No association between prenatal antibiotic exposure and atopic dermatitis among Japanese infants

Sasaki, Mari; Sakurai, Kenichi; Shimojo, Naoki; Yamamoto, Midori; Mori, Chisato

doi:10.1111/pai.13156

Cited by 5 publications

(8 citation statements)

References 10 publications

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“…Conversely, an overall negative association was observed between maternal active smoking during pregnancy and self-reported doctor diagnosis of eczema in seven studies 20,22,25,28,34,37,46 as well as paternal active smoking during the postnatal period and offspring food sensitisation assessed using serum immunoglobulin E levels in one study. 19 Although the evidence supporting the adverse effect of maternal passive smoking during pregnancy on offspring eczema development is limited, it remains an important finding given the high prevalence of pregnant women exposed to second-hand smoke worldwide-with estimates ranging from 24% to over 70% in different countries.…”

Section: Discussionmentioning

confidence: 94%

“…Of these, 1372 studies were deemed irrelevant and excluded (Figure 1), and 74 records were further reviewed using full texts. Finally, 32 studies with nearly 190,000 subjects were deemed eligible for inclusion in this meta‐analysis, 16–47 where one study compared two separate cohorts 47 (Table 1). Using the Newcastle–Ottawa Scale, 27 and 6 studies were considered as high and moderate quality, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…There were 17 studies which evaluated the association between maternal active smoking during pregnancy and offspring eczema development, 16,17,20,[22][23][24][25][26][27][28][29]31,34,37,41,43,46 6 studies for food allergy 17,21,23,33,45,47 and 2 studies for food sensitisation. 17,18 There was no significant association between maternal active smoking during pregnancy and the risk of eczema development when all assessment types were considered (RR = 0.92; 95% CI 0.84-1.00; Figure 2).…”

Section: Maternal Active Smokingmentioning

confidence: 99%

See 2 more Smart Citations

Smoke exposure and childhood atopic eczema and food allergy: A systematic review and meta‐analysis

Lau,

Lee,

Yap

et al. 2023

Pediatric Allergy Immunology

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BackgroundThere is no consensus on the effect of timing and type of smoke exposure on early allergy development. This study aimed to determine the relationship between early eczema or food allergy/hypersensitivity development in children by firstly investigating the effect of smoke exposure across critical development periods and secondly by analyzing effects of parental atcive or passive smoking.MethodsFour databases (PubMed, Web of Science, Scopus and Embase) were searched in May 2022 and assessed by two independent reviewers. Case–control, cross‐sectional or cohort studies reporting on smoke exposure from preconception to postnatal periods and atopic eczema, food allergy and/or hypersensitivity outcomes by age 3 years were included. The Newcastle–Ottawa Scale was used to assess study quality. Random effects model was used to estimate the pooled risk ratios.ResultsFrom 1689 identified records, 32 studies with nearly 190,000 subjects were included. Parental smoking during preconception, pregnancy and postnatal periods was generally not associated with the risk of eczema, food allergy and food sensitisation development by age 3 years. Maternal active smoking during pregnancy was negatively associated with self‐reported doctor diagnosis of eczema (RR = 0.87, 95% CI 0.77–0.98; I2 = 50.56) and maternal passive smoking during pregnancy was positively associated with clinician assessment of eczema in one study (RR = 1.38; 95% CI 1.06–1.79).ConclusionOur findings highlighted the importance of in utero programming in early‐life allergy development. Despite the weak evidence, our results suggest pregnant women should minimise their contact with second‐hand smoke to prevent offspring eczema development. There is a need for greater utilisation of objective allergy assessments in future studies.

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Section: Discussionmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Maternal Active Smokingmentioning

confidence: 99%

See 1 more Smart Citation

Smoke exposure and childhood atopic eczema and food allergy: A systematic review and meta‐analysis

Lau,

Lee,

Yap

et al. 2023

Pediatric Allergy Immunology

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“…Conversely, two Danish cohort studies that used a prospective design were conducted by Stensballe et al and the results showed that prenatal antibiotic use did not influence the risk of eczema in 411 and 30,675 children, respectively 23 . In addition, a study by Sasaki et al who used a Japanese nationwide dataset to conduct a prospective birth cohort study showed no association between prenatal antibiotic exposure and diagnosed or observed AD at 1 year old in 70,408 children (aOR 1.01, 95% CI 0.97–1.06) 24 . Compared to their studies, our large sample size, longer follow‐up period and taking all trimesters into account may increase the validity of the study findings.…”

Section: Discussionmentioning

confidence: 95%

Prenatal and early‐life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population‐based cohort study

