Top

Published in:

Open Access 28-09-2024 | Antibiotic | RESEARCH

Neonatal and early infancy antibiotic exposure is associated with childhood atopic dermatitis, wheeze and asthma

Authors: Santeri Räty, Helena Ollila, Olli Turta, Anna Pärtty, Ville Peltola, Hanna Lagström, Johanna Lempainen, Samuli Rautava

Published in: European Journal of Pediatrics | Issue 12/2024

Abstract

Antibiotics are frequently administered in the neonatal period and early infancy. Little is known about the long-term health consequences of early life antibiotic exposure. The objective is to investigate the association between neonatal and early life (0–6 months) antibiotic treatment and the development of atopic dermatitis, asthma and the use of inhaled corticosteroid medication later in childhood. We analyzed data obtained from hospital records and national registers in a cohort of 11,255 children. The association between early antibiotic exposure and the outcomes were analyzed using logistic regression. Confounding factors were included in the model. Neonatal antibiotic therapy for confirmed infection was associated with childhood atopic dermatitis (adjusted odds ratio 1.49; 95% confidence interval 1.15–1.94). Antibiotic therapy by six months of age was more common in children developing atopic dermatitis (adjusted odds ratio 1.38; 95% confidence interval 1.15–1.64), asthma (adjusted odds ratio 1.56; 95% confidence interval 1.32- 1.85) and inhaled corticosteroid medication use (adjusted odds ratio 1.88; 95% confidence interval 1.66–2.13).

Conclusions: Neonatal antibiotic therapy for confirmed or clinically diagnosed infection is associated with increased risk of atopic dermatitis later in childhood. Antibiotic treatment before six months of age is associated with atopic dermatitis, asthma and inhaled corticosteroid use.

What is known: • The use of antibiotics early in life has been associated with an increased risk of developing atopic dermatitis or asthma. • Confounding by indication or reverse causation may underlie the observed associations.
What is new: • Our results demonstrate that neonatal antibiotic therapy for confirmed or clinically diagnosed infection was associated with increased risk of atopic dermatitis and antibiotic treatment before six months of age was associated with atopic dermatitis, asthma and inhaled corticosteroid use in analyses adjusted for confounding factors.

Available only for authorised users

Schulman J, Benitz WE, Profit J et al (2019) Newborn antibiotic exposures and association with proven bloodstream infection. Pediatrics. https://doi.org/10.1542/peds.2019-1105CrossRefPubMed

Cox LM, Blaser MJ (2015) Antibiotics in early life and obesity. Nat Rev Endocrinol 11(3):182–190. https://doi.org/10.1038/nrendo.2014.210CrossRefPubMed

Turta O, Rautava S (2016) Antibiotics, obesity and the link to microbes - what are we doing to our children? BMC Med 14(1):4–9. https://doi.org/10.1186/s12916-016-0605-7CrossRef

Metzler S, Frei R, Schmaußer-Hechfellner E et al (2019) Association between antibiotic treatment during pregnancy and infancy and the development of allergic diseases. Pediatr Allergy Immunol 30(4):423–433. https://doi.org/10.1111/pai.13039CrossRefPubMed

Fishman E, Crawford G, DeVries A et al (2019) Association between early-childhood antibiotic exposure and subsequent asthma in the US Medicaid population. Ann Allergy Asthma Immunol 123(2):186-192.e9. https://doi.org/10.1016/j.anai.2019.05.018CrossRefPubMed

Yamamoto-Hanada K, Yang L, Narita M, Saito H, Ohya Y (2017) Influence of antibiotic use in early childhood on asthma and allergic diseases at age 5. Ann Allergy Asthma Immunol 119(1):54–58. https://doi.org/10.1016/j.anai.2017.05.013CrossRefPubMed

Aversa Z, Atkinson EJ, Schafer MJ et al (2020) Association of infant antibiotic exposure with childhood health outcomes. Mayo Clin Proc 96(1):66–77. https://doi.org/10.1016/j.mayocp.2020.07.019CrossRefPubMed

