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Relationship between prenatal antibiotic use and asthma in at-risk children
Brittany Lapin1, Julie Piorkowski1, Dennis Ownby2
1Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
Insights
Prenatal antibiotic exposure is linked to an increased risk of childhood asthma. This association was observed in children at risk, particularly with antibiotic use later in pregnancy.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Microbiome Research
Background:
- Asthma prevalence has significantly increased globally over the last three decades.
- Prenatal and perinatal periods are critical for immune system development.
- Systemic antibiotic use during pregnancy may disrupt the maternal or placental microbiome, potentially increasing asthma risk in offspring.
Purpose of the Study:
- To investigate the association between prenatal antibiotic exposure and the development of asthma and wheezing in high-risk children.
- To identify potential links between antibiotic use during pregnancy and respiratory health outcomes in early childhood.
Main Methods:
- Utilized data from a randomized education intervention study involving families at risk for asthma (1998-2009).
- Defined asthma as a physician-diagnosed asthma by year 3 and wheezing in the third year of life.
- Employed logistic regression models, controlling for potential confounders, to assess the impact of prenatal antibiotic use.
Main Results:
- Prenatal antibiotic use was identified as a significant risk factor for developing asthma (OR 3.1, 95% CI 1.4-6.8) after adjustments.
- A weaker association was observed between prenatal antibiotic use and wheezing (OR 1.8, 95% CI 0.9-3.3).
- The association between prenatal antibiotic use and asthma risk was consistent for use later in pregnancy, but not for first-trimester use.
Conclusions:
- Prenatal antibiotic exposure may be associated with an increased risk of asthma development in at-risk children.
- While not statistically significant for wheezing in this cohort, a trend suggests further investigation is warranted.
- Larger cohort studies are needed to further delineate the relationship between prenatal antibiotic exposure and childhood respiratory conditions.
Background:
Asthma prevalence has doubled in developed countries during the past 30 years. Pre- and perinatal events are essential in shaping the development of the immune system and systemic antibiotic use during this time could alter the maternal or placental microbiome, leading to an increase in the child's risk of developing asthma.
Objective:
To determine whether prenatal antibiotic use is associated with asthma and wheezing in children at risk for asthma.
Methods:
Using data from a randomized education intervention of families at risk for asthma from 1998 followed through 2009 in urban Chicago, asthma was defined as ever having a physician asthma diagnosis by year 3 and wheezing in the third year. Logistic regression models controlling for confounders investigated the effect of antibiotic use during pregnancy on these outcomes.
Results:
After adjustment, prenatal antibiotic use was a risk factor for asthma (odds ratio 3.1, 95% confidence interval 1.4-6.8) but was only weakly associated with wheezing (odds ratio 1.8, 95% confidence interval 0.9-3.3). Analyses of the effects of timing of prenatal antibiotic use on asthma and wheezing showed the relation remained consistent for antibiotic use later in pregnancy, but the outcomes were not associated with antibiotic use in the first trimester.
Conclusion:
This study suggests prenatal antibiotic use might be associated with the development of asthma in children at risk for asthma. Although the relation with prenatal antibiotics does not hold for wheezing in this study, there might be a trend that could be delineated further within a larger cohort study.
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