Prenatal and early‐life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population‐based cohort study
Background Atopic 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...
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| Veröffentlicht in: | Pediatric allergy and immunology 2023-05, Vol.34 (5), p.e13959-n/a |
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| creator | Chang, Yu‐Chuan Wu, Meng‐Che Wu, Hsing‐Ju Liao, Pei‐Lun Wei, James Cheng‐Chung |
| description | Background
Atopic 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.
Methods
We 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.
Results
A 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.
Conclusion
Maternal 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. |
| doi_str_mv | 10.1111/pai.13959 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2820016819</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2820016819</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3539-d0741de15fa1e0242cad1e17e55af965098295268bb29839e1cad76bcfa36b4c3</originalsourceid><addsrcrecordid>eNp1kc9OGzEQh62KqgTaAy-ALHGBwyb-E--uuUWIFqRI5dCeV157VjE468X2CnLrtTeesU9Sk4QekDqX0difvrH8Q-iEkinNNRuUnVIuhfyAJrnLghNeH6AJkUQUJRXVITqK8Z4QWvGSfkKHvGKcsVpM0O-7AL1KymHVGwwquM2fXy_OdpAPkm2tT1ZjeB58HANsobQCHGx8wL7DKvkh3xsIa5VsshHbHuuVdSZrL_ECZ7f1_ZM1gAc_jG475g2timCw9isfEo5pNJvP6GOnXIQv-36Mfn69_nF1Uyy_f7u9WiwLzQWXhSHVnBqgolMUCJszrQwFWoEQqpOlILJmUrCyblsmay6BZqAqW90pXrZzzY_R-c47BP84QkzN2kYNzqke_BgbVrP8UWVNZUbP3qH3fgx9fl2mqGR8zstX6mJH6eBjDNA1Q7BrFTYNJc1rPk3Op9nmk9nTvXFs12D-kW-BZGC2A56sg83_Tc3d4nan_AvzxJ1u</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2819234369</pqid></control><display><type>article</type><title>Prenatal and early‐life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population‐based cohort study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Chang, Yu‐Chuan ; Wu, Meng‐Che ; Wu, Hsing‐Ju ; Liao, Pei‐Lun ; Wei, James Cheng‐Chung</creator><creatorcontrib>Chang, Yu‐Chuan ; Wu, Meng‐Che ; Wu, Hsing‐Ju ; Liao, Pei‐Lun ; Wei, James Cheng‐Chung</creatorcontrib><description>Background
Atopic 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.
Methods
We 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.
Results
A 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.
Conclusion
Maternal 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.</description><identifier>ISSN: 0905-6157</identifier><identifier>EISSN: 1399-3038</identifier><identifier>DOI: 10.1111/pai.13959</identifier><identifier>PMID: 37232285</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Acetaminophen ; Acetaminophen - adverse effects ; Analgesics ; Anti-Bacterial Agents - adverse effects ; Antibiotics ; Atopic dermatitis ; Children ; Cohort analysis ; Cohort Studies ; Dermatitis ; Dermatitis, Atopic - epidemiology ; Dermatitis, Atopic - etiology ; Eczema ; Female ; gestational infection ; Humans ; Infant ; Infants ; Maternal & child health ; microbial dysbiosis ; Population studies ; Population-based studies ; Pregnancy ; Prenatal experience ; Prenatal Exposure Delayed Effects - chemically induced ; Prenatal Exposure Delayed Effects - epidemiology ; Public health ; Risk Factors</subject><ispartof>Pediatric allergy and immunology, 2023-05, Vol.34 (5), p.e13959-n/a</ispartof><rights>2023 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.</rights><rights>Copyright © 2023 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-d0741de15fa1e0242cad1e17e55af965098295268bb29839e1cad76bcfa36b4c3</citedby><cites>FETCH-LOGICAL-c3539-d0741de15fa1e0242cad1e17e55af965098295268bb29839e1cad76bcfa36b4c3</cites><orcidid>0000-0002-1464-9228 ; 0000-0002-1235-0679</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpai.13959$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpai.13959$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37232285$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Yu‐Chuan</creatorcontrib><creatorcontrib>Wu, Meng‐Che</creatorcontrib><creatorcontrib>Wu, Hsing‐Ju</creatorcontrib><creatorcontrib>Liao, Pei‐Lun</creatorcontrib><creatorcontrib>Wei, James Cheng‐Chung</creatorcontrib><title>Prenatal and early‐life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population‐based cohort study</title><title>Pediatric allergy and immunology</title><addtitle>Pediatr Allergy Immunol</addtitle><description>Background
Atopic 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.
Methods
We 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.
Results
A 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.
