Mueller N T, Rifas-Shiman S L, Blaser M J, Gillman M W, Hivert M-F
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.
Pediatr Obes. 2017 Apr;12(2):129-136. doi: 10.1111/ijpo.12119. Epub 2016 Mar 7.
Early postnatal antibiotic use has been shown to promote excess weight gain, but it is unclear whether intrauterine exposure to antibiotics is associated with foetal growth and adiposity. The objective of this study was to examine associations of antibiotic prescription in each trimester of pregnancy with foetal size and adipokine levels at birth.
In 2128 pregnant women from the pre-birth Project Viva cohort, from electronic medical records, we estimated antibiotic prescribing by timing during pregnancy. Outcomes were sex-specific birth weight-for-gestational-age z-score (BW/GA-z) and levels of umbilical cord leptin and adiponectin. We used linear regression models adjusted for maternal age, pre-pregnancy body mass index, parity, race/ethnicity, education, smoking during pregnancy, household income and child sex and additionally adjusted cord blood leptin and adiponectin models for gestation length.
Of the 2128 women in our sample, 643 (30.2%) were prescribed with oral antibiotics during pregnancy. Mean (standard deviation) BW/GA-z was 0.17 (0.97), cord blood leptin was 9.0 ng mL (6.6) and cord blood adiponectin was 28.8 ng mL (6.8). Overall, antibiotic prescription in pregnancy was associated with lower BW/GA-z [multivariable adjusted β -0.11; 95% confidence interval {CI} -0.20, -0.01]. In trimester-specific analyses, only second trimester antibiotic prescription was associated with lower BW/GA-z (β -0.23; 95% CI -0.37, -0.08). Overall, antibiotic prescription in pregnancy was not associated with cord blood leptin or adiponectin levels. However, in trimester-specific analyses, third trimester antibiotic prescription was associated with higher cord blood leptin (β 2.28 ng mL ; 95% CI 0.38, 4.17).
Antibiotics in mid-pregnancy were associated with lower birth weight for gestational age, whereas third trimester antibiotics were associated with higher cord blood leptin.
产后早期使用抗生素已被证明会促进体重过度增加，但尚不清楚子宫内接触抗生素是否与胎儿生长和肥胖有关。本研究的目的是探讨孕期各阶段抗生素处方与出生时胎儿大小和脂肪因子水平之间的关联。
在来自“生命孕育项目”队列的2128名孕妇中，我们从电子病历中根据孕期时间估算抗生素处方情况。结局指标为按性别划分的出生体重与胎龄的z评分（BW/GA-z）以及脐带血瘦素和脂联素水平。我们使用线性回归模型，对产妇年龄、孕前体重指数、产次、种族/族裔、教育程度、孕期吸烟情况、家庭收入和孩子性别进行了调整，并且对脐带血瘦素和脂联素模型按孕周进行了额外调整。
在我们样本中的2128名女性中，643名（30.2%）在孕期接受了口服抗生素处方。平均（标准差）BW/GA-z为0.17（0.97），脐带血瘦素为9.0 ng/mL（6.6），脐带血脂联素为28.8 ng/mL（6.8）。总体而言，孕期抗生素处方与较低的BW/GA-z相关[多变量调整β -0.11；95%置信区间{CI} -0.20，-0.01]。在按孕期阶段进行的分析中，只有孕中期抗生素处方与较低的BW/GA-z相关（β -0.23；95% CI -0.37，-0.08）。总体而言，孕期抗生素处方与脐带血瘦素或脂联素水平无关。然而，在按孕期阶段进行的分析中，孕晚期抗生素处方与较高的脐带血瘦素相关（β 增加2.28 ng/mL；95% CI 0.38，4.17）。
孕中期使用抗生素与较低的出生体重相关，而孕晚期使用抗生素与较高的脐带血瘦素相关。
