Elizabeth T Rogawski1, Daniel J Westreich2, Linda S Adair3, Sylvia Becker-Dreps4, Robert S Sandler5, Rajiv Sarkar6, Deepthi Kattula6, Honorine D Ward7, Steven Meshnick2, Gagandeep Kang6. 1. Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC. Electronic address: rogawski@virginia.edu. 2. Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC. 3. Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC. 4. Department of Family Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC. 5. Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC; Department of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC. 6. Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India. 7. Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA.
Abstract
OBJECTIVES: To estimate the effects of antibiotic exposures in the first 6 months of life on short- and long-term growth. STUDY DESIGN: In a prospective observational cohort study of 497 children from Vellore, India, we estimated short-term effects of antibiotics during the first 6 months using longitudinal general linear regression to model weight-for-age, height-for-age, and weight-for-height z-scores in monthly intervals. To estimate long-term effects, we modeled growth from 6 months to 3 years as a function of antibiotic use in the first 6 months. We also estimated the effects of antibiotics on the monthly relative risks of underweight, stunting, and wasting in the first 6 months and to 3 years. RESULTS: Underweight, stunting, and wasting were common in this population: 31%, 32%, and 15% on average after 6 months of age, respectively. There was no association between antibiotic exposures before 6 months and growth during that period. From 6 months to 3 years, adjusted absolute differences in weight and height were small (approximately -100 g and no more than -2 mm overall, respectively) and not statistically significant. CONCLUSIONS: Antibiotic exposures early in life were not associated with increased or decreased growth. The combination of malnutrition and recurrent illness likely complicate the relationship between antibiotic exposures and growth among children in low and middle-income countries.
OBJECTIVES: To estimate the effects of antibiotic exposures in the first 6 months of life on short- and long-term growth. STUDY DESIGN: In a prospective observational cohort study of 497 children from Vellore, India, we estimated short-term effects of antibiotics during the first 6 months using longitudinal general linear regression to model weight-for-age, height-for-age, and weight-for-height z-scores in monthly intervals. To estimate long-term effects, we modeled growth from 6 months to 3 years as a function of antibiotic use in the first 6 months. We also estimated the effects of antibiotics on the monthly relative risks of underweight, stunting, and wasting in the first 6 months and to 3 years. RESULTS: Underweight, stunting, and wasting were common in this population: 31%, 32%, and 15% on average after 6 months of age, respectively. There was no association between antibiotic exposures before 6 months and growth during that period. From 6 months to 3 years, adjusted absolute differences in weight and height were small (approximately -100 g and no more than -2 mm overall, respectively) and not statistically significant. CONCLUSIONS: Antibiotic exposures early in life were not associated with increased or decreased growth. The combination of malnutrition and recurrent illness likely complicate the relationship between antibiotic exposures and growth among children in low and middle-income countries.
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