Administration of Antibiotics to Children Before Age 2 Years Increases Risk for Childhood Obesity

Abstract

Background & Aims Childhood obesity is increasing and is associated with adult obesity. Antibiotics have been used to promote weight gain in livestock for several decades. Antibiotics are commonly prescribed for children, but it is not clear how exposure to antibiotics early in life affects risk for obesity. We performed a population-based cohort study to assess the association between antibiotic exposure before age 2 years and obesity at age 4 years. Methods We performed a retrospective cohort study of 21,714 children in The Health Improvement Network —a population-representative dataset of more than 10 million individuals derived from electronic medical records from 1995 through 2013 in the United Kingdom. Eligible subjects were registered within 3 months of birth with complete follow-up and height and weight were recorded within 12 months of their 4th birthday. Antibiotic exposure was assessed before age 2 years, and classified based on anti-anaerobic activity. The primary outcome was obesity at age 4 years. We performed logistic regression analyses, adjusting for maternal and sibling obesity, maternal diabetes, mode of delivery, socioeconomic status, year and country of birth, and urban dwelling. Results In the cohort, 1306 of the children (6.4%) were obese at 4 years of age. Antibiotic exposure was associated with an increased risk of obesity at 4 years (odds ratio [OR]=1.21; 95% confidence interval [CI], 1.07–1.38). Odds ratios increased with repeated exposures: for 1–2 prescriptions, OR=1.07 (95% CI, 0.91–1.23); for 3–5 prescriptions, OR=1.41 (95% CI, 1.20–1.65); for 6 or more prescriptions, OR=1.47 (95% CI, 1.19–1.82). Antifungal agents were not associated with obesity (OR=0.81; 95% CI, 0.59–1.11). Conclusions Administration of 3 or more courses of antibiotics before children reach an age of 2 years is associated with an increased risk of early childhood obesity.

Antibiotic treatment in infants: effect on the gastro-intestinal microbiome and long term consequences

“…14 Administration of three or more courses of antibiotics before children reach an age of two years is associated with an increased risk of early childhood obesity. 16 In a cohort study, 6.4 % children were obese at four years of age and exposure to antibiotics was associated with an increased risk of obesity at four years. 16 The more antibiotic courses, the stronger the risk.…”

“…16 In a cohort study, 6.4 % children were obese at four years of age and exposure to antibiotics was associated with an increased risk of obesity at four years. 16 The more antibiotic courses, the stronger the risk. 16 Children receiving antibiotics in the first year of life are more likely to be overweight at 12 years of age compared with those who were unexposed (32.4 vs 18.2%, P=0.002).…”

“…16 The more antibiotic courses, the stronger the risk. 16 Children receiving antibiotics in the first year of life are more likely to be overweight at 12 years of age compared with those who were unexposed (32.4 vs 18.2%, P=0.002). 17 Repeated exposure to broadspectrum antibiotics at ages 0 to 23 months is associated with early childhood obesity.…”

Letter: complex interplay between obesity and Clostridium difficile infection

“…4 This learning has been extended to humans with a recent study suggesting that the administration of three or more courses of antibiotics before children reach an age of 2 years is associated with an increased risk of early childhood obesity. 5 These observations remain a compelling argument for a microbiome affected aetiology of obesity.…”

Etiology and comorbidities of childhood obesity

“…They found that exposure to antibiotics in the first two years of life is associated with an increase in the risk of early childhood obesity. They suggested that repeated antibiotic use-three or more courses-is highly responsible for an increased risk of obesity risk (1).…”