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Updated: May 5, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Antibiotic treatment during infancy and increased body mass index in boys: an international cross-sectional study
R Murphy1, A W Stewart2, I Braithwaite3
1Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Insights
Early antibiotic exposure in infancy is linked to higher childhood body mass index (BMI) in boys, but not girls. This suggests a sex-specific effect of early life antibiotic use on obesity risk.
Area of Science:
- Pediatric Health
- Microbiome Research
- Obesity Epidemiology
Background:
- Antibiotic use in early life is common.
- The gut microbiome plays a role in metabolic health.
- Potential links between early antibiotic exposure and childhood obesity require investigation.
Purpose of the Study:
- To determine if antibiotic exposure within the first year of life is associated with increased childhood body mass index (BMI).
Main Methods:
- Secondary analysis of a large, multi-centre, cross-sectional study (The International Study of Asthma and Allergies in Childhood Phase Three).
- Data from 74,946 children aged 5-8 years across 18 countries on early-life antibiotic use and current BMI.
- Statistical analysis using a general linear mixed model, adjusting for multiple covariates including sex, age, and lifestyle factors.
Main Results:
- Early-life antibiotic exposure was significantly associated with increased childhood BMI in boys (+0.107 kg/m²).
- No significant association was found between early-life antibiotic exposure and BMI in girls.
- The association in boys remained significant after adjusting for potential confounders.
Conclusions:
- Antibiotic exposure in the first 12 months of life is associated with a small, sex-specific increase in BMI in young boys.
- Findings support the role of the gut microbiota in modulating obesity risk.
- Highlights the importance of considering sex-specific effects in pediatric health research.
Objective:
To investigate whether antibiotic exposure during the first year of life is associated with increased childhood body mass index (BMI).
Design:
Secondary analysis from a multi-centre, multi-country, cross-sectional study (The International Study of Asthma and Allergies in Childhood Phase Three).
Subjects:
A total of 74 946 children from 31 centres in 18 countries contributed data on antibiotic use in the first 12 months of life and current BMI.
Methods:
Parents/guardians of children aged 5-8 years completed questionnaires that included questions about their children's current height and weight, and whether in the child's first 12 months of life, they had received any antibiotics, paracetamol, were breastfed or the mother/female guardian smoked cigarettes, and whether the child had wheezed in the past 12 months. A general linear mixed model was used to determine the association of antibiotic exposure with BMI, adjusting for age, sex, centre, BMI measurement type (self-reported or measured), maternal smoking, breastfeeding, paracetamol use, gross national income and current wheeze.
Results:
There was a significant interaction between sex and early-life antibiotic exposure. Early-life antibiotic exposure was associated with increased childhood BMI in boys (+0.107 kg m(-2), P<0.0001), but not in girls (-0.008 kg m(-2), P=0.75) after controlling for age, centre and BMI measurement type. The association remained in boys (+0.104 kg m(-2), P<0.0007), after adjustment for maternal smoking, breastfeeding, paracetamol use and current wheeze. There was no interaction between age, maternal smoking, breastfeeding, paracetamol use, gross national income and current wheeze in the association between early antibiotic exposure and BMI.
Conclusions:
Exposure to antibiotics during the first 12 months of life is associated with a small increase in BMI in boys aged 5-8 years in this large international cross-sectional survey. By inference this provides additional support for the importance of gut microbiota in modulating the risk of obesity, with a sex-specific effect.
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