Early Life Exposure to Antibiotics and Mood and Anxiety Disorders in Children and Adolescents

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dc.contributor.authorDelara, Mahin
dc.contributor.examiningcommitteeDr. John Cairney (University of Toronto)en_US
dc.contributor.guestmembersDr. Geert t'Jong (pediatric and child health)en_US
dc.contributor.supervisorDr. Javier Mignone (Community Health Sciences),Dr. Nathan Nickle (Community Health Sciences), Dr.Diana McMillan (nursing)en_US
dc.date.accessioned2019-07-11T21:02:27Z
dc.date.available2019-07-11T21:02:27Z
dc.date.issued2019-06-18en_US
dc.date.submitted2019-06-30T18:11:59Zen
dc.degree.disciplineApplied Health Sciencesen_US
dc.degree.levelDoctor of Philosophy (Ph.D.)en_US
dc.description.abstractAbstract Objective: Mood and anxiety disorders are among the most prevalent conditions in children and adolescents with unknown etiology. Exposure to antibiotics in early life has been proposed as a possible risk factor in animal studies. This study was aimed to assess maternal antibiotic use in pregnancy and child antibiotic use in the first three years of life as potential risk factors for subsequent development of these disorders during childhood and adolescence. Methods: A population-based retrospective cohort study was conducted using the Manitoba Population Research Data Repository. The cohort included children born in Manitoba between 1996 and 2012 (221,139 mother-child dyads). Children were followed until the earliest mood and anxiety disorders diagnoses, 19th birthday, migration, death or end of the study period. The antibiotic prescription was identified in the Drug Program Information Network. Physician-diagnosed mood and anxiety disorders were identified using hospital abstracts, medical claims and prescription records. Cox proportional hazard regression was used to compute crude and adjusted hazard ratios (aHRs) with 95% confidence intervals (CI). Results: Children born to mothers who received one antibiotic course or more in pregnancy had significantly higher rates of mood and anxiety disorders compared to children with no exposure (aHR 1.08, 95% CI 1.03 - 1.13) after adjusting for child antibiotic use and other potential confounders. Overall, child antibiotic use during the first three years of life did not increase the risk of developing mood and anxiety disorders (aHR 1.00, 95% CI 0.94 -1.07) after adjusting for maternal antibiotic use and other potential confounders. Children who received tetracyclines, aminoglycosides, quinolones (aHR 1.33, 95% CI 1.24 - 1.43) or sulfonamides and trimethoprim (aHR 1.28, 95% CI 1.22 - 1.34) were at increased risk of developing mood and anxiety disorders. Conclusion: The modest associations observed for prenatal exposure to antibiotics overall and postnatal exposure to specific kinds of antibiotics may have been confounded by unmeasured factors. While the findings do not support a specific causal relationship between antibiotic use and mood and anxiety disorders due to study limitations, further exploration is merited, and nonetheless, it would be prudent to avoid unnecessary administration of antibiotics.  en_US
dc.description.noteOctober 2019en_US
dc.identifier.urihttp://hdl.handle.net/1993/34026
dc.language.isoengen_US
dc.rightsopen accessen_US
dc.subjectmood and anxiety disordersen_US
dc.titleEarly Life Exposure to Antibiotics and Mood and Anxiety Disorders in Children and Adolescentsen_US
dc.typedoctoral thesisen_US
local.subject.manitobayesen_US
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