Prenatal and early-life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population-based cohort study

被引:3
作者
Chang, Yu-Chuan [1 ]
Wu, Meng-Che [2 ,3 ,4 ]
Wu, Hsing-Ju [5 ,6 ,7 ]
Liao, Pei-Lun [8 ]
Wei, James Cheng-Chung [3 ,9 ,10 ,11 ]
机构
[1] Chang Bing Show Chwan Mem Hosp, Dept Pediat, Changhua, Taiwan
[2] Taichung Vet Gen Hosp, Childrens Med Ctr, Div Gastroenterol, Taichung, Taiwan
[3] Chung Shan Med Univ, Sch Med, Taichung, Taiwan
[4] Natl Chung Hsing Univ, Coll Med, Dept Postbaccalaureate Med, Taichung, Taiwan
[5] Natl Changhua Univ Educ, Dept Biol, Changhua, Taiwan
[6] Show Chwan Mem Hosp, Res Assistant Ctr, Changhua, Taiwan
[7] Chang Bing Show Chwan Mem Hosp, Dept Med Res, Changhua, Taiwan
[8] Chung Shan Med Univ Hosp, Dept Med Res, Taichung, Taiwan
[9] Chung Shan Med Univ Hosp, Div Allergy Immunol & Rheumatol, Taichung, Taiwan
[10] China Med Univ, Grad Inst Integrated Med, Taichung, Taiwan
[11] Chung Shan Med Univ Hosp, Dept Allergy Immunol & Rheumatol, 110,Sec 1,Jianguo N Rd, Taichung 40201, Taiwan
关键词
acetaminophen; antibiotics; atopic dermatitis; gestational infection; microbial dysbiosis; ALLERGIC DISEASE; MICROBIOME; PREGNANCY; ECZEMA; ASTHMA; DYSBIOSIS;
D O I
10.1111/pai.13959
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BackgroundAtopic dermatitis (AD) contributes to substantial social and financial costs in public health care systems. Antibiotic exposure during pregnancy has been proposed as a risk factor, but findings remain inconsistent. The aim of this study was to investigate the association between prenatal antibiotic use and childhood AD. MethodsWe performed a population-based cohort study using data collected from the Taiwan Maternal and Child Health Database from 2009 to 2016. Associations were determined using Cox proportional hazards model and were adjusted for several potential covariates, including maternal atopic disorders and gestational infections. Children with and without maternal predispositions of atopic diseases and postnatal antibiotic/acetaminophen exposures within 1 year were stratified to identify the subgroups at risk. ResultsA total of 1,288,343 mother-child pairs were identified and 39.5% received antibiotics prenatally. Maternal antibiotic use during pregnancy was slightly positively associated with childhood AD (aHR 1.04, 95% CI 1.03-1.05), especially in the first and second trimesters. An apparent dose-response pattern was observed with an 8% increased risk when the exposure was >= 5 courses prenatally (aHR 1.08, 95% CI 1.06-1.11). Subgroup analysis showed the positive association remained significant regardless of postnatal infant antibiotic use, but the risk attenuated to null in infants who were not exposed to acetaminophen (aHR 1.01, 95% CI 0.96-1.05). The associations were higher in children whose mothers were without AD compared to those whose mothers were with AD. In addition, postnatal antibiotic or acetaminophen exposure of infants was associated with an increased risk of developing AD after 1 year of age. ConclusionMaternal antibiotic use during pregnancy was associated with an increased risk of childhood AD in a dose-related manner. Further research may be warranted to investigate this variable using a prospectively designed study, and also to examine whether or not this association is specifically related to pregnancy.
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页数:12
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共 34 条
[1]   Maternal diet before and during pregnancy and risk of asthma and allergic rhinitis in children [J].
Baiz, Nour ;
Just, Jocelyne ;
Chastang, Julie ;
Forhan, Anne ;
de Lauzon-Guillain, Blandine ;
Magnier, Anne-Marie ;
Annesi-Maesano, Isabella .
