Periconceptional and Gestational Exposure to Antibiotics and Childhood Asthma

Abstract

BackgroundPrevious studies suggest that maternal antibiotics exposure during pregnancy may increase the risk of childhood asthma, but the results were inconsistent. Furthermore, most studies did not examine periconception period as an exposure window. We aim to assess the associations between maternal exposure to specific antibiotics before and during pregnancy and the risk of asthma in early childhood.MethodsData from the Collaborative Perinatal Project were used. Maternal exposure to antibiotics before and during pregnancy was recorded at each prenatal visit. A total of 39,907 singleton children were followed up to 7 years of age. Multilevel multiple logistic regression models were used to control for potential confounders and account for multiple pregnancies per woman.ResultsMaternal use of penicillin or chloramphenicol was associated with an increased risk of asthma in the offspring (adjusted odds ratio = 1.21, 95% confidence interval 1.08–1.36 for penicillin; 1.72 [1.14–2.59] for chloramphenicol). The risk was significantly increased if penicillin or chloramphenicol was used in the 1st trimester (1.09 [1.04–1.13] for penicillin and 1.23 [1.01–1.51] for chloramphenicol).ConclusionMaternal exposure to certain antibiotics is associated with childhood asthma by 7 years of age. Early pregnancy may be a sensitive window.

The First Microbial Colonizers of the Human Gut: Composition, Activities, and Health Implications of the Infant Gut Microbiota

“…As discussed below for metabolic diseases, antibiotic-induced modification of the early-life microbiota has been shown to increase the risk of allergic asthma in laboratory animals (317). In addition, epidemiological data sets have provided support for the notion that a link exists between perinatal antibiotic exposure and the risk of subsequent allergic disease development (318)(319)(320). In this regard, recent evidence suggests that the risk of suffering from asthma is higher in infants who exhibited gut microbiota dysbiosis during the first 100 days of life and that this risk is associated with particular bacterial groups.…”

Incidence of Prenatal and Postnatal Risk Factors for Childhood Astma

“…In pregnant mothers β-lactam antibiotics were most commonly used (n = 6; 55%), which is in accordance to literature data. The use of penicillin, especially during the first trimester of pregnancy, significantly increases the risk of asthma in childhood [21]. In our study, antibiotics have been administered during all trimesters of pregnancy.…”

Morphogenesis and maturation of the embryonic and postnatal intestine

“…Germ-free mice exhibit profound developmental defects [7] including severely impaired adaptive immune development [173,174], altered systemic metabolism [175], decreased epithelial turnover and impaired villus formation [176], altered glycosylation of the luminal surface of the intestine [177,178], and increased epithelial barrier permeability [179]. Disruptions in gut bacterial colonization and subsequent immune development caused by antibiotic exposure [180], Caesarean birth [181], or prematurity [182–184] are associated with autoimmune and inflammatory diseases [185,186], developmental delay [187], and infection risk [188] during the neonatal period and beyond [185,189]. Colonization of the gastrointestinal tract occurs during birth, feeding, and through exposure to the extra-uterine environment.…”