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Impact of early life antibiotic exposure on the preschool developmental status: a nationwide population-based study

Ye Kyung Kim1,2, Peong Gang Park3

  • 1Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea (the Republic of).

BMJ Paediatrics Open
|July 16, 2025
PubMed

Insights

Early antibiotic exposure in infants under 90 days old is linked to a modest increase in developmental delays, particularly affecting motor skills, cognition, and communication. Longer exposure duration correlates with higher risk, necessitating careful prescription practices.

Area of Science:

  • Pediatric Neurodevelopment
  • Pharmacology and Toxicology

Background:

  • Growing concerns surround early antibiotic exposure's impact on neurodevelopmental outcomes.
  • Large-scale studies on this topic in early childhood are limited.

Purpose of the Study:

  • To investigate the association between early-life antibiotic exposure and developmental delays in preschool-aged children.
  • To assess the risk of global and domain-specific developmental delays following antibiotic use within the first 90 days of life.

Main Methods:

  • A nationwide, population-based retrospective cohort study.
  • Utilized data from the Korean National Health Insurance System and NHSPIC (2015-2022).
  • Included 1,848,841 children assessed at 4-6 months and 54-60 months of age.

Main Results:

  • 23% of infants received antibiotics within the first 3 months of life.
  • Early antibiotic exposure showed a slight increase in developmental delay risk (OR 1.03).
  • Delays were noted in gross motor, fine motor, cognition, and communication, with a dose-response relationship observed.

Conclusions:

  • Antibiotic exposure in the first 90 days of life may be associated with a modest increase in global developmental delays.
  • Motor skills, cognitive functions, and communication abilities appear particularly affected.
  • Prudent antibiotic prescribing for infants under 90 days is recommended.
Abstract

Keywords:
Child Health

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