Association of prenatal antibiotics with measures of infant adiposity and the gut microbiome

Abstract

Background Prenatal antibiotic exposure has been associated with an altered infant gut microbiome composition and higher risk of childhood obesity, but no studies have examined if prenatal antibiotics simultaneously alter the gut microbiome and adiposity in infants. Method In this prospective study (Nurture: recruitment 2013–2015 in North Carolina, United States), we examined in 454 infants the association of prenatal antibiotic exposure (by any prenatal antibiotic exposure; by trimester of pregnancy; by number of courses; by type of antibiotics) with infant age- and sex-specific weight-for-length z score (WFL-z) and skinfold thicknesses (subscapular, triceps, abdominal) at 12 months of age. In a subsample, we also examined whether prenatal antibiotic exposure was associated with alterations in the infant gut microbiome at ages 3 and 12 months. Results Compared to infants not exposed to prenatal antibiotics, infants who were exposed to any prenatal antibiotics had 0.21 (95% confidence interval [CI] 0.02, 0.41) higher WFL-z at 12 months, and 0.28 (95% CI 0.02, 0.55) higher WFL-z if they were exposed to antibiotics in the second trimester, after adjustment for potential confounders, birth weight, and gestational age. We also observed a dose-dependent association (P-value for trend = 0.006) with infants exposed to ≥ 3 courses having 0.41 (95% CI 0.13, 0.68) higher WFL-z at 12 months. After further adjustment for delivery method, only second-trimester antibiotic exposure remained associated with higher infant WFL-z (0.27, 95% CI 0.003, 0.54) and subscapular skinfold thickness (0.49 mm, 95% CI 0.11, 0.88) at 12 months. Infants exposed to second-trimester antibiotics versus not had differential abundance of 13 bacterial amplicon sequence variants (ASVs) at age 3 months and 17 ASVs at 12 months (false discovery rate adjusted P-value < 0.05). Conclusions Prenatal antibiotic exposure in the second trimester was associated with an altered infant gut microbiome composition at 3 and 12 months and with higher infant WFL-z and subscapular skinfold thickness at 12 months. Electronic supplementary material The online version of this article (10.1186/s12941-019-0318-9) contains supplementary material, which is available to authorized users.

Association of in Utero Antibiotic Exposure With Childhood Ear Infection Trajectories: A National Birth Cohort Study

“…One is that maternal microbiome changes induced through antibiotic use lead to neonatal acquisition of a more disordered, higher risk microbiome. 20 Our observation that maternal antibiotic use is associated with a moderate frequency of otitis media that decreases with time is consistent with a disordered infant microbiome that is gradually restored. Second, there may be direct anatomic or structural impacts from foetal middle ear antibiotic exposures that might not be reversible and lead to consistently high rates of otitis media.…”

Obesity, Early Life Gut Microbiota, and Antibiotics

“…Across an number of studies, a consistent association has been found between antibiotic-induced changes in the gut microbiota and either childhood adiposity or obesity [ 121 , 122 , 123 , 124 , 125 ]. Zhang and colleagues investigated the influence that prenatal antibiotic exposure had on infant weight for length score (WFL-score), adiposity, and alterations in the gut microbiota [ 121 ]. A total of 237 of the 454 infants included in the study were exposed to antibiotics during gestation, which, for the purposes of the study, was defined as second-trimester exposure.…”

Nutri-Epigenetics and Gut Microbiota: How Birth Care, Bonding and Breastfeeding Can Influence and Be Influenced?

“…The effect on both mother’s and child’s health of administering antibiotics during pregnancy or around the time of birth has not been completely elucidated. Several studies have been carried out to investigate the potential adverse effects of using antibiotics prenatally, during pregnancy or neonatally on the baby’s gut microbiome and the development of the infant immune system—possibly leading to childhood atopy, asthma, allergy and obesity [ 67 , 68 ].…”