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First-Year Antibiotics Exposure in Relation to Childhood Asthma, Allergies, and Airway Illnesses
Zhijun Zou1, Wei Liu2, Chen Huang1
1Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai 200093, China.
Insights
Early antibiotic exposure in the first year of life significantly increases the risk of childhood asthma, allergies, and airway illnesses like pneumonia and wheeze. These findings highlight the importance of judicious antibiotic use in infants.
Area of Science:
- Pediatrics
- Environmental Health
- Epidemiology
Background:
- The relationship between early antibiotic exposure and childhood respiratory and allergic diseases remains a subject of ongoing scientific debate.
- Understanding these associations is crucial for public health initiatives and clinical practice guidelines.
Purpose of the Study:
- To investigate the association between antibiotic exposure during a child's first year of life and the subsequent development of asthma, allergies, and airway illnesses.
- To identify specific childhood health outcomes linked to early antibiotic use.
Main Methods:
- A cross-sectional study involving 13,335 preschoolers in Shanghai, China (2011-2012).
- Parental questionnaires collected data on household environment, lifestyle, and child health outcomes.
- Multivariate logistic regression analysis was employed to assess the associations.
Main Results:
- First-year antibiotic exposure was significantly associated with increased odds of lifetime pneumonia, croup, wheeze, asthma, food allergy, and allergic rhinitis.
- Exposure also correlated with higher incidence of current common cold, dry cough, atopic dermatitis, wheeze, and rhinitis symptoms.
- Effect modification by individual characteristics and other early life exposures was observed.
Conclusions:
- First-year antibiotic exposure emerges as a significant risk factor for childhood pneumonia, asthma, and allergies.
- Individual child characteristics and co-occurring early life exposures may modulate the impact of early antibiotics on allergic and airway conditions.
Abstract:
Background: Associations of early antibiotics exposures with childhood asthma, allergies, and airway illnesses are debated. Objectives: We aimed to investigate associations of first-year antibiotics exposure with childhood asthma, allergies, and airway illnesses. Methods: A cross-sectional study was conducted among preschoolers in Shanghai, China during 2011-2012. A questionnaire regarding household environment and lifestyles and childhood health outcomes was reported by the child's parents. Results: In total, 13,335 questionnaires (response rate: 85.3%) were analyzed and 3049 (24.1%) children had first-year antibiotics exposure. In the multivariate logistic regression analyses, first-year antibiotics exposure had significant associations with the higher odds of lifetime-ever pneumonia (adjusted OR, 95% CI: 2.15, 1.95-2.37), croup (1.46, 1.24-1.73), wheeze (1.44, 1.30-1.60), asthma (1.38, 1.19-1.61), food allergy (1.29, 1.13-1.46), and allergic rhinitis (1.23, 1.07-1.41), and as well as current (one year before the survey) common cold (≥3 times) (1.38, 1.25-1.52), dry cough (1.27, 1.13-1.42), atopic dermatitis (1.25, 1.09-1.43), wheeze (1.23, 1.10-1.38), and rhinitis symptoms (1.15, 1.04-1.26). These associations were different in children with different individual characteristics (age, sex, family history of atopy, and district) and other early exposures (breastfeeding, home decoration, pet-keeping, and environmental tobacco smoke). Conclusions: Our results indicate that first-year antibiotics exposure could be a strong risk factor for childhood pneumonia, asthma, allergies, and their related symptoms. The individual characteristics and other early exposures may modify effects of early antibiotic exposure on childhood allergies and airway illnesses.
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