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Antibiotic Use In Utero and Early Life and Risk of Chronic Childhood Conditions in New Zealand: Protocol for a Data
Sharan Ram1, Marine Corbin1, Andrea 't Mannetje1
1Centre for Public Health Research, Massey University, Wellington, New Zealand.
Insights
Antibiotic use during pregnancy and early childhood is linked to increased risks of type 1 diabetes (T1D) and attention-deficit/hyperactive disorder (ADHD). This research provides insights for preventing chronic childhood conditions.
Area of Science:
- Pediatric Health
- Microbiome Research
- Epidemiology
Background:
- Global rise in chronic childhood conditions.
- Potential link to antibiotic overuse and gut dysbiosis.
Purpose of the Study:
- Assess antibiotic use in utero and early life.
- Investigate development of type 1 diabetes (T1D), ADHD, and inflammatory bowel disease.
Main Methods:
- Retrospective cohort studies using linked administrative data.
- Analysis of antibiotic exposure in 4 time periods for over 300,000 children.
- Cox proportional hazards regression models adjusting for confounders.
Main Results:
- Data linkage complete for 315,789 children.
- Preliminary findings show prenatal and early-life antibiotic exposure associated with T1D.
- Full analyses for all outcomes by end of 2025.
Conclusions:
- Linked cohort studies provide critical knowledge on antibiotics and childhood conditions.
- Potential to inform primary prevention strategies.
- Focus on targeted changes in antibiotic use.
Background:
The incidence of many common chronic childhood conditions has increased globally in the past few decades, which has been suggested to be potentially attributed to antibiotic overuse leading to dysbiosis in the gut microbiome.
Objective:
This linkage study will assess the role of antibiotic use in utero and in early life in the development of type 1 diabetes (T1D), attention-deficit/hyperactive disorder (ADHD), and inflammatory bowel disease.
Methods:
The study design involves several retrospective cohort studies using linked administrative health and social data from Statistics New Zealand's Integrated Data Infrastructure. It uses data from all children who were born in New Zealand between October 2005 and December 2010 (N=334,204) and their mothers. Children's antibiotic use is identified for 4 time periods (at pregnancy, at ≤1 year, at ≤2 years, and at ≤5 years), and the development of T1D, ADHD, and inflammatory bowel disease is measured from the end of the antibiotic use periods until death, emigration, or the end of the follow-up period (2021), whichever came first. Children who emigrated or died before the end of the antibiotic use period are excluded. Cox proportional hazards regression models are used while adjusting for a range of potential confounders.
Results:
As of September 2024, data linkage has been completed, involving the integration of antibiotic exposure and outcome variables for 315,789 children. Preliminary analyses show that both prenatal and early life antibiotic consumption is associated with T1D. Full analyses for all 3 outcomes will be completed by the end of 2025.
Conclusions:
This series of linked cohort studies using detailed, complete, and systematically collected antibiotic prescription data will provide critical new knowledge regarding the role of antibiotics in the development of common chronic childhood conditions. Thus, this study has the potential to contribute to the development of primary prevention strategies through, for example, targeted changes in antibiotic use.
International Registered Report Identifier (Irrid):
DERR1-10.2196/66184.
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