Pediatric Allergy Outpatients Clinic, Department of Pediatrics, Venizeleion General Hospital of Heraklion, Heraklion, Greece.
Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
Eur Ann Allergy Clin Immunol. 2023 Nov;55(6):271-277. doi: 10.23822/EurAnnACI.1764-1489.266. Epub 2022 Sep 1.
The human microbiome is important due to the impact it has on host immunologic development and allergy-associated diseases. This study aimed to investigate the impact of prenatal exposure to antibiotics on the incidence of atopic dermatitis (AD) in children at 18 months of age. Mothers were interviewed at baseline, in the maternity ward and by phone questionnaire after 18 months. Demographic data, mode of delivery, yoghurt consumption, antibiotic and other drug use during pregnancy, atopic history, diagnosis of AD and history of infections in the offspring were noted. 385 mothers were interviewed at baseline. 231 (60%) mothers with 236 children responded at follow up. Cesarean section was reported in 116 (50.2%) deliveries while antibiotic use during pregnancy in 55/231 (23.8%) women. 43/236 (18.22%) infants were diagnosed with AD. Intravenous antibiotic use was associated with a 7.7 increased risk of AD diagnosis in the offspring (95%CI 1.23-48.27, p = 0.029). An increased odd for AD was recorded for mothers 30-40 years of age (OR 4.50, 95%CI 1.08-18.7, p = 0.039). No significant association between cesarean section and AD (p = 0.70) was recorded. In multivariate analysis, reported food allergy (OR 8.03, 95%CI 2.30-27.97, p = 0.001) and otitis media episodes in children (OR 3.76, 95%CI 1.60-8.83, p = 0.002) were significantly associated with AD diagnosis. An increased risk of AD was recorded only when antibiotics were given prenatally by intravenous route and in women between 30-40 years of age. Children with food allergy had an increased risk for AD. The relatively high percentage of cesarean sections was not a risk factor for AD.
人类微生物组很重要，因为它会影响宿主免疫发育和与过敏相关的疾病。本研究旨在调查产前暴露于抗生素对 18 个月大儿童特应性皮炎（AD）发病率的影响。母亲在基线、产房和 18 个月后通过电话问卷进行了访谈。记录了人口统计学数据、分娩方式、酸奶消费、怀孕期间抗生素和其他药物的使用、特应性病史、AD 诊断和后代感染史。 385 名母亲接受了基线访谈。231 名（60%）母亲中有 236 名儿童在随访时做出了回应。116 例（50.2%）分娩为剖宫产，55 例（23.8%）孕妇在怀孕期间使用了抗生素。236 例婴儿中有 43 例被诊断为 AD。静脉内使用抗生素会使后代 AD 诊断的风险增加 7.7 倍（95%CI 1.23-48.27，p=0.029）。30-40 岁的母亲 AD 发病风险增加（OR 4.50，95%CI 1.08-18.7，p=0.039）。剖宫产与 AD 之间无显著相关性（p=0.70）。多变量分析显示，报告的食物过敏（OR 8.03，95%CI 2.30-27.97，p=0.001）和儿童中耳炎发作（OR 3.76，95%CI 1.60-8.83，p=0.002）与 AD 诊断显著相关。 仅当抗生素通过静脉途径在产前给予且母亲年龄在 30-40 岁之间时，AD 的风险才会增加。有食物过敏的儿童患 AD 的风险增加。相对较高的剖宫产率不是 AD 的危险因素。
