Prenatal exposure to antibiotics and the risk of inflammatory diseases in children: a population-based study
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Date
2019-09-19
Authors
Bhardwaj, Aseem
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Abstract
The gut microbiota plays a vital role in immune regulation. The composition of the maternal microbiota contributes to shaping the neonatal gut microbiota. Any factor causing dysbiosis can dysregulate healthy immune system development and can precipitate inflammatory disorders. The objective of this study was to determine the association between prenatal antibiotic utilization and the risk of inflammatory disorders in a Manitoban birth cohort from 1996 to 2012. We used Cox regression analyses and expressed the results as adjusted hazards ratios (aHR) with 95% confidence intervals (CI). Prenatal antibiotic exposure was found to be significantly associated with inflammatory bowel disease (IBD) (aHR: 1.83, 95% CI: 1.30–2.55) in children. We also observed a significant association between maternal post-pregnancy exposure and risk of IBD in children (aHR1.74; 95% CI 1.25-2.42). None of the classes of the antibiotics used during prenatal period showed a specific association with IBD in the infants.
Reduced odds of development of IBD was found to be associated with the winter season of birth (aHR 0.57; 95% CI 0.34–0.94), parity (aHR 0.84; 95% CI 0.72-0.97), formula feeding (aHR
0.43; 95% CI 0.25-0.76), low income status (aHR 0.37; 95% CI 0.20-0.68), and number of children in the household (aHR 0.82; 95% CI 0.70–0.96). No association was found between prenatal exposure of antibiotics and connective tissue disorders (CTD) in children. However, a significant association was observed between antibiotic exposure (aHR 1.33; 95% CI: 1.03–1.71) and CTD, when the exposure was within one year of birth. Reduced risk of CTD was associated with the male gender (aHR 0.51; 95% CI: 0.40–0.66), and with an increased mother’s hospital utilization (aHR 0.76; 95% CI: 0.60–0.97). However, increased risk of CTD was observed with increased child’s hospital utilization (aHR 8.94; 95% CI 7.35-10.86), and maternal exposure to sulfonamide and trimethoprim class of antibiotics (aHR 1.81; 95% CI 1.20-2.73).
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Keywords
Antibiotics, Inflammatory Diseases, IBD, CTD