Pre- and post-natal exposure to antibiotics and the development of eczema, recurrent wheezing and atopic sensitization in children up to the age of 4 years.
ABSTRACT Little data are available on the relationship between indirect antibiotic exposure of the child in utero or during lactation and allergic diseases. On the other hand, several studies have been conducted on the association with direct post-natal antibiotic exposure, but the results are conflicting.
The aim of this study was to investigate pre- and post-natal antibiotic exposure and the subsequent development of eczema, recurrent wheeze and atopic sensitization in children up to the age of 4 years.
We conducted an aetiologic study in 773 children based on a prospective birth cohort project in which environmental and health information were collected using questionnaires. Antibiotic exposure was assessed as maternal antibiotic intake during pregnancy and during lactation and as medication intake of the child. The chronology of exposures and outcomes was taken into account during the data processing. At the age of 1 and 4 years, a blood sample was taken for the quantification of specific IgE.
Prenatal antibiotic exposure was significantly positively associated with eczema, whereas no association was found with recurrent wheeze and atopic sensitization. We found a positive, although statistically not significant, association between antibiotic exposure through breastfeeding and recurrent wheeze. Neither eczema nor atopic sensitization was significantly associated with antibiotic exposure through breastfeeding. Finally, we observed a negative association between the use of antibiotics in the first year of life and eczema and atopic sensitization, and also between antibiotic use after the first year of life and recurrent wheeze, eczema and atopic sensitization.
Indirect exposure to antibiotics (in utero and during lactation) increases the risk for allergic symptoms in children, while direct exposure to antibiotics appears to be protective. The biological mechanisms underlying these findings still need to be elucidated.
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ABSTRACT: Although cesarean delivery and prenatal exposure to antibiotics are likely to affect the gut microbiome in infancy, their effect on the development of atopic dermatitis (AD) in infancy is unclear. The influence of individual genotypes on these relationships is also unclear. To evaluate with a prospective birth cohort study whether cesarean section, prenatal exposure to antibiotics, and susceptible genotypes act additively to promote the development of AD in infancy.PLoS ONE 01/2014; 9(5):e96603. · 3.53 Impact Factor
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ABSTRACT: BACKGROUND: A number of studies have suggested that early life exposure to antibiotics may lead to an increased risk of subsequent eczema. OBJECTIVE: To conduct a systematic literature review on the association between antibiotic use antenatally or in the first year of life, and the development of eczema. METHODS: We completed a systematic review and meta-analysis of observational studies involving children or young adults aged 0-25 years, which assessed the impact of antibiotic exposure either in utero or during the first 12 months of life on subsequent eczema risk. RESULTS: Twenty studies examined the association between prenatal and/or postnatal exposure to antibiotics and development of eczema in early life. The pooled OR for the seventeen studies examining postnatal antibiotic exposure was 1.41 (95% confidence interval [CI] 1.30 to 1.53). The pooled OR for the ten longitudinal studies was 1.40 (1.19 to 1.64), compared to a pooled OR of 1.43 (1.36 to 1.51) for the seven cross-sectional studies. There was a significant dose-response association, suggesting a 7% risk increase in eczema risk for each additional antibiotic course received during the first year of life (pooled OR=1.07 [1.02-1.11]). Finally, the pooled OR for the four studies relating to antenatal exposure was 1.30 (0.86 to 1.95). CONCLUSION: Exposure to antibiotics in the first year of life, but not prenatally, is more common in children with eczema. This article is protected by copyright. All rights reserved.British Journal of Dermatology 06/2013; · 3.76 Impact Factor
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ABSTRACT: There is a growing desire to explain the worldwide rise in the prevalence of atopic dermatitis (AD). Trend data on the burden of AD suggest that the picture in the developing world may soon resemble that of wealthier nations, where AD affects over 20% of children. This, combined with significant variations in prevalence within countries, emphasizes the importance of environmental factors. Many hypotheses have been explored, from the modulation of immune priming by hygiene, gut microbiota diversity, and exposure to endotoxins through farm animals to the effects of pollution, climate, and diet. The discovery of the filaggrin skin barrier gene and its importance in AD development and severity has brought the focus on gene–environment interactions and the identification of environmental factors that impact on skin barrier function. This article reviews our current understanding of the epidemiology of AD, with an emphasis on the findings reported in the international literature over the last 5 years.Allergy 11/2013; · 5.88 Impact Factor