Department of Pediatrics, Amsterdam Gastroenterology, Metabolism & Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam Reproduction & Development, Amsterdam.
Department of Pediatrics, St. Antonius Hospital, Nieuwegein.
J Pediatr Gastroenterol Nutr. 2022 Jun 1;74(6):770-775. doi: 10.1097/MPG.0000000000003428. Epub 2022 Feb 24.
Antibiotics may contribute to the development of functional gastrointestinal disorders (FGIDs). This study aimed to determine whether antibiotics during the first week of life, infantile colic in the first year of life, gut-associated immune markers at 1 year of age, and allergies at 4-6 years of age in term-born children were associated with a higher prevalence of FGIDs at 4-6 years of age.
A prospective observational cohort of 436 term-born infants was followed up at the age of 4-6 years; 151 received broad-spectrum antibiotics (AB+), and 285 healthy controls (AB-). Validated Questionnaire On Pediatric Gastrointestinal Symptoms-Rome III and International Study of Asthma and Allergy in Childhood questionnaires were sent to parents of 418 available children. The independent t-test, chi-squared test or non-parametric test and logistic multivariate regression analyses were used.
In total, 340 of 418 (81%) questionnaires were completed. Only the presence of functional abdominal pain was significantly higher in AB+ than AB- (4% vs 0.4%, respectively, P = 0.045). Children with food allergy fulfilled significantly more often the criteria for irritable bowel syndrome (IBS) and abdominal migraine (26% vs 9%, P = 0.002 and 7% vs 1%, P = 0.043, respectively) compared to non-allergic children. No differences in FGIDs existed at the age of 4-6 years between children with and without a history of infantile colic. There were significant differences in gut-associated immune markers between children with and without FGIDs.
Antibiotics during the first week of life resulted in a higher risk for functional abdominal pain at 4-6 years. Furthermore, food allergy was associated with IBS and abdominal migraine at 4-6years.
抗生素可能会导致功能性胃肠疾病（FGIDs）的发生。本研究旨在确定生命的第一周使用抗生素、婴儿绞痛在生命的第一年、1 岁时与肠道相关的免疫标志物以及 4-6 岁时的过敏与 4-6 岁时 FGIDs 的更高患病率是否相关。
对 436 名足月出生的婴儿进行前瞻性观察队列研究，在 4-6 岁时进行随访；其中 151 名婴儿接受了广谱抗生素（AB+）治疗，285 名健康对照（AB-）。向 418 名可用儿童的父母发送了经过验证的儿科胃肠道症状罗马 III 问卷和国际儿童哮喘和过敏研究问卷。使用独立样本 t 检验、卡方检验或非参数检验和逻辑多元回归分析。
在总共 418 份问卷中，有 340 份（81%）完成了问卷。只有 AB+组的功能性腹痛的发生率显著高于 AB-组（分别为 4%和 0.4%，P=0.045）。与非过敏儿童相比，食物过敏儿童更常符合肠易激综合征（IBS）和腹型偏头痛（26%比 9%，P=0.002 和 7%比 1%，P=0.043）的诊断标准。在 4-6 岁时，有或无婴儿绞痛病史的儿童之间的 FGIDs 无差异。有或无 FGIDs 的儿童之间的与肠道相关的免疫标志物存在显著差异。
生命的第一周使用抗生素会增加 4-6 岁时功能性腹痛的风险。此外，食物过敏与 4-6 岁时的 IBS 和腹型偏头痛有关。