Conclusion
Maternal 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.</description><subject>Acetaminophen</subject><subject>Acetaminophen - adverse effects</subject><subject>Analgesics</subject><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Antibiotics</subject><subject>Atopic dermatitis</subject><subject>Children</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Dermatitis</subject><subject>Dermatitis, Atopic - epidemiology</subject><subject>Dermatitis, Atopic - etiology</subject><subject>Eczema</subject><subject>Female</subject><subject>gestational infection</subject><subject>Humans</subject><subject>Infant</subject><subject>Infants</subject><subject>Maternal & child health</subject><subject>microbial dysbiosis</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Pregnancy</subject><subject>Prenatal experience</subject><subject>Prenatal Exposure Delayed Effects - chemically induced</subject><subject>Prenatal Exposure Delayed Effects - epidemiology</subject><subject>Public health</subject><subject>Risk Factors</subject><issn>0905-6157</issn><issn>1399-3038</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9OGzEQh62KqgTaAy-ALHGBwyb-E--uuUWIFqRI5dCeV157VjE468X2CnLrtTeesU9Sk4QekDqX0difvrH8Q-iEkinNNRuUnVIuhfyAJrnLghNeH6AJkUQUJRXVITqK8Z4QWvGSfkKHvGKcsVpM0O-7AL1KymHVGwwquM2fXy_OdpAPkm2tT1ZjeB58HANsobQCHGx8wL7DKvkh3xsIa5VsshHbHuuVdSZrL_ECZ7f1_ZM1gAc_jG475g2timCw9isfEo5pNJvP6GOnXIQv-36Mfn69_nF1Uyy_f7u9WiwLzQWXhSHVnBqgolMUCJszrQwFWoEQqpOlILJmUrCyblsmay6BZqAqW90pXrZzzY_R-c47BP84QkzN2kYNzqke_BgbVrP8UWVNZUbP3qH3fgx9fl2mqGR8zstX6mJH6eBjDNA1Q7BrFTYNJc1rPk3Op9nmk9nTvXFs12D-kW-BZGC2A56sg83_Tc3d4nan_AvzxJ1u</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Chang, Yu‐Chuan</creator><creator>Wu, Meng‐Che</creator><creator>Wu, Hsing‐Ju</creator><creator>Liao, Pei‐Lun</creator><creator>Wei, James Cheng‐Chung</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1464-9228</orcidid><orcidid>https://orcid.org/0000-0002-1235-0679</orcidid></search><sort><creationdate>202305</creationdate><title>Prenatal and early‐life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population‐based cohort study</title><author>Chang, Yu‐Chuan ; Wu, Meng‐Che ; Wu, Hsing‐Ju ; Liao, Pei‐Lun ; Wei, James Cheng‐Chung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-d0741de15fa1e0242cad1e17e55af965098295268bb29839e1cad76bcfa36b4c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acetaminophen</topic><topic>Acetaminophen - adverse effects</topic><topic>Analgesics</topic><topic>Anti-Bacterial Agents - adverse effects</topic><topic>Antibiotics</topic><topic>Atopic dermatitis</topic><topic>Children</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Dermatitis</topic><topic>Dermatitis, Atopic - epidemiology</topic><topic>Dermatitis, Atopic - etiology</topic><topic>Eczema</topic><topic>Female</topic><topic>gestational infection</topic><topic>Humans</topic><topic>Infant</topic><topic>Infants</topic><topic>Maternal & child health</topic><topic>microbial dysbiosis</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Pregnancy</topic><topic>Prenatal experience</topic><topic>Prenatal Exposure Delayed Effects - chemically induced</topic><topic>Prenatal Exposure Delayed Effects - epidemiology</topic><topic>Public health</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Yu‐Chuan</creatorcontrib><creatorcontrib>Wu, Meng‐Che</creatorcontrib><creatorcontrib>Wu, Hsing‐Ju</creatorcontrib><creatorcontrib>Liao, Pei‐Lun</creatorcontrib><creatorcontrib>Wei, James Cheng‐Chung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric allergy and immunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Yu‐Chuan</au><au>Wu, Meng‐Che</au><au>Wu, Hsing‐Ju</au><au>Liao, Pei‐Lun</au><au>Wei, James Cheng‐Chung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prenatal and early‐life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population‐based cohort study</atitle><jtitle>Pediatric allergy and immunology</jtitle><addtitle>Pediatr Allergy Immunol</addtitle><date>2023-05</date><risdate>2023</risdate><volume>34</volume><issue>5</issue><spage>e13959</spage><epage>n/a</epage><pages>e13959-n/a</pages><issn>0905-6157</issn><eissn>1399-3038</eissn><abstract>Background
Atopic 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.
Methods
We 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.
Results
A 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.
Conclusion
Maternal 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.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37232285</pmid><doi>10.1111/pai.13959</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-1464-9228</orcidid><orcidid>https://orcid.org/0000-0002-1235-0679</orcidid></addata></record> |
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| ispartof | Pediatric allergy and immunology, 2023-05, Vol.34 (5), p.e13959-n/a |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Acetaminophen Acetaminophen - adverse effects Analgesics Anti-Bacterial Agents - adverse effects Antibiotics Atopic dermatitis Children Cohort analysis Cohort Studies Dermatitis Dermatitis, Atopic - epidemiology Dermatitis, Atopic - etiology Eczema Female gestational infection Humans Infant Infants Maternal & child health microbial dysbiosis Population studies Population-based studies Pregnancy Prenatal experience Prenatal Exposure Delayed Effects - chemically induced Prenatal Exposure Delayed Effects - epidemiology Public health Risk Factors |
| title | Prenatal and early‐life antibiotic exposure and the risk of atopic dermatitis in children: A nationwide population‐based cohort study |
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