Infection, antibiotic exposure, and risk of celiac disease: A systematic review and meta‐analysis

Jiang, Hai‐yin; Zhang, Xue; Zhou, Yuanyue; Jiang, Chun‐min; Shi, Yu-dan

doi:10.1111/jgh.14928

Cited by 23 publications

(14 citation statements)

References 43 publications

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“…Antibiotics are provided to approximately 25% of pregnant women and account for nearly 80% of all medications prescribed during pregnancy. 158 , 159 Evidence supporting an association between early antibiotic exposure and the risk of allergy/atopy, 160 obesity, 161 diabetes, 162 and celiac disease, 163 and concerns regarding antibiotic resistance, 164 highlight the need for management guidelines regarding the requirement, dose, and duration of perinatal antibiotics considering the risk of altering maternal and offspring intestinal microbiota.…”

Section: Discussionmentioning

confidence: 99%

Maternal exposures and the infant gut microbiome: a systematic review with meta-analysis

et al. 2021

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Early life, including the establishment of the intestinal microbiome, represents a critical window of growth and development. Postnatal factors affecting the microbiome, including mode of delivery, feeding type, and antibiotic exposure have been widely investigated, but questions remain regarding the influence of exposures in utero on infant gut microbiome assembly. This systematic review aimed to synthesize evidence on exposures before birth, which affect the early intestinal microbiome. Five databases were searched in August 2019 for studies exploring pre-pregnancy or pregnancy 'exposure' data in relation to the infant microbiome. Of 1,441 publications identified, 76 were included. Factors reported influencing microbiome composition and diversity included maternal antibiotic and probiotic uses, dietary intake, pre-pregnancy body mass index (BMI), gestational weight gain (GWG), diabetes, mood, and others. Eleven studies contributed to three meta-analyses quantifying associations between maternal intrapartum antibiotic exposure (IAP), BMI and GWG, and infant microbiome alpha diversity (Shannon Index). IAP, maternal overweight/ obesity and excessive GWG were all associated with reduced diversity. Most studies were observational, few included early recruitment or longitudinal follow-up, and the timing, frequency, and methodologies related to stool sampling and analysis were variable. Standardization and collaboration are imperative to enhance understanding in this complex and rapidly evolving area.

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Section: Discussionmentioning

confidence: 99%

Maternal exposures and the infant gut microbiome: a systematic review with meta-analysis

et al. 2021

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“…VEO-IBD is considered a different entity from later-onset IBD, 44 since genetics play a far more important aetiological role than microbial dysbiosis. 45 This may explain the lack of an association with early life antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Early life antibiotics and childhood gastrointestinal disorders: a systematic review

Kamphorst

Daele

Vlieger

et al. 2021

bmjpo

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BackgroundIn adults, there is increasing evidence for an association between antibiotic use and gastrointestinal (GI) disorders but in children, the evidence is scarce.ObjectiveAssess the association between exposure to antibiotics in the first 2 years of life in term born children and the presence of chronic GI disorders later in childhood.DesignFor this systematic review the MEDLINE, Embase, WHO trial register and Web of Science were systematically searched from inception to 8 June 2020. Title and abstract screening (n=12 219), full-text screening (n=132) as well as the quality assessment with the Newcastle-Ottawa Scale were independently performed by two researchers.Main outcome measuresThe association between antibiotics and inflammatory bowel disease (IBD) (n=6), eosinophilic oesophagitis (EoE) (n=5), coeliac disease (CeD) (n=6), infantile colics (n=3), functional constipation (n=2), recurrent abdominal pain, regurgitation, functional diarrhoea and infant dyschezia were examined.ResultsTwenty-two studies were included, 11 cohort and 11 case–control studies. A best evidence synthesis showed strong evidence for an association between antibiotic exposure in the first 2 years of life and the presence of IBD, and CeD during childhood. Moderate evidence was found for an association with EoE and no association with functional constipation in the first year of life. There was insufficient evidence for the other studied disorders.ConclusionsThe use of antibiotics in early life may increase the risk of GI disorders later in life. Further studies are necessary to unravel the underlying mechanisms and determine potential preventive measures. Meanwhile judicious use of antibiotics in early childhood is highly warranted.PROSPERO registration numberPROSPERO CRD42019132631.

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“…TEDDY group of investigators has recently reported that the childhood gastrointestinal infection, not respiratory infections, is associated with increased risk of coeliac autoimmunity in genetically susceptible individuals (hazard ratio 1.33) 155 . Furthermore, a systemic review and meta‐analysis including 19 observational studies has shown that any infection in childhood is associated with a 37% increase in the odds of developing CD, particularly among those requiring hospitalisation 156 …”

Section: Risk Factors For CDmentioning

confidence: 99%

Review article: Epidemiology of coeliac disease

Makharia

Chauhan

Singh

et al. 2022

Aliment Pharmacol Ther

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Coeliac disease is an immune-mediated disease caused by ingestion of gluten in genetically susceptible individuals. Coeliac disease has been thought to affect mainly people of European origin but subsequently many studies revealed that it affects people living in North America, Oceania, South America, Asia as well as Africa. The global pooled seroprevalence and prevalence of biopsy-confirmed coeliac disease are 1.4% and 0.7% respectively. The pooled incidence rates in women and men are 17.4 (95% CI: 13.7-21.1) and 7.8 (95% CI: 6.3-9.2) per 100 000 person-years respectively.The systematic reviews, based on many population-based data, suggest that both the prevalence and the incidence of coeliac disease has increased over past three decades, which may be attributable not only to an increase in the detection rate (improvement in diagnostic tests, simplification of diagnostic criteria and increase in awareness about the disease) but also because of modernisation and globalisation related changes in the dietary practices including increase in the use of convenience food and dietary gluten. In addition to genetic factors, while there are many environmental risk factors, including age at the first introduction of gluten, breastfeeding, caesarean section, exposure to antibiotics and gut microbiome; the amount of gluten ingestion during early part of life, however, has been shown to increase the risk of coeliac disease, and this is relevant from the point of view of primary prevention. In this review, we have reviewed and summarised the literature, up till year 2021, related to the global and continent-wise epidemiology and risk factors associated with coeliac disease.

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Infection, antibiotic exposure, and risk of celiac disease: A systematic review and meta‐analysis

Cited by 23 publications

References 43 publications

Maternal exposures and the infant gut microbiome: a systematic review with meta-analysis

Maternal exposures and the infant gut microbiome: a systematic review with meta-analysis

Early life antibiotics and childhood gastrointestinal disorders: a systematic review

Review article: Epidemiology of coeliac disease

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