Early-life exposure to antibiotics and subsequent development of atopic dermatitis

Cantarutti, Anna; Amidei, Claudio Barbiellini; Bonaugurio, Andrea Stella; Rescigno, P.; Canova, Cristina

doi:10.1080/17512433.2022.2092471

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…We identified all children born between 2004 and 2018, followed from birth to at least 4 years (maximum follow-up of 14 years). Children were required to have at least 2 visits during the first 2 years of life at least 6 months apart [13], born at term (≥37 gestational weeks) and with birth weight greater than 2500 g, and without genetic diseases (ie, achondroplasia, Cornelia de Lange, Down, Prader-Willi, Turner, and Williams syndromes [14][15][16][17][18][19][20][21]) or congenital anomalies. The final cohort consisted of 121,540 children (Figure S1 in Multimedia Appendix 1).…”

Section: Study Populationmentioning

confidence: 99%

Association Between Early-Life Exposure to Antibiotics and Development of Child Obesity: Population-Based Study in Italy

Cantarutti,

Rescigno,

Da Borso

et al. 2024

JMIR Public Health Surveill

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Background Childhood obesity is a significant public health problem representing the most severe challenge in the world. Antibiotic exposure in early life has been identified as a potential factor that can disrupt the development of the gut microbiome, which may have implications for obesity. Objective This study aims to evaluate the risk of developing obesity among children exposed to antibiotics early in life. Methods An Italian retrospective pediatric population-based cohort study of children born between 2004 and 2018 was adopted using the Pedianet database. Children were required to be born at term, with normal weight, and without genetic diseases or congenital anomalies. We assessed the timing of the first antibiotic prescription from birth to 6, 12, and 24 months of life and the dose-response relationship via the number of antibiotic prescriptions recorded in the first year of life (none, 1, 2, and ≥3 prescriptions). Obesity was defined as a BMI z score >3 for children aged ≤5 years and >2 for children aged >5 years, using the World Health Organization growth references. The obese incidence rate (IR) × 100 person-years and the relative 95% CI were computed using infant sex, area of residence, preschool and school age, and area deprivation index, which are the covariates of interest. A mixed-effect Cox proportional hazards model was used to estimate the hazard ratio and 95% CI for the association between antibiotic exposure in early life and child obesity between 24 months and 14 years of age, considering the family pediatricians as a random factor. Several subgroup and sensitivity analyses were performed to assess the robustness of our results. Results Among 121,540 children identified, 54,698 were prescribed at least an antibiotic within the first year of life and 26,990 were classified as obese during follow-up with an incidence rate of 4.05 cases (95% CI 4.01-4.10) × 100 person-year. The risk of obesity remained consistent across different timings of antibiotic prescriptions at 6 months, 1 year, and 2 years (fully adjusted hazard ratio [aHR] 1.07, 95% CI 1.04-1.10; aHR 1.06, 95% CI 1.03-1.09; and aHR 1.07, 95% CI 1.04-1.10, respectively). Increasing the number of antibiotic exposures increases the risk of obesity significantly (P trend<.001). The individual-specific age analysis showed that starting antibiotic therapy very early (between 0 and 5 months) had the greatest impact (aHR 1.12, 95% CI 1.08-1.17) on childhood obesity with respect to what was observed among those who were first prescribed antibiotics after the fifth month of life. These results were consistent across subgroup and sensitivity analyses. Conclusions The results from this large population-based study support the association between early exposure to antibiotics and an increased risk of childhood obesity. This association becomes progressively stronger with both increasing numbers of antibiotic prescriptions and younger age at the time of the first prescription.

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Section: Study Populationmentioning

confidence: 99%

Association Between Early-Life Exposure to Antibiotics and Development of Child Obesity: Population-Based Study in Italy

Cantarutti,

Rescigno,

Da Borso

et al. 2024

JMIR Public Health Surveill

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The Prolonged Impact of Early-Life Antibiotics Exposure on 81 Common Diseases: Evidence from Epidemiology, Genetics, and Causality

