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Int J Obes (Lond). 2019 Jan 22. doi: 10.1038/s41366-018-0316-6. [Epub ahead of print]

Maternal antibiotic use during pregnancy and childhood obesity at age 5 years.

Author information

1
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. bill.heerman@vumc.org.
2
Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, 80014, USA.
3
School of Public Health, Oregon Health and Science University/Portland State University, Portland, OR, USA.
4
Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
5
Applied Clinical Research Center, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
6
Therapeutics Research and Infectious Disease Epidemiology Group, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
7
Dr. Gillman is now Director of the Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, Bethesda, MD, USA.
8
Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
9
HealthPartners Institute, Department of Research, Bloomington, MN, USA.
10
North Fork School District, Utica, OH, USA.
11
Department of Pediatrics, New York University, Bellevue Hospital Center, New York, NY, USA.

Abstract

OBJECTIVE:

The benefits of antibiotic treatment during pregnancy are immediate, but there may be long-term risks to the developing child. Prior studies show an association between early life antibiotics and obesity, but few have examined this risk during pregnancy.

SUBJECTS:

To evaluate the association of maternal antibiotic exposure during pregnancy on childhood BMI-z at 5 years, we conducted a retrospective cohort analysis. Using electronic health record data from seven health systems in PCORnet, a national distributed clinical research network, we included children with same-day height and weight measures who could be linked to mothers with vital measurements during pregnancy. The primary independent variable was maternal outpatient antibiotic prescriptions during pregnancy (any versus none). We examined dose response (number of antibiotic episodes), spectrum and class of antibiotics, and antibiotic episodes by trimester. The primary outcome was child age- and sex-specific BMI-z at age 5 years.

RESULTS:

The final sample was 53,320 mother-child pairs. During pregnancy, 29.9% of mothers received antibiotics. In adjusted models, maternal outpatient antibiotic prescriptions during pregnancy were not associated with child BMI-z at age 5 years (β = 0.00, 95% CI -0.03, 0.02). When evaluating timing during pregnancy, dose-response, spectrum and class of antibiotics, there were no associations of maternal antibiotics with child BMI-z at age 5 years.

CONCLUSION:

In this large observational cohort, provision of antibiotics during pregnancy was not associated with childhood BMI-z at 5 years.

PMID:
30670848
DOI:
10.1038/s41366-018-0316-6

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