Early exposure to antibiotic drugs and risk for psychiatric disorders: a population-based study

Area of Science:

• Pediatric Psychiatry
• Pharmacology
• Epidemiology

Background:

• Early life exposure to infections and antibiotics is linked to psychiatric disorders.
• Familial factors may confound the association between prenatal exposure and psychiatric risk.
• Antibiotic use during pregnancy and early childhood warrants investigation for potential psychiatric risks.

Purpose of the Study:

• To investigate the association between antibiotic drug exposure during fetal life and the first two postnatal years and the risk of psychiatric disorders in children.
• To determine if familial factors confound the observed associations.
• To assess the impact of early antibiotic exposure on a wide spectrum of psychiatric diagnoses and psychotropic drug treatment.

Main Methods:

• Longitudinal, nationwide study of approximately 1 million births in Finland (1996-2012).
• Data collected on maternal antibiotic exposure during pregnancy and child exposure in the first two postnatal years.
• Cox proportional hazards modeling used to analyze associations with psychiatric diagnoses and psychotropic medication until 2014.

Main Results:

• Antibiotic exposure was associated with a 10-50% increased risk for sleep disorders, ADHD, conduct disorder, mood and anxiety disorders, and other behavioral/emotional disorders (ICD-10 F98).
• Increased risks for childhood psychotropic medication were also observed.
• Prenatal exposure effects were not explained by familial confounding or maternal infections.

Conclusions:

• Early life antibiotic drug exposure is associated with an increased risk for the development of psychopathology in childhood.
• Findings are of significant public health relevance due to the high prevalence of early-life antibiotic exposure.
• Further research is needed to differentiate effects of antibiotic use versus targeted infections.