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Associations between pre- and postnatal antibiotic exposures and early allergic outcomes: A population-based birth
Fanny Kelderer1, Ingrid Mogren2, Catharina Eriksson3
1Department of Clinical Sciences, Pediatrics Umeå University, Umeå, Sweden.
Insights
Early antibiotic exposure in children is linked to increased allergy risk, particularly wheeze, asthma, and eczema. However, postnatal antibiotics showed a protective effect against food sensitization.
Area of Science:
- Pediatric Allergy and Immunology
- Microbiome Research
- Environmental Health
Background:
- Early life antibiotic exposure is a potential factor influencing the risk of developing allergies.
- Understanding the impact of antibiotic use during pregnancy and early childhood on allergic outcomes is crucial.
Purpose of the Study:
- To investigate the associations between antibiotic exposures before and after birth and the development of allergic manifestations up to 18 months of age.
- To determine the relationship between prenatal and postnatal antibiotic use and allergic outcomes in infants.
Main Methods:
- A prospective, population-based birth cohort study (NorthPop) including 1387 mother-child dyads.
- Data on antibiotic exposure collected via web-based questionnaires; allergic symptoms, diagnoses, and sensitization (serum IgE) assessed up to 18 months.
- Bivariable and multivariable logistic regression analyses used to estimate associations.
Main Results:
- Prenatal antibiotic exposure showed a borderline association with wheeze and a positive association with food sensitization in crude analyses, which attenuated in adjusted models.
- Postnatal antibiotic exposure was significantly associated with increased risk of wheeze, asthma, and eczema.
- Postnatal antibiotics were negatively associated with food sensitization but not with food allergy or inhalant sensitization.
Conclusions:
- Both pre- and postnatal antibiotic exposures are associated with allergic manifestations in early childhood.
- While postnatal antibiotics increased the risk for several allergic conditions, they were linked to a decreased risk of food sensitization.
- Further research is needed to explore the long-term relationship between antibiotic exposure, food sensitization, and subsequent respiratory allergies.
Background:
Early life antibiotic treatment is one likely exposure influencing allergy risk. The objective was to investigate associations between pre- and postnatal antibiotic exposures and the development of allergic manifestations until age 18 months.
Methods:
We included 1387 mother-child dyads from the prospective, population-based NorthPop birth cohort study. Data on antibiotic exposures in pregnancy and childhood were collected by web-based questionnaires. Until the child turned 18 months old, parents (n = 1219) reported symptoms of wheeze, eczema, and physician-diagnosed asthma; parents (n = 1025) reported physician-diagnosed food allergy. At age 18 months, serum immunoglobulin E levels to inhalant (Phadiatop) and food (Food mix fx5) allergens were determined. Associations were estimated using bivariable and multivariable logistic regressions.
Results:
Prenatal antibiotic exposure was positively associated with food sensitization in the crude (OR 1.82, 95% CI 1.01-3.26) but not in the adjusted analyses (aOR 1.58, 0.82-3.05). A borderline significant association was found between prenatal exposure and wheeze (aOR 1.56, 0.95-2.57). Postnatal antibiotics were positively associated with wheeze (aOR 2.14, 1.47-3.11), asthma (aOR 2.35, 1.32-4.19), and eczema (aOR 1.49, 1.07-2.06). Postnatal antibiotics were negatively associated with food sensitization (aOR 0.46, 95% CI 0.25-0.83) but not with food allergy nor sensitization to inhalants.
Conclusion:
Pre- and postnatal antibiotic exposure demonstrated positive associations with allergic manifestations and the former also with food sensitization. In contrast, there was a negative association between postnatal antibiotics and food sensitization. Food sensitization is often transient but may precede respiratory allergies. Future studies should investigate the relationship between antibiotic exposure and food sensitization later in childhood.
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