Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute and
Applied Clinical Research Center and Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Pediatrics. 2018 Dec;142(6). doi: 10.1542/peds.2018-0290. Epub 2018 Oct 31.
: media-1vid110.1542/5839981580001PEDS-VA_2018-0290 OBJECTIVES: To determine the association of antibiotic use with weight outcomes in a large cohort of children.
Health care data were available from 2009 to 2016 for 35 institutions participating in the National Patient-Centered Clinical Research Network. Participant inclusion required same-day height and weight measurements at 0 to <12, 12 to <30, and 48 to <72 months of age. We assessed the association between any antibiotic use at <24 months of age with BMI score and overweight or obesity prevalence at 48 to <72 months (5 years) of age, with secondary assessments of antibiotic spectrum and age-period exposures. We included children with and without complex chronic conditions.
Among 1 792 849 children with a same-day height and weight measurement at <12 months of age, 362 550 were eligible for the cohort. One-half of children (52%) were boys, 27% were African American, 18% were Hispanic, and 58% received ≥1 antibiotic prescription at <24 months of age. At 5 years, the mean BMI score was 0.40 (SD 1.19), and 28% of children had overweight or obesity. In adjusted models for children without a complex chronic condition at 5 years, we estimated a higher mean BMI score by 0.04 (95% confidence interval [CI] 0.03 to 0.05) and higher odds of overweight or obesity (odds ratio 1.05; 95% CI 1.03 to 1.07) associated with obtaining any (versus no) antibiotics at <24 months.
Antibiotic use at <24 months of age was associated with a slightly higher body weight at 5 years of age.
在一个大型儿童队列中，确定抗生素使用与体重结果的相关性。
2009 年至 2016 年，全国以患者为中心的临床研究网络的 35 个机构提供了医疗数据。参与者纳入标准为：在 0 至<12、12 至<30 和 48 至<72 个月时，当天进行身高和体重测量。我们评估了<24 个月时使用任何抗生素与 48 至<72 个月（5 岁）时 BMI 评分和超重或肥胖患病率之间的相关性，对抗生素谱和年龄-时期暴露进行了二次评估。我们纳入了有或没有复杂慢性疾病的儿童。
在 1792849 名<12 个月时当天进行身高和体重测量的儿童中，有 362550 名符合队列纳入标准。一半的儿童（52%）为男孩，27%为非裔美国人，18%为西班牙裔，58%的儿童在<24 个月时接受了至少 1 次抗生素处方。在 5 岁时，平均 BMI 评分为 0.40（标准差 1.19），28%的儿童超重或肥胖。在 5 岁时无复杂慢性疾病的儿童的调整模型中，我们估计，与未使用抗生素的儿童相比，<24 个月时使用任何抗生素（而非未使用抗生素）的儿童，平均 BMI 评分增加 0.04（95%置信区间 [CI] 0.03 至 0.05），超重或肥胖的可能性更高（比值比 1.05；95%CI 1.03 至 1.07）。
<24 个月时使用抗生素与 5 岁时的体重略高有关。
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