Association of Early Antibiotic Exposure With Childhood Body Mass Index Trajectory Milestones

Aris, Izzuddin M.; Lin, Pi I.D.; Rifas‐Shiman, Sheryl L.; Bailey, L. Charles; Boone‐Heinonen, Janne; Eneli, Ihuoma; Solomonides, Anthony; Janicke, David M.; Toh, Sengwee; Forrest, Christopher B.; Block, Jason P.

doi:10.1001/jamanetworkopen.2021.16581

Cited by 15 publications

(6 citation statements)

References 46 publications

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“…In contrast, almost every very preterm-birth neonate is exposed to a variable duration of antibiotics in the NICU [8,18]. While most studies investigate the effects of early-life antibiotic exposure on growth outcomes in term-birth infants [3,5,19], few have examined these effects in preterm-birth children [20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Association of Neonatal Antibiotic Exposure with Long-Term Growth Trajectory Faltering in Preterm-Birth Children

Lin,

Chu,

Lin

et al. 2024

Neonatology

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Introduction: Preterm neonates often receive a variety of duration of antibiotic exposure during admission. The aim of the study was to evaluate whether neonatal antibiotic exposure is relevant with longitudinal growth problems in preterm-birth children. Methods: This prospective study enrolled 481 infants who were born <32 weeks of gestation, discharged, and longitudinally followed from corrected age (CA) 6–60 months. After excluding 153 infants with blood culture-confirmed bacteremia, necrotizing enterocolitis, severe cerebral palsy, intestinal ostomy, and congenital anomaly, 328 infants were included for analysis. Covariates included perinatal demographics, neonatal morbidities, extrauterine growth restriction, and antibiotic exposure accumulated by term equivalent age. The primary outcome was the anthropometric trajectories in z-score of bodyweight (zBW), body height (zBH), and body mass index (zBMI) from CA 6–60 months. Results: Antibiotic exposure duration was significantly negatively associated with zBW and zBH at CA 6, 12, and 60 months, and zBMI at CA 60 months. Multivariate generalized estimating equation analyses showed antibiotic exposure duration had significantly faltering z-score increment from CA 6 to 60 months in zBW and zBH (adjusted mean [95% CI]; ΔzBW: −0.021 [−0.041 to −0.001], p = 0.042; ΔzBH: −0.019 [−0.035 to −0.002], p = 0.027) after adjustment. Children with neonatal antibiotic exposure duration >15 days were significantly lower in the mean anthropometric zBW, zBH, and zBMI at CA 6, 12, 24, and 60 months compared with children with neonatal antibiotic exposure ≤15 days (all p < 0.01). Conclusions: Growth increments were negatively associated with antibiotic exposure duration in preterm neonates implicating that antibiotic stewardship and growth follow-up for preterm neonates are thus warranted.

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Section: Discussionmentioning

confidence: 99%

Association of Neonatal Antibiotic Exposure with Long-Term Growth Trajectory Faltering in Preterm-Birth Children

Lin,

Chu,

Lin

et al. 2024

Neonatology

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“…Another recent study by Aris et al on 0-48-month-old children documented that antibiotic exposure was associated with statistically significant BMI trajectory milestones during infancy and early childhood. These associations were the strongest for children with at least four episodes of antibiotic exposure [ 41 ].…”

Section: Reviewmentioning

confidence: 99%

Early-Life Antibiotics and Childhood Obesity: Yeast Probiotics as a Strategy to Modulate Gut Microbiota

Rawat¹,

Narain²,

Marathe³

et al. 2023

Cureus

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This study aimed to review the existing literature to investigate the potential link between early-life antibiotic use and being overweight or obese in children. PubMed, Web of Science, Embase, Google Scholar, and Cochrane Library were searched to identify studies published until August 2021 that assessed the relationship between early-childhood antibiotic use and measures of body mass index. The studies included children aged 0-18 years. Only cohort studies were taken into consideration. Studies published in languages other than English were excluded. Antibiotic usage in early life may increase the risk of obesity in children and the addition of yeast probiotics, such as Saccharomyces boulardii CNCM I 745, to antibiotic prescription can serve as a potential option to mitigate this risk.

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“…Of concern was that infants have a higher abundance of ARGs in their gut flora relative to adults ( 6 , 7 ), and antibiotic exposure during this period can adversely affect long-term health by disrupting gut microbial maturation over time ( 7 ). It is estimated that 80% of children in high-income countries receive antibiotics in the first 48 months of life ( 7 , 8 ), and the rate is worse in low- and middle-income countries, where each child will receive an average of 11 antibiotic courses in the first two years ( 7 , 9 ). Therefore, overuse of antibiotics accelerates the spread of AR among bacteria and poses serious health problems ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Synergistic horizontal transfer of antibiotic resistance genes and transposons in the infant gut microbial genome

Ding,

Jiang,

et al. 2024

mSphere

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Transposons, plasmids, bacteriophages, and other mobile genetic elements facilitate horizontal gene transfer in the gut microbiota, allowing some pathogenic bacteria to acquire antibiotic resistance genes (ARGs). Currently, the relationship between specific ARGs and specific transposons in the comprehensive infant gut microbiome has not been elucidated. In this study, ARGs and transposons were annotated from the Unified Human Gastrointestinal Genome (UHGG) and the Early-Life Gut Genomes (ELGG). Association rules mining was used to explore the association between specific ARGs and specific transposons in UHGG, and the robustness of the association rules was validated using the external database in ELGG. Our results suggested that ARGs and transposons were more likely to be relevant in infant gut microbiota compared to adult gut microbiota, and nine robust association rules were identified, among which Klebsiella pneumoniae , Enterobacter hormaechei_A , and Escherichia coli_D played important roles in this association phenomenon. The emphasis of this study is to investigate the synergistic transfer of specific ARGs and specific transposons in the infant gut microbiota, which can contribute to the study of microbial pathogenesis and the ARG dissemination dynamics. IMPORTANCE The transfer of transposons carrying antibiotic resistance genes (ARGs) among microorganisms accelerates antibiotic resistance dissemination among infant gut microbiota. Nonetheless, it is unclear what the relationship between specific ARGs and specific transposons within the infant gut microbiota. K. pneumoniae , E. hormaechei_A , and E. coli_D were identified as key players in the nine robust association rules we discovered. Meanwhile, we found that infant gut microorganisms were more susceptible to horizontal gene transfer events about specific ARGs and specific transposons than adult gut microorganisms. These discoveries could enhance the understanding of microbial pathogenesis and the ARG dissemination dynamics within the infant gut microbiota.

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Association of Early Antibiotic Exposure With Childhood Body Mass Index Trajectory Milestones

Cited by 15 publications

References 46 publications

Association of Neonatal Antibiotic Exposure with Long-Term Growth Trajectory Faltering in Preterm-Birth Children

Association of Neonatal Antibiotic Exposure with Long-Term Growth Trajectory Faltering in Preterm-Birth Children

Early-Life Antibiotics and Childhood Obesity: Yeast Probiotics as a Strategy to Modulate Gut Microbiota

Synergistic horizontal transfer of antibiotic resistance genes and transposons in the infant gut microbial genome

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