Early antibiotic exposure not linked with childhood weight gain

1. Of children exposed to antibiotics within the first 6 months of life, there was no significant difference in childhood weight gain when compared to those not exposed to antibiotics.

2. Among 92 twins, the 46 children who received antibiotics within 6 months of life did not experience a significant weight difference compared to their siblings who did not receive antibiotics.

Evidence Rating Level: 2 (Good)

Study Rundown: The use of antibiotics in children has been increasing over the decades. While the more immediate and short-term side effects of antibiotic therapies are well known, the long-term effects on children are not well documented. Previous studies have revealed conflicting data on a possible link between antibiotic exposure and body mass in children. Thus, by analyzing more than 38,000 singleton children and 92 twins, this study sought to definitively determine if an association between antibiotic exposure and body mass exists in children. Of singleton births, 14% of children were exposed to antibiotics in the first 6 months of life, but this was not significantly associated with a difference in body weight. Similarly, 46 twins were exposed to antibiotics during their first 6 months of life, but the study found no difference in body weight between this child and their matched twin who did not receive antibiotics.

Overall, this study suggests that antibiotic use within the first 6 months of life is not associated with a significant weight difference at 7 years of age compared to those not exposed to antibiotics. By looking at twin pairs discordant in antibiotic exposure, the study was able to mitigate the effect of environmental and genetic factors. However, the study did only look at overall weight and did not measure adiposity itself, which may have been affected.

Click to read the study in JAMA

Relevant Reading: Trends of outpatient prescription drug utilization in US children, 2002-2010.

In-Depth [retrospective cohort]: This retrospective, longitudinal cohort study looked to determine any association between antibiotic exposure early in life and childhood weight gain. Children included in the study were born between 2001 and 2011 at 35 weeks or greater gestational age, had a birth weight of 2000 grams or more, and had regular preventive health visits. Antibiotic exposure within the first 6 months was analyzed, and weight gain was measured over the first 8 years of life. Of 38,522 singleton births, 5,287 (14%) of children were exposed to antibiotics within the first 6 months of life. This was not associated with a significant difference in weight when compared to those children who did not receive antibiotics (0.05 kg; 95%CI -0.004 to 0.11 kg of added weight between 2 and 5 years of age, p = 0.07). Of 92 children in 46 twin sets, 46 of the children (50%) received antibiotics within 6 months of age. After adjusting for sex, birth weight, and baseline length, antibiotic exposure was again not associated with a significant weight change (-0.09 kg difference per year; 95%CI -0.26 to 0.08 kg, p = 0.30).

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