University of Zurich, Zurich, Switzerland.
Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.
Pediatr Allergy Immunol. 2019 Jun;30(4):423-433. doi: 10.1111/pai.13039. Epub 2019 Mar 5.
Allergies are a serious public health issue, and prevalences are rising worldwide. The role of antibiotics in the development of allergies has repeatedly been discussed, as results remain inconsistent. The aim of this study was to investigate the association between pre- and post-natal antibiotic exposure and subsequent development of allergies (atopic dermatitis, food allergy, asthma, atopic sensitization and allergic rhinitis).
A total of 1080 children who participated in a European birth cohort study (PASTURE) were included in this analysis. Data on antibiotic exposure during pregnancy and/or first year of life and allergic diseases were collected by questionnaires from pregnancy up to 6 years of age and analysed by performing logistic regressions. To take into account reverse causation, we included models, where children with diagnosis or symptoms of the respective disease in the first year of life were excluded.
Antibiotic exposure in utero was significantly and positively associated with atopic dermatitis and food allergy. The strongest effect was on diseases with onset within the first year of life (for atopic dermatitis: aOR 1.66, 95% CI 1.11-2.48 and for food allergy: aOR 3.01, 95% CI 1.22-7.47). Antibiotics in the first year of life were positively associated with atopic dermatitis up to 4 years (aOR 2.73, 95% CI 1.66-4.49) and also suggested a dose-response relationship. A tendency was observed with asthma between 3 and 6 years (aOR 1.65, 95% CI 0.95-2.86).
Our findings show positive associations between exposure to antibiotics and allergies, mainly atopic dermatitis and food allergy within the first year of life, after prenatal exposure, and atopic dermatitis and asthma after post-natal exposure to antibiotics in children born in rural settings.
过敏是一个严重的公共卫生问题，且其发病率在全球范围内呈上升趋势。抗生素在过敏发展中的作用已被反复讨论，但结果仍不一致。本研究旨在调查产前和产后抗生素暴露与随后过敏（特应性皮炎、食物过敏、哮喘、特应性致敏和过敏性鼻炎）的发展之间的关联。
本分析纳入了参加欧洲出生队列研究（PASTURE）的 1080 名儿童。在妊娠期间和/或生命的第一年通过问卷调查收集了抗生素暴露数据和过敏疾病数据，从妊娠到 6 岁进行分析，并通过逻辑回归进行分析。为了考虑反向因果关系，我们纳入了模型，其中排除了在生命的第一年有相应疾病诊断或症状的儿童。
胎儿期抗生素暴露与特应性皮炎和食物过敏显著正相关。最强的影响是在生命的第一年发病的疾病（特应性皮炎：aOR 1.66，95%CI 1.11-2.48；食物过敏：aOR 3.01，95%CI 1.22-7.47）。生命的第一年的抗生素与 4 岁时的特应性皮炎正相关（aOR 2.73，95%CI 1.66-4.49），且呈剂量-反应关系。在 3 至 6 岁之间，哮喘也有趋势（aOR 1.65，95%CI 0.95-2.86）。
我们的研究结果表明，在农村环境中出生的儿童中，抗生素暴露与过敏之间存在正相关，主要是特应性皮炎和食物过敏，在生命的第一年，经产前暴露，以及在生命的第二年经产后暴露。
