早期儿童抗生素和慢性儿科疾病:一个回顾性队列研究
Matthew A Beier1,2, Soko Setoguchi3,4,5, Tobias Gerhard4,5,6
1Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA.
The Journal of infectious diseases
|April 16, 2025
概括
儿童早期使用抗生素与喘,食物过敏,过敏性鼻炎和智力障碍的风险增加有关,特别是在多处方的情况下. 大多数其他慢性疾病的相关性很小.
科学领域:
- 儿科健康 儿科健康
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 儿童早期接触抗生素是慢性儿科疾病的潜在危险因素.
- 之前的研究面临着未测量的混因素带来的挑战.
- 这项研究调查了早期抗生素使用与过敏,自身免疫和神经发育/精神疾病之间的联系.
研究的目的:
- 评估在生命的前两年和慢性儿科疾病的发展抗生素处方之间的关系.
- 评估抗生素暴露对过敏,自身免疫和神经发育/精神病结局的影响.
- 通过强大的统计方法,尽量减少混偏差.
主要方法:
- 使用英国电子健康记录 (1987-2020) 的回顾性队列研究.
- 主要暴露:出生到2岁之间的抗生素处方.
- 结果:喘,食物过敏,过敏性鼻炎,自身免疫性疾病,神经发育/精神疾病和前臂骨折 (负对照) 的诊断.
- 统计分析:多变量考克斯回归和兄弟匹配条件考克斯回归.
主要成果:
- 在2岁之前接触抗生素与喘 (HR 1.24) 食物过敏 (HR 1.33) 和过敏性鼻炎 (HR 1.06) 的风险增加有关.
- 发现与智力障碍存在剂量依赖的关联 (5+vs1-2课程:HR 1.73;兄弟匹配HR 2.79).
- 对于大多数自身免疫,神经发育和精神疾病,没有观察到任何显著的关联. 兄弟匹配的分析表明混最小.
结论:
- 儿童早期多次服用抗生素与患喘,食物过敏,过敏性鼻炎和智力障碍的可能性更高有关.
- 这项研究表明,在早期接触抗生素后,大多数自身免疫,神经发育和精神疾病的风险最小.
- 研究结果强调了小孩子明智使用抗生素的重要性.
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