Toivonen L, Schuez-Havupalo L, Karppinen S et al (2020) Antibiotic treatments during infancy, changes in nasal microbiota, and asthma development: Population-based cohort study. Clin Infect Dis. https://doi.org/10.1093/cid/ciaa262CrossRef

Toivonen L, Forsström V, Waris M, Peltola V (2019) Acute respiratory infections in early childhood and risk of asthma at age 7 years. J Allergy Clin Immunol 143(1):407-410.e6. https://doi.org/10.1016/j.jaci.2018.08.025CrossRefPubMed

10.

Uzan-Yulzari A, Turta O, Belogolovski A et al (2021) Neonatal antibiotic exposure impairs child growth during the first six years of life by perturbing intestinal microbial colonization. Nat Commun. https://doi.org/10.1038/s41467-020-20495-4CrossRefPubMed

11.

Strömberg Celind F, Wennergren G, Vasileiadou S, Alm B, Goksör E (2018) Antibiotics in the first week of life were associated with atopic asthma at 12 years of age. Acta Paediatr Int J Paediatr 107(10):1798–1804. https://doi.org/10.1111/apa.14332CrossRef

12.

(2022) Asthma. Current care guidelines. Working group set up by the finnish medical society duodecim, the finnish respiratory society board, the finnish paediatric society, finnish society for pediatric allergy and the finnish society of clinical physiology. Helsinki: the finnish medical society duodecim. Available online at: www.kaypahoito.fi. Accessed 2 Sept 2024

13.

Mitre E, Susi A, Kropp LE, Schwartz DJ, Gorman GH, Nylund CM (2018) Association between use of acid-suppressive medications and antibiotics during infancy and allergic diseases in early childhood. JAMA Pediatr. https://doi.org/10.1001/jamapediatrics.2018.0315CrossRefPubMed

14.

Hirsch AG, Pollak J, Glass TA et al (2017) Early-life antibiotic use and subsequent diagnosis of food allergy and allergic diseases. Clin Exp Allergy 47(2):236–244. https://doi.org/10.1111/cea.12807CrossRefPubMed

15.

Jartti T, Gern JE (2017) Role of viral infections in the development and exacerbation of asthma in children. J Allergy Clin Immunol 140(4):895–906. https://doi.org/10.1016/j.jaci.2017.08.003CrossRefPubMed

16.

Michi AN, Love ME, Proud D (2020) Rhinovirus-induced modulation of epithelial phenotype: Role in asthma. Viruses. https://doi.org/10.3390/v12111328CrossRefPubMed

17.

Schoch JJ, Satcher KG, Garvan CW, Monir RL, Neu J, Lemas DJ (2023) Association between early life antibiotic exposure and development of early childhood atopic dermatitis. JAAD Int 10:68–74. https://doi.org/10.1016/j.jdin.2022.11.002CrossRefPubMed

18.

Kowalik A, Cichocka-Jaros E, Kwinta P (2023) Atopic dermatitis and gestational age - is there an association between them? A review of the literature and an analysis of pathology. Postep Dermatologii i Alergol 40(3):341–349. https://doi.org/10.5114/ada.2023.128999CrossRef

19.

Goksör E, Alm B, Pettersson R et al (2013) Early fish introduction and neonatal antibiotics affect the risk of asthma into school age. Pediatr Allergy Immunol 24(4):339–344. https://doi.org/10.1111/pai.12078CrossRefPubMed

20.

Raita Y, Toivonen L, Schuez-Havupalo L et al (2020) Maturation of nasal microbiota and antibiotic exposures during early childhood: A population-based cohort study. Clin Microbiol Infect 27(2):283.e1-283.e7. https://doi.org/10.1016/j.cmi.2020.05.033CrossRefPubMed

21.

