Use of Antibiotics during Pregnancy Increases the Risk of Asthma in Early Childhood

Stensballe, Lone Graff; Simonsen, Jacob; Jensen, Signe Marie; Bønnelykke, Klaus; Bisgaard, Hans

doi:10.1016/j.jpeds.2012.09.049

Cited by 217 publications

(201 citation statements)

References 15 publications

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“…A number of studies [5][6][7][8][9][10][11][12][13][14][15][16][17][18] assessed the association between prenatal antibiotic exposure and risk of wheezing and asthma in children. Most of them found a positive association, but the estimates were weak in some of the studies.…”

Section: Discussionmentioning

confidence: 99%

“…Six previous studies analysed exposures for each trimester of pregnancy separately and three of them [7,11,18] found the strongest associations for exposure in late pregnancy, especially during the third trimester. In the other three studies [6,[15][16][17] associations did not depend on the period of exposure.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, several studies reported an increased risk of wheezing and asthma in infants and children after prenatal antibiotic exposure [5][6][7][8][9][10][11][12][13][14][15][16][17][18]. An imbalance of maternal vaginal and bowel bacterial flora caused by antibiotic treatment could lead to an abnormal early colonisation of infant gut and airway through vertical transmission during birth.…”

Section: Introductionmentioning

confidence: 99%

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Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study

et al. 2015

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The role of prenatal antibiotic exposure in the development of childhood wheezing is debated. We evaluated whether this association could potentially be explained by confounding factors.Antibiotic use in the first and third trimester of pregnancy, wheezing in children aged ⩽18 months and confounding factors were assessed in singletons participating in the NINFEA (Nascita e Infanzia: gli Effetti dell'Ambiente) birth cohort (n=3530 for first-trimester exposure and n=3985 for third-trimester exposure).There was no evidence of an association between antibiotic exposure in the first trimester of pregnancy and ever-wheezing (adjusted risk ratio (RR) 1.02, 95% CI 0.80-1.30) or recurrent wheezing (RR 0.99, 95% CI 0.54-1.82). For the third-trimester exposure, the crude RRs (95% CI) of ever-wheezing and recurrent wheezing were 1.34 (1.10-1.64) and 2.72 (1.80-4.11), respectively, which decreased to 1.12 (0.90-1.39) and 2.09 (1.32-3.29) after adjustment. The RRs of wheezing after genitourinary infections during pregnancy were increased independently of antibiotic treatment.In conclusion, the association between prenatal antibiotic exposure and infant wheezing could be largely explained by confounding factors, in particular respiratory infections during pregnancy. An excess risk of wheezing after antibiotic exposure during the third trimester of pregnancy remains after adjustment. @ERSpublications Confounders explain increased risk of infant wheeze after antibiotic exposure in the first but not third trimester

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study

et al. 2015

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“…In the past several years, a burgeoning number of studies has examined the association between maternal antibiotic use during pregnancy and risk of child asthma and, to our knowledge, all have observed positive associations even after controlling for multiple potentially confounding factors [19][20][21][22][23][24]. But is this association causal?…”

mentioning

confidence: 99%

Maternal antibiotic use and child asthma: is the association causal?

2018

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“…Antibiotic use during pregnancy and in infants and toddlers has been associated with the development of asthma later in life, [522][523][524] although not all studies have shown this association. 525 Intake of the analgesic, paracetamol (acetaminophen), may be associated with asthma in both children and adults, 526 although exposure during infancy may be confounded by use of paracetamol for respiratory tract infections.…”

Section: Medications and Other Factorsmentioning

confidence: 99%