Chang

et al. 2023

Pediatric Allergy Immunology

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Background: Atopic dermatitis (AD) contributes to substantial social and financial costs in public health care systems. Antibiotic exposure during pregnancy has been proposed as a risk factor, but findings remain inconsistent. The aim of this study was to investigate the association between prenatal antibiotic use and childhood AD. Methods:We performed a population-based cohort study using data collected from the Taiwan Maternal and Child Health Database from 2009 to 2016. Associations were determined using Cox proportional hazards model and were adjusted for several potential covariates, including maternal atopic disorders and gestational infections.Children with and without maternal predispositions of atopic diseases and postnatal antibiotic/acetaminophen exposures within 1 year were stratified to identify the subgroups at risk. Results:A total of 1,288,343 mother-child pairs were identified and 39.5% received antibiotics prenatally. Maternal antibiotic use during pregnancy was slightly positively associated with childhood AD (aHR 1.04, 95% CI 1.03-1.05), especially in the first and second trimesters. An apparent dose-response pattern was observed with an 8% increased risk when the exposure was ≥5 courses prenatally (aHR 1.08, 95% CI 1.06-1.11). Subgroup analysis showed the positive association remained significant regardless of postnatal infant antibiotic use, but the risk attenuated to null in infants who were not exposed to acetaminophen (aHR 1.01, 95% CI 0.96-1.05). The associations were higher in children whose mothers were without AD compared to those whose mothers were with AD. In addition, postnatal antibiotic or acetaminophen exposure of infants was associated with an increased risk of developing AD after 1 year of age. Conclusion:Maternal antibiotic use during pregnancy was associated with an increased risk of childhood AD in a dose-related manner. Further research may be warranted to investigate this variable using a prospectively designed study, and also to examine whether or not this association is specifically related to pregnancy.

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“…In addition, a study by Sasaki et al who used a Japanese nationwide dataset to conduct a prospective birth cohort study showed no association between prenatal antibiotic exposure and diagnosed or observed AD at 1 year old in 70408 children (aOR 1.01, 95% CI 0.97-1.06). 23 Similar to the study by Stensballe et al, their follow-up period was also shorter and excluded children born through cesarean delivery, which may influence the risk of prenatal antibiotic exposure in AD.…”

Section: Comparison With Other Studiesmentioning

confidence: 96%

Prenatal antibiotic exposure and the risk of atopic dermatitis in children: a nationwide population-based cohort study.

Chang

et al. 2022

Preprint

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Background: Atopic dermatitis (AD) contributes to substantial social and financial costs in public health care systems. Antibiotic exposure during pregnancy has been proposed as a risk factor, but findings remain inconsistent. The aim of this study was to investigate the association between prenatal antibiotic use and childhood AD. Methods: We performed a population-based cohort study using data collected from the Taiwan Maternal and Child Health Database from 2009 to 2016. Associations were determined using Cox proportional hazards model and were adjusted for several potential covariates, including maternal atopic disorders and gestational infections. Subgroup analyses evaluated the influence of postnatal infant antibiotic/acetaminophen use on the association between prenatal antibiotic exposure and childhood AD diagnosed after 1 year of age. Results: A total of 1288343 mother-child pairs were identified and 39.5% received antibiotics prenatally. Maternal antibiotic use during pregnancy was slightly positively associated with childhood AD (aHR 1.05, 95% CI 1.04-1.06), especially in the first and second trimesters. An apparent dose-response pattern was observed with an 11% increased risk when the exposure was ≥5 courses prenatally (aHR 1.11, 95% CI 1.09-1.14). Subgroup analysis showed the positive association remained significant regardless of postnatal antibiotic use; however, a negative association was found in children without postnatal infant acetaminophen use (aHR 1.02, 95% CI 0.97-1.07). Conclusion: Maternal antibiotic use during pregnancy was associated with increased risk of childhood AD in a dose-related manner. Possible confounders existed between prenatal antibiotics and postnatal infant acetaminophen use in the subgroup analysis. Further research may be warranted to investigate this variable using a prospectively designed study, and also to examine whether or not this association is specifically related to pregnancy.

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No association between prenatal antibiotic exposure and atopic dermatitis among Japanese infants

Cited by 5 publications

References 10 publications

Smoke exposure and childhood atopic eczema and food allergy: A systematic review and meta‐analysis

Smoke exposure and childhood atopic eczema and food allergy: A systematic review and meta‐analysis

Prenatal and early‐life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population‐based cohort study

Prenatal antibiotic exposure and the risk of atopic dermatitis in children: a nationwide population-based cohort study.

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