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Maternal and early postnatal antibiotic exposure may increase the risk of autism spectrum disorder with regression

Boli Cheng1, Xi Lai2, Huan Liu3

  • 1Department of Pediatrics, Affiliated Hospital of North Sichuan Medical College, North Sichuan Medical College, Nanchong 637000, China.

Neurotoxicology and Teratology
|August 31, 2025
PubMed

Insights

Antibiotic exposure during pregnancy and early childhood may increase the risk of autism spectrum disorder with regression (ASD-R). Children with ASD-R showed higher rates of antibiotic exposure, suggesting it could be a risk factor for regression and potentially more severe symptoms.

Area of Science:

  • Neurodevelopmental disorders
  • Pediatric health
  • Pharmacology

Background:

  • Autism spectrum disorder (ASD) is a complex neurodevelopmental condition.
  • A subset of children with ASD experience regression, characterized by loss of previously acquired skills.
  • Understanding potential environmental risk factors for ASD with regression (ASD-R) is crucial for early intervention.

Purpose of the Study:

  • To investigate the association between antibiotic exposure during maternal pregnancy and the early postnatal period and the risk of ASD-R.
  • To determine if antibiotic exposure influences the severity of core symptoms in children with ASD.

Main Methods:

  • A case-control study involving 483 children diagnosed with ASD.
  • Children were categorized into ASD with regression (ASD-R) and ASD without regression (ASD-NR) groups.
  • Caregiver-reported questionnaires assessed antibiotic use during maternal pregnancy and the early postnatal period.

Main Results:

  • Significantly higher proportions of antibiotic exposure were observed in the ASD-R group during maternal pregnancy (10.3%) and before age 2 (44.0%) compared to the ASD-NR group (2.9% and 33.1%).
  • Maternal antibiotic exposure was associated with a higher likelihood of regression in children with ASD (adjusted OR = 3.36).
  • Early postnatal antibiotic exposure also increased the risk of regression (adjusted OR = 1.50) and was linked to more severe core symptoms, as measured by the ABC scale.

Conclusions:

  • Elevated rates of antibiotic exposure during pregnancy and early postnatal periods were found in children with ASD-R.
  • Maternal and early postnatal antibiotic exposure may represent significant risk factors for regression in children with ASD.
  • Antibiotic exposure history may correlate with increased severity of core ASD symptoms.
Abstract

Keywords:
AntibioticsAutism spectrum disorderDevelopmental regressionEarly postnatalMaternal pregnancy

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