Antenatal antibiotic exposure associated with increased risk of childhood asthma

1. In a population-based cohort study in Manitoba, maternal exposure to antibiotics prior to, during, and following pregnancy was associated with a dose-dependent increase in asthma among infants

Evidence Rating Level: 2

One of the challenges faced by physicians is to weigh the risks and benefits of certain treatments during the prenatal and postpartum period, as different exposures can have long-term effects on exposed offspring. One of the ongoing areas of study currently is the association between antibiotic exposure and childhood development of asthma, as exposure can have deleterious effects on immune development and gut microbiota. In this population-based cohort study, researchers used records from the general population in Manitoba, Canada. Participants included 213,661 mother-child couples born between 1996 and 2012. Prescription records determined prenatal antibiotic use, the exposure in this study. Hospital records, billing claims, and prescriptions determined asthma diagnosis status, the outcome in this study. Results showed that prenatal antibiotic use was associated with an increased risk of childhood asthma using Cox regression (Hazard ration is 1.29 with a 95% Confidence Interval of 1.26–1.33. These results also accounted for maternal asthma diagnosis status. It is worth noting that maternal antibiotic use in the nine months before pregnancy (adjusted HR 1.28, 1.24–1.31) and the nine months after pregnancy (adjusted HR 1.32, 1.29–1.36) were also found to have similar associations with childhood asthma. Study findings suggest that both prenatal, and postpartum exposure to antibiotics appear to be associated with an increased risk of development of childhood asthma. Results should be used to further inform practitioners during prescription, and further studies may be warranted to delineate which classes of antibiotics are more or less associated with asthma development.

Click to read the study in BMJ

Image: PD

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