Jiang,

Guo,

Yao

et al. 2023

Preprint

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Background: The widespread administration of antibiotics to children has prompted concerns regarding the potential adverse effects associated with their use. Early-life exposure to antibiotics has been linked with various health issues, including gastrointestinal disorders, dermatological conditions, and asthma. However, previous studies exhibit certain constraints regarding its scope and ability to establish causal relationships between early-life antibiotics exposure and health complications. This study aimed to systematically investigate the long-lasting effects of antibiotics on various systemic diseases, providing epidemiological and genetic evidence. Methods: Leveraging electronic hospital records, questionnaire data, and genotype data in UK Biobank, we examined 158,391 individuals with documented early-life antibiotics exposure to comprehensively analyze the associations between early antibiotics exposure and systemic diseases. We initiated an observational study scrutinizing the links between antibiotics usage and various diseases. Subsequently, eight Mendelian randomization methods were employed to meticulously account for confounding variables and investigate potential causality. Moreover, genetic correlation analyses were conducted to validate these associations from a genetic perspective. Eventually, colocalization analyses were performed to identify shared genetic structures among them. Results: In our observational study involving 81 common diseases, our findings revealed significnat associations between the exposure to antibiotics during early life and 45 diseases, after correcting the false discovery rate. Among these, 11 diseases demonstrated causal evidence. These diseases include type-2 diabetes (OR = 1.27 [1.18,1.36], P = 4.8×10− 11), depression (OR = 1.77 [1.67,1.89], P = 2.2×10− 72), inflammatory bowel disease (OR = 1.28 [1.14,1.45], P = 6.2×10− 5), polymyalgia rheumatica (OR = 1.28 [1.07,1.53], P = 6.4×10− 3), giant cell arteritis (OR = 1.55 [1.12, 2.14], P = 7.5×10− 3), chronic tonsil and adenoid diseases (OR = 2.13 [1.73, 2.62], P = 1.3×10− 12), other upper respiratory conditions (OR = 1.4 [1.24,1.59], P = 9.7×10− 8), hordeolum and other deep inflammation of the eyelid (OR = 2.13 [1.32,3.41], P = 1.80×10− 3), sciatica (OR = 1.54 [1.35,1.76], P = 8.30×10− 11), cystitis (OR = 1.51 [1.31,1.74], P = 8.10×10− 9), and bronchiectasis (OR = 2.7 [2.37,3.06], P = 9.7×10− 52), and 5 of these had genetic correlations. Additionally, we identified common pleiotropic genetic loci linking antibiotics exposure to these 5 diseases. Conclusions: The study unveiled the enduring and detrimental effects of prolonged antibiotic usage during early life, which can potentially result in the development of diseases across multiple bodily systems, either directly or indirectly.

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Association Between Early-Life Exposure to Antibiotics and Development of Child Obesity: Population-Based Study in Italy (Preprint)

Cantarutti,

Rescigno,

Da Borso

et al. 2023

Preprint

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BACKGROUND Childhood obesity is a significant public health problem representing the most severe challenge in the world. Antibiotic exposure in early life has been identified as a potential factor that can disrupt the development of the gut microbiome, which may have implications for obesity. OBJECTIVE This study aims to evaluate the risk of developing obesity among children exposed to antibiotics early in life. METHODS An Italian retrospective pediatric population-based cohort study of children born between 2004 and 2018 was adopted using the Pedianet database. Children were required to be born at term, with normal weight, and without genetic diseases or congenital anomalies. We assessed the timing of the first antibiotic prescription from birth to 6, 12, and 24 months of life and the dose-response relationship via the number of antibiotic prescriptions recorded in the first year of life (none, 1, 2, and ≥3 prescriptions). Obesity was defined as a BMI <i>z</i> score >3 for children aged ≤5 years and >2 for children aged >5 years, using the World Health Organization growth references. The obese incidence rate (IR) × 100 person-years and the relative 95% CI were computed using infant sex, area of residence, preschool and school age, and area deprivation index, which are the covariates of interest. A mixed-effect Cox proportional hazards model was used to estimate the hazard ratio and 95% CI for the association between antibiotic exposure in early life and child obesity between 24 months and 14 years of age, considering the family pediatricians as a random factor. Several subgroup and sensitivity analyses were performed to assess the robustness of our results. RESULTS Among 121,540 children identified, 54,698 were prescribed at least an antibiotic within the first year of life and 26,990 were classified as obese during follow-up with an incidence rate of 4.05 cases (95% CI 4.01-4.10) × 100 person-year. The risk of obesity remained consistent across different timings of antibiotic prescriptions at 6 months, 1 year, and 2 years (fully adjusted hazard ratio [aHR] 1.07, 95% CI 1.04-1.10; aHR 1.06, 95% CI 1.03-1.09; and aHR 1.07, 95% CI 1.04-1.10, respectively). Increasing the number of antibiotic exposures increases the risk of obesity significantly (<i>P</i> trend<.001). The individual-specific age analysis showed that starting antibiotic therapy very early (between 0 and 5 months) had the greatest impact (aHR 1.12, 95% CI 1.08-1.17) on childhood obesity with respect to what was observed among those who were first prescribed antibiotics after the fifth month of life. These results were consistent across subgroup and sensitivity analyses. CONCLUSIONS The results from this large population-based study support the association between early exposure to antibiotics and an increased risk of childhood obesity. This association becomes progressively stronger with both increasing numbers of antibiotic prescriptions and younger age at the time of the first prescription.

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Early-life exposure to antibiotics and subsequent development of atopic dermatitis

Cited by 3 publications

References 30 publications

Association Between Early-Life Exposure to Antibiotics and Development of Child Obesity: Population-Based Study in Italy

Association Between Early-Life Exposure to Antibiotics and Development of Child Obesity: Population-Based Study in Italy

The Prolonged Impact of Early-Life Antibiotics Exposure on 81 Common Diseases: Evidence from Epidemiology, Genetics, and Causality

Association Between Early-Life Exposure to Antibiotics and Development of Child Obesity: Population-Based Study in Italy (Preprint)

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