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Published on: August 7, 2017
Childhood infection burden, recent antibiotic exposure and vascular phenotypes in preschool children
Angela Yu1, Maria A C Jansen2, Geertje W Dalmeijer2
1Department of Paediatrics, Monash University, Clayton, Australia.
Insights
Recent antibiotic use in early childhood is linked to poorer vascular health, including increased carotid intima-media thickness and reduced artery distensibility. Further research is needed to distinguish antibiotic effects from infection impacts.
Area of Science:
- Pediatric health
- Cardiovascular research
- Vascular biology
Background:
- Severe childhood infections are known to impact adult cardiovascular health.
- The link between less severe childhood infections and cardiovascular outcomes remains unclear.
Purpose of the Study:
- To examine the association between common, non-hospitalized infections, antibiotic exposure, and preclinical vascular changes in young children.
- To investigate the impact of early-life infections and antibiotic use on cardiovascular health markers.
Main Methods:
- Prospective birth cohort study (Wheezing-Illnesses-Study-Leidsche-Rijn).
- Data collected from birth to 5 years on antibiotic prescriptions, general practitioner (GP)-diagnosed infections, and febrile illnesses.
- Vascular phenotypes including carotid intima-media thickness (CIMT), carotid artery distensibility, and blood pressure (BP) measured at age 5.
- Statistical analysis using general linear regression models adjusted for covariates.
Main Results:
- Each antibiotic prescription within 3-6 months prior to assessment correlated with increased CIMT.
- Antibiotic exposure was associated with decreased carotid artery distensibility.
- Febrile episodes showed a weak association with increased diastolic blood pressure; GP-diagnosed infections did not show significant associations with vascular phenotypes.
Conclusions:
- Early childhood antibiotic exposure is associated with adverse vascular phenotypes.
- Further mechanistic studies are required to differentiate effects of antibiotics versus infections.
- Findings may inform preventative strategies for childhood cardiovascular health.
Background:
Severe childhood infection has a dose-dependent association with adult cardiovascular events and with adverse cardiometabolic phenotypes. The relationship between cardiovascular outcomes and less severe childhood infections is unclear.
Aim:
To investigate the relationship between common, non-hospitalised infections, antibiotic exposure, and preclinical vascular phenotypes in young children.
Design:
A Dutch prospective population-derived birth cohort study.
Methods:
Participants were from the Wheezing-Illnesses-Study-Leidsche-Rijn (WHISTLER) birth cohort. We collected data from birth to 5 years on antibiotic prescriptions, general practitioner (GP)-diagnosed infections, and monthly parent-reported febrile illnesses (0-1 years). At 5 years, carotid intima-media thickness (CIMT), carotid artery distensibility, and blood pressure (BP) were measured. General linear regression models were adjusted for age, sex, smoke exposure, birth weight z-score, body mass index, and socioeconomic status.
Results:
Recent antibiotic exposure was associated with adverse cardiovascular phenotypes; each antibiotic prescription in the 3 and 6 months prior to vascular assessment was associated with an 18.1 μm (95% confidence interval, 4.5-31.6, p = 0.01) and 10.7 μm (0.8-20.5, p = 0.03) increase in CIMT, respectively. Each additional antibiotic prescription in the preceding 6 months was associated with an 8.3 mPa-1 decrease in carotid distensibility (-15.6- -1.1, p = 0.02). Any parent-reported febrile episode (compared to none) showed weak evidence of association with diastolic BP (1.6 mmHg increase, 0.04-3.1, p = 0.04). GP-diagnosed infections were not associated with vascular phenotypes.
Conclusions:
Recent antibiotics are associated with adverse vascular phenotypes in early childhood. Mechanistic studies may differentiate antibiotic-related from infection-related effects and inform preventative strategies.
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