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Prenatal antibiotics exposure and preschoolers' internalizing and externalizing problems: A biomonitoring-based
Menglong Geng1, Peng Ding1, Sheng Wang2
1School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.
Insights
Prenatal exposure to certain antibiotics in the first trimester is linked to increased risks of internalizing and externalizing behavioral problems in preschoolers. This study highlights potential risks associated with antibiotic use during early pregnancy.
Area of Science:
- Environmental Health
- Developmental Psychology
- Perinatal Medicine
Background:
- Limited biomonitoring studies exist on prenatal antibiotic exposure and preschooler behavioral issues.
- Understanding these associations is crucial for public health and early childhood development.
- This research addresses the gap by investigating the link between prenatal antibiotic exposure and behavioral problems.
Purpose of the Study:
- To investigate the relationship between prenatal antibiotic exposure and internalizing and externalizing problems in preschoolers.
- To identify specific antibiotics and exposure periods associated with behavioral outcomes.
- To explore potential modifying factors in the relationship between prenatal antibiotic exposure and child behavior.
Main Methods:
- Analysis of data from 2449 mother-child pairs.
- Repeated urine sample collection across three trimesters to measure 43 antibiotics and 2 metabolites.
- Preschooler behavioral problems assessed using the Achenbach Child Behavior Checklist; statistical analysis via Poisson regression models.
Main Results:
- First-trimester exposure to oxytetracycline, tetracycline, doxycycline, and preferred veterinary antibiotics (PVAs) was associated with increased internalizing problems.
- First-trimester doxycycline exposure linked to higher risk of externalizing problems.
- First-trimester doxycycline and PVA exposure associated with increased total behavioral problems.
Conclusions:
- Prenatal exposure to specific antibiotics during the first trimester may increase the risk of internalizing and externalizing problems in preschoolers.
- Caregiver type and children's outdoor activity levels may modify these associations.
- Findings underscore the importance of careful antibiotic use during pregnancy.
Background:
Biomonitoring-based epidemiological studies on prenatal antibiotic exposure and behavioral problems in preschoolers are lacking. The present study aimed to investigate the relationship between prenatal antibiotic exposure and internalizing and externalizing problems in preschoolers.
Methods:
Data from 2449 mother-child pairs were analyzed. Urine samples were repeatedly collected across three trimesters, and 43 antibiotics and 2 metabolites were measured, including preferred as veterinary antibiotics (PVAs), VAs, preferred as human antibiotics and human antibiotics. Preschoolers' internalizing and externalizing problems were evaluated by the Achenbach Child Behavior Checklist. Poisson regression models with generalized estimating equations were used to estimate risk ratios (RRs) and 95 % confidence intervals (CIs) for preschoolers' internalizing, externalizing and total problems across tertiles of antibiotic concentrations during three periods of pregnancy, and performed several subgroup analyses.
Results:
First-trimester urinary oxytetracycline (RR = 1.69, 95%CI: 1.20, 2.39, P-FDR = 0.011), tetracycline (RR = 1.91, 95%CI: 1.36, 2.68, P-FDR < 0.001), doxycycline (RR = 1.66, 95%CI: 1.28, 2.17, P-FDR < 0.001) and PVAs (RR = 1.79, 95%CI: 1.29, 2.48, P-FDR < 0.001) concentrations in the highest tertile were related to an elevated risk of internalizing problems compared with concentrations in the lowest tertile. First-trimester urinary doxycycline concentrations in the third tertile were also associated with an increased risk of externalizing problems compared with the first tertile (RR = 2.00, 95%CI: 1.28, 3.15, P-FDR = 0.042). Compared with concentrations in the lowest tertile, first-trimester urinary doxycycline (RR = 1.63, 95%CI: 1.19, 2.22, P-FDR = 0.028) and PVAs (RR = 1.67, 95%CI: 1.14, 2.43, P-FDR = 0.047) concentrations in the middle tertile were related to an increased risk of total problems. Furthermore, the type of main caregiver and children's outdoor activities time modified the relationships between specific prenatal antibiotic exposure and preschoolers' behavioral problems.
Conclusions:
Exposure to specific antibiotics during the first trimester may be related to an increased risk of internalizing and externalizing problems in preschoolers.
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