Early Antibiotics Usage During Infancy is Associated With High Risk of Celiac Disease Autoimmunity: A...

Area of Science:

• Pediatric autoimmune disorders
• Microbiome and immunology
• Environmental health impacts

Background:

• Celiac disease (CD) arises from genetic predisposition and environmental factors.
• Early-life antibiotic use is a potential environmental influence on CD development.

Purpose of the Study:

• To investigate the association between early-life antibiotic exposure and celiac disease autoimmunity (CDA).
• To explore dose-response relationships and effect modifiers in this association.

Main Methods:

• Retrospective cohort study of over 1.8 million children born 1995-2022 in Israel.
• Antibiotic exposure assessed by type, timing, and count in the first year of life.
• CDA diagnosed via serology; Cox models adjusted for sex, ethnicity, and socioeconomic position (SEP).

Main Results:

• 56% of children received antibiotics in their first year.
• Antibiotic exposure in the first year correlated with a 9% increased CDA risk (HR 1.090).
• A dose-response was observed, with ≥10 prescriptions increasing risk significantly (HR 1.426); stronger in females and low SEP.

Conclusions:

• First-year antibiotic exposure is associated with elevated CDA risk.
• Increased prescription numbers amplify this risk, particularly in females.
• Early antibiotic use represents a significant environmental factor in CDA pathogenesis.