A E Cassidy-Bushrow1,2, C Burmeister1, S Havstad1,2, A M Levin1,2, S V Lynch3, D R Ownby2,4, A G Rundle5, K J Woodcroft1,2, E M Zoratti2,6, C C Johnson1,2, G Wegienka1,2. 1. Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA. 2. Center for Allergy, Asthma and Immunology Research, Henry Ford Hospital, Detroit, MI, USA. 3. Department of Medicine, University of California, San Francisco, CA, USA. 4. Division of Allergy and Clinical Immunology, Department of Pediatrics, Augusta University, Augusta, GA, USA. 5. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. 6. Division of Allergy and Clinical Immunology, Henry Ford Hospital, Detroit, MI, USA.
Abstract
BACKGROUND/ OBJECTIVES: Growing evidence suggests that antibiotic use is associated with childhood body mass index (BMI), potentially via mechanisms mediated by gut microbiome alterations. Less is known on the potential role of prenatal antimicrobial use in offspring obesity risk. We examined whether prenatal antibiotic or antifungal use was associated with BMI at the age of 2 years in 527 birth cohort participants. METHODS/ SUBJECTS: Antimicrobial use was obtained from the prenatal medical record. Height and weight were measured at the age of 2 years. Overweight/obesity was defined as a BMI ⩾85th percentile. RESULTS: A total of 303 (57.5%) women used antibiotics and 101 (19.2%) used antifungals during pregnancy. Prenatal antifungal use was not associated with child BMI at the age of 2 years. In the fully adjusted model, prenatal antibiotic use was associated with a 0.20±0.10 (P=0.046) higher mean BMI Z-score at the age of 2 years. Associations between prenatal antibiotic use and childhood BMI varied by trimester of exposure, with first or second-trimester exposure more strongly associated with larger BMI at the age of 2 years for both BMI Z-score (interaction P=0.032) and overweight/obesity (interaction P=0.098) after covariate adjustment. CONCLUSIONS: Prenatal antibiotic, but not antifungal, use is associated with larger BMI at the age of 2 years; associations were stronger for antibiotic exposures in earlier trimesters. Future studies examining whether these associations are due to alterations in the maternal and/or infant microbiome are necessary. Children who are overweight at the age of 2 years are at higher risk for being overweight as they age; prenatal antibiotic use is a potentially modifiable exposure that could reduce childhood obesity.
BACKGROUND/ OBJECTIVES: Growing evidence suggests that antibiotic use is associated with childhood body mass index (BMI), potentially via mechanisms mediated by gut microbiome alterations. Less is known on the potential role of prenatal antimicrobial use in offspring obesity risk. We examined whether prenatal antibiotic or antifungal use was associated with BMI at the age of 2 years in 527 birth cohort participants. METHODS/ SUBJECTS: Antimicrobial use was obtained from the prenatal medical record. Height and weight were measured at the age of 2 years. Overweight/obesity was defined as a BMI ⩾85th percentile. RESULTS: A total of 303 (57.5%) women used antibiotics and 101 (19.2%) used antifungals during pregnancy. Prenatal antifungal use was not associated with child BMI at the age of 2 years. In the fully adjusted model, prenatal antibiotic use was associated with a 0.20±0.10 (P=0.046) higher mean BMI Z-score at the age of 2 years. Associations between prenatal antibiotic use and childhood BMI varied by trimester of exposure, with first or second-trimester exposure more strongly associated with larger BMI at the age of 2 years for both BMI Z-score (interaction P=0.032) and overweight/obesity (interaction P=0.098) after covariate adjustment. CONCLUSIONS: Prenatal antibiotic, but not antifungal, use is associated with larger BMI at the age of 2 years; associations were stronger for antibiotic exposures in earlier trimesters. Future studies examining whether these associations are due to alterations in the maternal and/or infant microbiome are necessary. Children who are overweight at the age of 2 years are at higher risk for being overweight as they age; prenatal antibiotic use is a potentially modifiable exposure that could reduce childhood obesity.
Authors: John Penders; Carel Thijs; Cornelis Vink; Foekje F Stelma; Bianca Snijders; Ischa Kummeling; Piet A van den Brandt; Ellen E Stobberingh Journal: Pediatrics Date: 2006-08 Impact factor: 7.124
Authors: Maria G Dominguez-Bello; Elizabeth K Costello; Monica Contreras; Magda Magris; Glida Hidalgo; Noah Fierer; Rob Knight Journal: Proc Natl Acad Sci U S A Date: 2010-06-21 Impact factor: 11.205
Authors: Christos S Mantzoros; Sheryl L Rifas-Shiman; Catherine J Williams; Jessica L Fargnoli; Theodoros Kelesidis; Matthew W Gillman Journal: Pediatrics Date: 2009-02 Impact factor: 7.124
Authors: Omry Koren; Julia K Goodrich; Tyler C Cullender; Aymé Spor; Kirsi Laitinen; Helene Kling Bäckhed; Antonio Gonzalez; Jeffrey J Werner; Largus T Angenent; Rob Knight; Fredrik Bäckhed; Erika Isolauri; Seppo Salminen; Ruth E Ley Journal: Cell Date: 2012-08-03 Impact factor: 41.582
Authors: Kjersti Aagaard; Kevin Riehle; Jun Ma; Nicola Segata; Toni-Ann Mistretta; Cristian Coarfa; Sabeen Raza; Sean Rosenbaum; Ignatia Van den Veyver; Aleksandar Milosavljevic; Dirk Gevers; Curtis Huttenhower; Joseph Petrosino; James Versalovic Journal: PLoS One Date: 2012-06-13 Impact factor: 3.240
Authors: Torri D Metz; Jennifer McKinney; Amanda A Allshouse; Shanna Doucette Knierim; J Christopher Carey; Kent D Heyborne Journal: J Matern Fetal Neonatal Med Date: 2019-02-07