Koebnick Corinna, Tartof Sara Y, Sidell Margo A, Rozema Emily, Chung Joanie, Chiu Vicki Y, Taylor Zackary W, Xiang Anny H, Getahun Darios
Kaiser Permanente Southern California, Research and Evaluation, Pasadena, CA, United States.
Kaiser Permanente, Department of Research and Evalutaion, Pasadena, CA, United States.
JMIR Res Protoc. 2019 Jul 30;8(7):e12065. doi: 10.2196/12065.
The widespread use of antepartum and intrapartum antibiotics has raised concerns about the possible disruption of the child's gut microbiota and effects on the maturation from the infant to the adult microbiome. The Fetal Antibiotic EXposure (FAX) study provides a cohort to examine the association between in-utero exposure to antibiotics and adverse childhood outcomes including body weight, atopic diseases, and autism spectrum disorders and to investigate the role of other potential factors mitigating or moderating the risk for adverse outcomes.
The aim of this paper was to describe the methods, cohort characteristics, and retention of infants included in the study cohort.
For this retrospective cohort study, we included children born in Kaiser Permanente Southern California (KPSC) hospitals between January 1, 2007, and December 31, 2015, within 22 to 44 completed weeks of gestation with KPSC insurance coverage during the first year of life. Follow-up data collection was performed through electronic medical records.
The study cohort was comprised 223,431 children of which 65.7% (146,720/223,431) were exposed to antibiotics in-utero: 19.0% (42,511/223,431) were exposed during the antepartum period, 30.0% (66,896/223,431) during the intrapartum period, and 16.7% (37,313/223,431) exposed during both the antepartum and intrapartum periods. During their first year of life, children had a median of 5 weight and height measurements; the frequency of weight and height measurements declined to a median of 3 in their second year of life and 2 for 3 to 5 years of age. The 5-year retention of children in the health plan was over 80% with the highest retention for Hispanic children.
This cohort of children will provide a unique opportunity to address key questions regarding the long-term sequelae of in-utero exposure to antibiotics using real-world data. The high retention and multiple medical visits over time allow us to model the trajectories of body mass index over time.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/12065.
产前和产时抗生素的广泛使用引发了人们对儿童肠道微生物群可能受到破坏以及对从婴儿到成人微生物组成熟过程产生影响的担忧。胎儿抗生素暴露（FAX）研究提供了一个队列，以研究子宫内接触抗生素与儿童不良结局（包括体重、过敏性疾病和自闭症谱系障碍）之间的关联，并调查其他潜在因素在减轻或调节不良结局风险方面的作用。
本文旨在描述研究队列中纳入的婴儿的方法、队列特征和保留情况。
对于这项回顾性队列研究，我们纳入了2007年1月1日至2015年12月31日在南加州凯撒医疗集团（KPSC）医院出生的儿童，这些儿童在出生后第一年有KPSC保险覆盖，且妊娠周数为22至44周。通过电子病历进行随访数据收集。
研究队列包括223,431名儿童，其中65.7%（146,720/223,431）在子宫内接触过抗生素：19.0%（42,511/223,431）在产前接触，30.0%（66,896/223,431）在产时接触，16.7%（37,313/223,431）在产前和产时均接触。在出生后的第一年，儿童体重和身高测量的中位数为5次；体重和身高测量的频率在第二年降至中位数3次，3至5岁时降至2次。儿童在健康计划中的5年保留率超过80%，西班牙裔儿童的保留率最高。
这一队列儿童将提供一个独特的机会，利用真实世界的数据来解决关于子宫内接触抗生素的长期后遗症的关键问题。随着时间的推移，高保留率和多次就诊使我们能够模拟体重指数随时间的变化轨迹。
国际注册报告标识符（IRRID）：DERR1-10.2196/12065
Zotero 插件
