Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2021 Jan;96(1):66-77. doi: 10.1016/j.mayocp.2020.07.019. Epub 2020 Nov 16.
To investigate the extent to which antibiotic exposure in the first 2 years of life is associated with the risk of immunological, metabolic, and neurobehavioral health conditions with childhood onset.
In this population-based cohort study, we identified all children born in Olmsted County, Minnesota, between January 1, 2003, and December 31, 2011, through the Rochester Epidemiology Project medical records-linkage system. Demographic characteristics, antibiotic prescriptions, and diagnostic codes through June 30, 2017, were retrieved using the Rochester Epidemiology Project infrastructure. Time-to-event analysis was performed to assess the impact of antibiotic exposure on the risk of several adverse health conditions.
This study included 14,572 children (7026 girls and 7546 boys), of whom 70% (10,220) received at least 1 antibiotic prescription during the first 2 years of life. Early antibiotic exposure was associated with an increased risk of childhood-onset asthma, allergic rhinitis, atopic dermatitis, celiac disease, overweight, obesity, and attention deficit hyperactivity disorder (hazard ratios ranging from 1.20 to 2.89; P<.05 for all). The associations were influenced by the number, type, and timing of antibiotic exposure. Moreover, children exposed to antibiotics had a higher probability of having combinations of conditions, particularly when given multiple prescriptions.
The present study finds significant associations between early life antibiotic exposure and several distinct health conditions with childhood onset. Additional research is warranted to establish practical guidelines to optimize the benefit and minimize the risk of antibiotics in children.
研究生命最初 2 年内抗生素暴露与儿童期发病的免疫、代谢和神经行为健康状况风险之间的关系。
在这项基于人群的队列研究中，我们通过罗切斯特流行病学项目医疗记录链接系统，确定了 2003 年 1 月 1 日至 2011 年 12 月 31 日期间在明尼苏达州奥姆斯特德县出生的所有儿童。使用罗切斯特流行病学项目基础设施检索人口统计学特征、抗生素处方和截至 2017 年 6 月 30 日的诊断代码。采用时间事件分析评估抗生素暴露对多种不良健康状况风险的影响。
本研究纳入了 14572 名儿童（7026 名女孩和 7546 名男孩），其中 70%（10220 名）在生命最初 2 年内至少接受过 1 次抗生素处方。早期抗生素暴露与儿童期发病的哮喘、过敏性鼻炎、特应性皮炎、乳糜泻、超重、肥胖和注意缺陷多动障碍风险增加相关（危险比范围为 1.20 至 2.89；所有 P 值均<.05）。这些关联受抗生素暴露的数量、类型和时间的影响。此外，接受抗生素治疗的儿童更有可能同时存在多种疾病，尤其是接受多次处方时。
本研究发现生命早期抗生素暴露与儿童期发病的多种特定健康状况之间存在显著关联。需要进一步研究以制定实用指南，优化儿童抗生素的获益并降低风险。
