervention strategies across key developmental stages-from maternal nutrition and microbiome modulation during pregnancy to delivery-related factors such as birth mode, intrapartum antibiotic use, and early breastfeeding practices. Postnatal strategies include breastfeeding promotion, timely and diverse dietary introduction, antibiotic stewardship, and minimization of detrimental environmental exposures. Such approaches may be particularly relevant for high-risk groups, notably children born to individuals with IBD. Practical guidance is provided for families affected by IBD, alongside a discussion on how universal and risk-stratified strategies may be integrated. However, it is important to note that most of these strategies remain hypothetical, with limited validation. Emerging research areas include maternal dietary interventions, microbiome-based therapies, and the utilization of digital tools for risk monitoring. This review also addresses ethical and implementation challenges inherent to early-life prevention research and intervention.
PMID:41078161 | DOI:10.1093/ibd/izaf205
