Antenatal exposure to antibiotics and the risk of chronic diseases in childhood: a population-based study

Abstract

The maternal microbiome plays an important role in shaping the microorganism development in the infant’s gut. The neonatal immune system development is driven by the gut microbiota and dysbiosis can precipitate chronic disease development during childhood. The aim of this study was to estimate the association of antenatal antibiotics and development of childhood chronic diseases study, in the 1996-2012 Manitoban birth cohort. Cox regression analyses were employed to determine these associations, and results are reported reporting them as adjusted hazard ratios (aHR) and confidence intervals (CI). Antenatal antibiotic exposure was significantly associated with an increased risk of severe allergy (aHR: 1.08; CI: 1.01-1.15), celiac disease (aHR: 1.59, CI: 1.46-1.71) and cholelithiasis (aHR: 1.46, CI: 1.21-1.77). Associations remained significant after being classified by antibiotic type. There was also a dose-response with increasing risk of celiac disease and cholelithiasis following multiple antenatal antibiotic exposures. The timing of antenatal exposure, however, did not modify the associations, and the associations for childhood celiac disease and cholelithiasis were similar for maternal antibiotic use during the nine months before and after pregnancy. Although our results revealed a potential risk of childhood severe allergy, celiac disease and cholelithiasis among offspring of mothers exposed to antenatal antibiotics, a similar risk associated with maternal antibiotic exposure during the 9-months before pregnancy and 9-months after pregnancy periods for the three diseases contradicts an exclusive association.