Department of Public Health and Primary Care, Trinity College Dublin, Russell Center, Tallaght Cross, Dublin 24, Ireland.
World J Pediatr. 2019 Aug;15(4):390-397. doi: 10.1007/s12519-018-00223-1. Epub 2019 Jan 12.
Taking oral antibiotics during childhood has been linked with an increased risk of childhood obesity. This study assessed any potential association in number of courses of antibiotics taken between 2-3 and 4-5 years of age and body mass trajectory up to age 5.
The study was a secondary analysis of 8186 children and their parents from the infant cohort of the Irish National Longitudinal Study of Children. Antibiotic use was measured by parental recall between ages 2-3 and 4-5. Longitudinal models described the relationship between antibiotic exposure and body mass index (BMI) standard deviation scores and binary outcomes, and examined interactions between covariates, which included socioeconomic status, diet assessed by food frequency questionnaires and maternal BMI.
Any antibiotic usage between 2 and 3 years did not predict risk of overweight or obesity at age 5. Four or more courses of antibiotics between 2 and 3 years were independently associated with obesity at age 5 (odds ratio 1.6, 95% confidence interval 1.11-2.31). Effect size was modest (coefficient + 0.09 body mass SD units, standard error 0.04, P = 0.037). Maternal BMI modified the relationship: ≥ 4 courses of antibiotics between 2 and 3 years were associated with a + 0.12 body mass SD units increase in weight at age 5 among children of normal-weight mothers (P = 0.035), but not in children of overweight mothers.
Number of antibiotic courses, rather than antibiotic use, may be an important factor in any link between early antibiotic exposure and subsequent childhood obesity. Research is needed to confirm differential effects on babies of normal versus overweight/obese mothers independent of socioeconomic factors.
儿童时期服用口服抗生素与儿童肥胖风险增加有关。本研究评估了 2-3 岁和 4-5 岁之间服用抗生素的疗程数量与 5 岁前体重变化轨迹之间的潜在关联。
该研究是对爱尔兰国家儿童纵向研究婴儿队列中 8186 名儿童及其父母的二次分析。抗生素使用情况通过父母在 2-3 岁和 4-5 岁之间的回忆来测量。纵向模型描述了抗生素暴露与体重指数（BMI）标准差评分和二项结局之间的关系，并检查了包括社会经济地位、通过食物频率问卷评估的饮食和母亲 BMI 在内的协变量之间的相互作用。
任何 2-3 岁之间的抗生素使用均不能预测 5 岁时超重或肥胖的风险。2-3 岁之间使用 4 个或更多疗程的抗生素与 5 岁时肥胖独立相关（比值比 1.6，95%置信区间 1.11-2.31）。影响程度较小（系数+0.09 体重标准差单位，标准误 0.04，P=0.037）。母亲 BMI 改变了这种关系：2-3 岁之间使用 4 个或更多疗程的抗生素与正常体重母亲的孩子 5 岁时体重增加 0.12 个体重标准差单位相关（P=0.035），但与超重母亲的孩子无关。
抗生素疗程数量而不是抗生素使用可能是早期抗生素暴露与随后儿童肥胖之间任何关联的重要因素。需要研究以确认在独立于社会经济因素的情况下，正常体重和超重/肥胖母亲的婴儿的抗生素使用效果是否存在差异。
