Association Between Prenatal Antibiotic Exposure and Infant Wheeze Outcomes

Aim: This study examined the association between antibiotic exposure during pregnancy and the development of wheezing and cough during infancy. Methods: We analysed data from 12 cohorts in the Environmental influences on Child Health Outcomes Cohort Consortium. Outcomes during the first 18 months after birth included the presence of wheeze or dry cough and treatment or intervention for these symptoms, including medications, emergency room visits, and hospitalisations. We used generalised estimating equations and logistic models with adjustment for inverse propensity scores for exposure to antibiotics. Results: A total of 4721 pregnancies were included, resulting in 4779 infants. Overall, 1,701/4,721 (36%) individuals received antibiotics during pregnancy, and wheezing was reported in 1,214/4,779 (26%) infants. In adjusted analyses, prenatal antibiotics were not associated with a higher odds of wheeze (OR = 1.06; 95% CI 0.91, 1.24) or hospitalisations or emergency room visits for wheeze or dry cough. However, prenatal antibiotic exposure was associated with a higher odds of medication use for wheeze or dry cough (OR = 1.62; 95% CI 1.10, 2.38). Conclusions: Prenatal antibiotic exposure may be associated with an increased odds of medication use for wheeze or dry cough during infancy but may not increase the risk of more severe events.