Hakola Leena, Lundqvist Annamari, Gissler Mika, Virta Lauri J, Virtanen Suvi M, Metsälä Johanna
Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland; Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland; Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Public Health, Finnish Institute for Health and Welfare, Helsinki, Finland.
J Pediatr. 2025 Jan;276:114292. doi: 10.1016/j.jpeds.2024.114292. Epub 2024 Sep 6.
To study whether prenatal and postnatal exposure to antibiotics is associated with the risk of type 1 diabetes in childhood.
This case cohort study included 2869 children diagnosed with type 1 diabetes by the end of 2009 who were born between January 1, 1996, and December 31, 2008, in Finland and a reference cohort (n = 74 263) representing 10% of each birth cohort. Exposure to antibiotics was assessed in different time periods. The data were derived from Special Reimbursement Register, Drug Prescription Register, and Population Register and analyzed with weighted Cox proportional hazards regression models.
Exposure to any antibiotics before or during pregnancy, in the neonatal ward, during the first year of life, or during the 2 first years of life, was not associated with the risk of type 1 diabetes in the offspring. Exposure to macrolides in the year preceding pregnancy (adjusted hazard ratio [HR], 1.17; 95% CI, 1.02-1.33) and to sulfonamides and trimethoprim during pregnancy (adjusted HR, 1.91; 95% CI, 1.07-3.41) was associated with an increased risk of type 1 diabetes in the offspring. Exposure to sulfonamides and trimethoprim during first 2 years of life was associated with a decreased risk of type 1 diabetes (adjusted HR, 0.84; 95% CI, 0.73-0.97). The number of antibiotic purchases among mothers or children was not associated with type 1 diabetes risk.
Prenatal and postnatal exposure to antibiotics in general did not increase the risk of type 1 diabetes in the offspring. However, the type of antibiotic and timing of exposure may play a role in type 1 diabetes risk.
研究产前和产后接触抗生素是否与儿童1型糖尿病风险相关。
这项病例队列研究纳入了2869名于2009年底前被诊断为1型糖尿病的儿童，他们于1996年1月1日至2008年12月31日在芬兰出生，以及一个代表每个出生队列10%的参考队列（n = 74263）。在不同时间段评估抗生素接触情况。数据来源于特殊报销登记册、药物处方登记册和人口登记册，并采用加权Cox比例风险回归模型进行分析。
孕期或孕期前、新生儿病房、生命的第一年或生命的前两年接触任何抗生素，均与后代患1型糖尿病的风险无关。孕前一年接触大环内酯类抗生素（调整后风险比[HR]，1.17；95%置信区间[CI]，1.02 - 1.33）以及孕期接触磺胺类药物和甲氧苄啶（调整后HR，1.91；95% CI，1.07 - 3.41）与后代患1型糖尿病的风险增加相关。生命的前两年接触磺胺类药物和甲氧苄啶与1型糖尿病风险降低相关（调整后HR，0.84；95% CI，0.73 - 0.97）。母亲或儿童购买抗生素的数量与1型糖尿病风险无关。
一般而言，产前和产后接触抗生素不会增加后代患1型糖尿病的风险。然而，抗生素的类型和接触时间可能在1型糖尿病风险中起作用。
