Department of Paediatrics, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland.
Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland.
Eur J Pediatr. 2024 Dec;183(12):5191-5202. doi: 10.1007/s00431-024-05775-1. Epub 2024 Sep 28.
Antibiotics are frequently administered in the neonatal period and early infancy. Little is known about the long-term health consequences of early life antibiotic exposure. The objective is to investigate the association between neonatal and early life (0-6 months) antibiotic treatment and the development of atopic dermatitis, asthma and the use of inhaled corticosteroid medication later in childhood. We analyzed data obtained from hospital records and national registers in a cohort of 11,255 children. The association between early antibiotic exposure and the outcomes were analyzed using logistic regression. Confounding factors were included in the model. Neonatal antibiotic therapy for confirmed infection was associated with childhood atopic dermatitis (adjusted odds ratio 1.49; 95% confidence interval 1.15-1.94). Antibiotic therapy by six months of age was more common in children developing atopic dermatitis (adjusted odds ratio 1.38; 95% confidence interval 1.15-1.64), asthma (adjusted odds ratio 1.56; 95% confidence interval 1.32- 1.85) and inhaled corticosteroid medication use (adjusted odds ratio 1.88; 95% confidence interval 1.66-2.13). Conclusions: Neonatal antibiotic therapy for confirmed or clinically diagnosed infection is associated with increased risk of atopic dermatitis later in childhood. Antibiotic treatment before six months of age is associated with atopic dermatitis, asthma and inhaled corticosteroid use. What is known: • The use of antibiotics early in life has been associated with an increased risk of developing atopic dermatitis or asthma. • Confounding by indication or reverse causation may underlie the observed associations. What is new: • Our results demonstrate that neonatal antibiotic therapy for confirmed or clinically diagnosed infection was associated with increased risk of atopic dermatitis and antibiotic treatment before six months of age was associated with atopic dermatitis, asthma and inhaled corticosteroid use in analyses adjusted for confounding factors.
抗生素在新生儿期和婴儿早期经常使用。对于早期生活中抗生素暴露的长期健康后果知之甚少。目的是研究新生儿和婴儿早期（0-6 个月）抗生素治疗与特应性皮炎、哮喘以及儿童后期使用吸入性皮质类固醇药物之间的关系。我们分析了来自医院记录和国家登记处的 11255 名儿童的数据。使用逻辑回归分析早期抗生素暴露与结果之间的关系。该模型纳入了混杂因素。确诊感染的新生儿抗生素治疗与儿童特应性皮炎有关（调整后的优势比 1.49；95%置信区间 1.15-1.94）。在发生特应性皮炎的儿童中，6 个月前接受抗生素治疗的情况更为常见（调整后的优势比 1.38；95%置信区间 1.15-1.64）、哮喘（调整后的优势比 1.56；95%置信区间 1.32-1.85）和吸入性皮质类固醇药物的使用（调整后的优势比 1.88；95%置信区间 1.66-2.13）。结论：新生儿确诊或临床诊断为感染时使用抗生素与儿童后期特应性皮炎的风险增加有关。6 个月前使用抗生素与特应性皮炎、哮喘和吸入性皮质类固醇的使用有关。已知：• 生命早期使用抗生素与特应性皮炎或哮喘风险增加有关。• 指示性混杂或反向因果关系可能是观察到的关联的基础。新内容：• 我们的研究结果表明，新生儿确诊或临床诊断为感染时使用抗生素与特应性皮炎风险增加有关，6 个月前使用抗生素与特应性皮炎、哮喘和吸入性皮质类固醇的使用有关，在调整混杂因素后进行分析。