Stokholm J, Blaser MJ, Thorsen J et al (2018) Maturation of the gut microbiome and risk of asthma in childhood. Nat Commun 9(1):1–10. https://doi.org/10.1038/s41467-017-02573-2CrossRef

22.

Toivonen L, Karppinen S, Schuez-Havupalo L et al (2020) Longitudinal changes in early nasal microbiota and the risk of childhood asthma. Pediatrics 146(4):e20200421. https://doi.org/10.1542/peds.2020-0421CrossRefPubMed

23.

Arrieta MC, Stiemsma LT, Dimitriu PA et al (2015) Early infancy microbial and metabolic alterations affect risk of childhood asthma. Sci Transl Med. https://doi.org/10.1126/scitranslmed.aab2271CrossRefPubMed

24.

Adami AJ, Bracken SJ, Guernsey LA et al (2018) Early-life antibiotics attenuate regulatory T cell generation and increase the severity of murine house dust mite-induced asthma. Pediatr Res 84(3):426–434. https://doi.org/10.1038/s41390-018-0031-yCrossRefPubMedPubMedCentral

25.

Yang X, Feng H, Zhan X et al (2019) Early-life vancomycin treatment promotes airway inflammation and impairs microbiome homeostasis. Aging (Albany NY) 11(7):2071–2081. https://doi.org/10.18632/aging.101901CrossRefPubMed

26.

Dharmage SC, Lodge CJ, Lowe AJ, Allen KJ (2015) Antibiotics and risk of asthma: A debate that is set to continue. Clin Exp Allergy 45(1):6–8. https://doi.org/10.1111/cea.12424CrossRefPubMed

27.

Chernikova D, Yuan I, Shaker M (2019) Prevention of allergy with diverse and healthy microbiota: An update. Curr Opin Pediatr 31(3):418–425. https://doi.org/10.1097/MOP.0000000000000766CrossRefPubMed

28.

Fujimura KE, Sitarik AR, Havstad S et al (2016) Neonatal gut microbiota associates with childhood multisensitized atopy and T cell differentiation. Nat Med 22(10):1187–1191. https://doi.org/10.1038/nm.4176CrossRefPubMedPubMedCentral

Title: Neonatal and early infancy antibiotic exposure is associated with childhood atopic dermatitis, wheeze and asthma
Authors: Santeri Räty
Helena Ollila
Olli Turta
Anna Pärtty
Ville Peltola
Hanna Lagström
Johanna Lempainen
Samuli Rautava
Publication date: 28-09-2024
Publisher: Springer Berlin Heidelberg
Keywords: Antibiotic
Atopic Dermatitis
Bronchial Asthma
Published in: European Journal of Pediatrics / Issue 12/2024
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-024-05775-1

Hepatic vein Doppler ultrasound to estimate central venous pressure in mechanically ventilated children

RESEARCH

Association between preterm birth and asthma and atopic dermatitis in preschool children: a nationwide population-based study

Open Access
Atopic Dermatitis
RESEARCH

Postpandemic fluctuations of regional respiratory syncytial virus hospitalization epidemiology: potential impact on an immunization program in Switzerland

Normative computed tomography angiography values of the aortic root, aorta, and aortic arch in children

CT Angiography
RESEARCH

Diagnosis and management of suspected Lyme neuroborreliosis-related facial nerve palsy in children by paediatricians and general practitioners: a French survey

Neurologic Lyme Disease
RESEARCH

The association between atopic dermatitis and linear growth in children- a systematic review

Atopic Dermatitis
REVIEW

Keynote webinar | Spotlight on adolescent vaping

Live
Webinar | 29-01-2025 | 18:00 (CET)

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Watch it live: Wednesday 29th January, 18:00-19:30 CET

Prof. Ann McNeill

Dr. Debbie Robson

Benji Horwell

Developed by: Springer Medicine

Join the webinar

Keynote webinar | Spotlight on adolescent vaping

Springer Medicine

Abstract

Please log in to get access to this content