ALLERGY ASTHMA AND CLINICAL IMMUNOLOGY, 2019, 15 (1)
[2]   A Review of Antibiotic Use in Pregnancy [J].
Bookstaver, P. Brandon ;
Bland, Christopher M. ;
Griffin, Brooke ;
Stover, Kayla R. ;
Eiland, Lea S. ;
McLaughlin, Milena .
PHARMACOTHERAPY, 2015, 35 (11) :1052-1062
[3]   Prenatal antibiotic exposure, asthma, and the atopic march: A systematic review and meta-analysis [J].
Cait, Alissa ;
Wedel, Alexander ;
Arntz, Jeanne L. ;
Duinkerken, Jacyra ;
Datye, Swarali ;
Cait, Jessica ;
Alhasan, Moumen M. ;
Conrad, Melanie L. .
ALLERGY, 2022, 77 (11) :3233-3248
[4]   Current Understanding of Dysbiosis in Disease in Human and Animal Models [J].
DeGruttola, Arianna K. ;
Low, Daren ;
Mizoguchi, Atsushi ;
Mizoguchi, Emiko .
INFLAMMATORY BOWEL DISEASES, 2016, 22 (05) :1137-1150
[5]   Pre- and post- natal exposure to antibiotics and the development of eczema, recurrent wheezing and atopic sensitization in children up to the age of 4 years [J].
Dom, S. ;
Droste, J. H. J. ;
Sariachvili, M. A. ;
Hagendorens, M. M. ;
Oostveen, E. ;
Bridts, C. H. ;
Stevens, W. J. ;
Wieringa, M. H. ;
Weyler, J. J. .
CLINICAL AND EXPERIMENTAL ALLERGY, 2010, 40 (09) :1378-1387
[6]   Antibiotic exposure and adverse long-term health outcomes in children: A systematic review and meta-analysis [J].
Duong, Quynh A. ;
Pittet, Laure F. ;
Curtis, Nigel ;
Zimmermann, Petra .
JOURNAL OF INFECTION, 2022, 85 (03) :213-300
[7]   What's new in atopic eczema? An analysis of systematic reviews published in 2019. Part 1: Risk factors and prevention [J].
Earp, E. ;
Tsianou, Z. ;
Grindlay, D. J. C. ;
Rogers, N. K. ;
Olabi, B. .
CLINICAL AND EXPERIMENTAL DERMATOLOGY, 2021, 46 (07) :1205-1210
[8]   What's new in atopic eczema? An analysis of systematic reviews published in 2017. Part 2: epidemiology, aetiology and risk factors [J].
Hale, G. ;
Davies, E. ;
Grindlay, D. J. C. ;
Rogers, N. K. ;
Harman, K. E. .
CLINICAL AND EXPERIMENTAL DERMATOLOGY, 2019, 44 (08) :868-873
[9]   Maternal exposure to antibiotics increases the risk of infant eczema before one year of life: a meta-analysis of observational studies [J].
Huang, Fa-Qing ;
Lu, Chang-Yu ;
Wu, Shi-Ping ;
Gong, Shao-Zhi ;
Zhao, Yan .
WORLD JOURNAL OF PEDIATRICS, 2020, 16 (02) :143-151
[10]   Global Skin Disease Morbidity and Mortality An Update From the Global Burden of Disease Study 2013 [J].
Karimkhani, Chante ;
Dellavalle, Robert P. ;
Coffeng, Luc E. ;
Flohr, Carsten ;
Hay, Roderick J. ;
Langan, Sinead M. ;
Nsoesie, Elaine O. ;
Ferrari, Alize J. ;
Erskine, Holly E. ;
Silverberg, Jonathan I. ;
Vos, Theo ;
Naghavi, Mohsen .
JAMA DERMATOLOGY, 2017, 153 (05) :406-412