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Prenatal antimicrobial use and early-childhood body mass index
A E Cassidy-Bushrow1,2, C Burmeister1, S Havstad1,2
1Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA.
Insights
Prenatal antibiotic exposure is linked to higher childhood body mass index (BMI) by age two, especially when used in early pregnancy. This finding highlights a potential factor in early childhood obesity risk.
Area of Science:
- Pediatric Health
- Maternal Health
- Microbiome Research
Background:
- Childhood obesity is a growing concern with potential links to early life exposures.
- Gut microbiome alterations are implicated in the relationship between antibiotic use and body mass index (BMI).
- The impact of prenatal antimicrobial exposure on offspring obesity risk remains less understood.
Purpose of the Study:
- To investigate the association between prenatal antibiotic or antifungal use and offspring BMI at age two.
- To explore if the timing of prenatal antimicrobial exposure influences childhood BMI.
Main Methods:
- A birth cohort of 527 participants was analyzed.
- Prenatal antimicrobial use was recorded from medical records.
- Child height and weight were measured at age two to calculate BMI, with overweight/obesity defined as BMI at or above the 85th percentile.
Main Results:
- Prenatal antibiotic use was associated with a higher mean BMI Z-score (0.20±0.10, P=0.046) at age two.
- No significant association was found between prenatal antifungal use and child BMI.
- Exposure to antibiotics in the first or second trimester showed a stronger association with increased BMI Z-score and overweight/obesity risk.
Conclusions:
- Prenatal antibiotic use, particularly in earlier trimesters, is associated with increased childhood BMI at age two.
- Antifungal use during pregnancy was not linked to offspring BMI.
- Further research into microbiome alterations is needed; prenatal antibiotic exposure may be a modifiable risk factor for childhood obesity.
Background/Objectives:
Growing evidence suggests that antibiotic use is associated with childhood body mass index (BMI), potentially via mechanisms mediated by gut microbiome alterations. Less is known on the potential role of prenatal antimicrobial use in offspring obesity risk. We examined whether prenatal antibiotic or antifungal use was associated with BMI at the age of 2 years in 527 birth cohort participants.
Methods/Subjects:
Antimicrobial use was obtained from the prenatal medical record. Height and weight were measured at the age of 2 years. Overweight/obesity was defined as a BMI ⩾85th percentile.
Results:
A total of 303 (57.5%) women used antibiotics and 101 (19.2%) used antifungals during pregnancy. Prenatal antifungal use was not associated with child BMI at the age of 2 years. In the fully adjusted model, prenatal antibiotic use was associated with a 0.20±0.10 (P=0.046) higher mean BMI Z-score at the age of 2 years. Associations between prenatal antibiotic use and childhood BMI varied by trimester of exposure, with first or second-trimester exposure more strongly associated with larger BMI at the age of 2 years for both BMI Z-score (interaction P=0.032) and overweight/obesity (interaction P=0.098) after covariate adjustment.
Conclusions:
Prenatal antibiotic, but not antifungal, use is associated with larger BMI at the age of 2 years; associations were stronger for antibiotic exposures in earlier trimesters. Future studies examining whether these associations are due to alterations in the maternal and/or infant microbiome are necessary. Children who are overweight at the age of 2 years are at higher risk for being overweight as they age; prenatal antibiotic use is a potentially modifiable exposure that could reduce childhood obesity.
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