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Perinatal antibiotic exposure and infant sleep behavior: findings from the ABERRANT study
Andjela Markovic1,2,3,4, Salome Kurth1,4, Petra Zimmermann5,6,7,8
1Department of Psychology, University of Fribourg, Fribourg, Switzerland.
Insights
Antibiotic exposure during delivery was linked to subtle changes in infant sleep patterns, including more daytime sleep and fewer nighttime awakenings. These findings suggest potential impacts on early sleep regulation and the infant microbiome.
Area of Science:
- Perinatal health
- Infant neurodevelopment
- Microbiome research
Background:
- Antibiotic use during pregnancy and delivery may impact infant gut microbiome development.
- The effects of these antibiotics on infant sleep are not well understood.
- Altered infant sleep can have long-term neurodevelopmental consequences.
Purpose of the Study:
- To investigate the association between indirect antibiotic exposure and infant sleep patterns.
- To examine sleep at 2 and 6 months of age in relation to perinatal antibiotic exposure.
Main Methods:
- Prospective birth cohort study of 192 infants.
- Examined indirect antibiotic exposure (maternal use during third trimester or delivery).
- Used parent-reported sleep data and linear mixed-effects models.
Main Results:
- Delivery-related antibiotic exposure associated with higher daytime-to-nighttime sleep ratio.
- Delivery-related antibiotic exposure linked to fewer nighttime awakenings.
- No significant association found for sleep latency; effect sizes were small to moderate.
Conclusions:
- Indirect perinatal antibiotic exposure may be associated with altered infant sleep behavior.
- Findings suggest potential influence on early sleep regulation and the infant microbiome.
- Further research is warranted to explore underlying mechanisms.
Background:
Antibiotics administered during pregnancy and delivery can disrupt the developing infant intestinal microbiome, but their effects on infant sleep remain poorly understood. Given the critical role of sleep in early neurodevelopment, alterations in sleep during this sensitive developmental period may have lasting consequences for later cognitive and behavioral outcomes.
Methods:
In a prospective birth cohort study, associations between indirect antibiotic exposure (maternal antibiotic use during the third trimester of pregnancy or during delivery) and parent-reported sleep at 2 and/or 6 months were examined in 192 infants (46% females) using linear mixed-effects models.
Results:
Indirect antibiotic exposure during delivery was associated with a higher daytime-to-nighttime sleep ratio, reflecting relatively greater daytime sleep duration compared with nighttime sleep at both ages. Indirect antibiotic exposure during delivery was also associated with fewer nighttime awakenings, while no significant associations were observed for sleep latency. Effect sizes were small to moderate, suggesting subtle alterations in sleep behavior rather than overt sleep disturbance.
Conclusion:
These findings suggest that indirect perinatal antibiotic exposure may be associated with altered sleep behavior in infants and warrant further investigation into potential underlying mechanisms, including alterations of the developing microbiome.
Impact:
Indirect antibiotic exposure during delivery is associated with subtle differences in sleep behavior at 2 and 6 months. This study extends existing literature on perinatal antibiotic exposure by examining early sleep outcomes, an understudied domain despite the importance of sleep for neurodevelopment and infant health. Although the observed differences were small, these findings suggest that perinatal antibiotic exposure may influence early sleep regulation and highlight the need for further research into underlying mechanisms, including alterations in the infant microbiome.
