Maternal antibiotic exposure during pregnancy and the risk of allergic diseases in childhood: A meta‐analysis

Zhong, Yang; Zhang, Yuheng; Wang, Yan; Huang, Ruijie

doi:10.1111/pai.13411

Cited by 33 publications

(39 citation statements)

References 60 publications

(233 reference statements)

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“…We found that prenatal exposure to antibiotics was associated with an increased risk for IBD development. Antibiotic exposure could influence microbial colonization in utero, [131] the offspring of antibiotic-exposed mothers has been shown to display reduced abundance of Bifidobacterium and Lactobacillus, [132] and positive associations have been reported with asthma/wheezing and eczema/ atopic dermatitis, [133] pointing to biological plausibility in our findings. Our analysis for postnatal antibiotic exposure showed a trend toward increased risk of IBD.…”

Section: Discussionsupporting

confidence: 60%

Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses

et al. 2021

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Background: Early life exposures impact immune system development and therefore the risk of immunemediated diseases, including inflammatory bowel disease (IBD). We systematically reviewed the impact of pre-, peri-, and postnatal exposures up to the age of five years on subsequent IBD diagnosis. Methods: We identified case-control and cohort studies reporting on the association between early life environmental factors and Crohn's disease (CD), ulcerative colitis (UC), or IBD overall. Databases were search from their inception until May 24th, 2019 until July 14th, 2020. We conducted meta-analyses for quantitative review of relevant risk factors that were comparable across studies and qualitative synthesis of the literature for a wide range of early life exposures, including maternal health and exposures during pregnancy, perinatal factors, birth month and related-factors, breastfeeding, hygiene-related factors and social factors, immigration, antibiotics, offspring health, including infections, and passive smoking. PROSPERO registration: CRD42019134980. Findings: Prenatal exposure to antibiotics (OR 1.8; 95% CI 1.2À2.5) and tobacco smoke (OR 1.5; 95% CI 1.2À1.9), and early life otitis media (OR 2.1; 95% CI 1.2À3.6) were associated with IBD. There was a trend towards an association between exposure to antibiotics in infancy and IBD (OR: 1.7, 95% CI 0.97, 2.9), supported by positive data on population-based data. Breastfeeding was protective against IBD. Other early life risk factors had no association with IBD, but data were limited and heterogenous. Interpretation: Early life is an important period of susceptibility for IBD development later in life. Tobacco smoke, infections and antibiotics were associated positively, and breastfeeding was associated negatively with IBD. Our findings offer an opportunity to develop primary prevention strategies. Funding: This study did not receive any funding.

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Section: Discussionsupporting

confidence: 60%

Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses

et al. 2021

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“…The risk factors for the development of AD in childhood include a family history of allergic diseases, living in an urban area, exposure to antibiotics, and a high‐sugar diet 5 . However, maternal factors (eg, smoking exposure, breastfeeding, and maternal antibiotic consumption 6 ) that affect the risk of AD in children have received increasing attention 7,8 …”

Section: Introductionmentioning

confidence: 99%

Prepregnancy BMI, gestational weight gain and risk of childhood atopic dermatitis: A systematic review and meta‐analysis

Chen

Wang

Yao

et al. 2021

Pediatric Allergy Immunology

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Background Maternal weight before and during pregnancy influences the health of offspring. Several observational studies have investigated a link between the risk of childhood atopic dermatitis (AD) and prepregnancy maternal body mass index (BMI) and gestational weight gain (GWG), but the conclusions of these studies were inconsistent. The aim of this review was to evaluate the association between the risk of childhood AD and prepregnancy maternal BMI and GWG. Methods The PubMed, Embase, Cochrane, Web of Science, and Scopus databases were searched from inception to February 2, 2021. Observational studies investigating the association between the risk of childhood AD and prepregnancy maternal BMI and GWG were included. Fixed‐ or random‐effects models with inverse variance weights were used to calculate pooled risk estimates. Subgroup analysis and sensitivity analysis were used to explore the sources of heterogeneity. Results Thirteen studies with a total of 114 485 participants were included. Ten studies reported prepregnancy maternal BMI, and five reported GWG. Maternal underweight was associated with a higher risk of childhood AD (odds ratio [OR] = 1.06; 95% confidence interval [CI], 1.02‐1.10). Continuous BMI was not related to childhood AD (OR = 1.00; 95% CI, 0.98‐1.02). In comparison with normal GWG, moderate/very high GWG increased the risk of childhood AD (OR = 1.05; 95% CI, 1.02‐1.08; OR = 1.13; 95% CI, 1.07‐1.19, respectively), while low GWG decreased the risk (OR = 0.92; 95% CI, 0.89‐0.96). Excessive GWG relative to recommendations was associated with a higher risk of childhood AD (OR = 1.05; 95% CI, 1.01‐1.10), while a lower risk of childhood AD was associated with inadequate GWG relative to recommendations (OR = 0.87, 95% CI: 0.83‐0.91). Conclusions Maternal underweight, high GWG, and excessive GWG relative to recommendations are associated with an elevated risk of childhood AD, while low GWG and inadequate GWG relative to recommendations decreased the risk. Weight management before and during pregnancy is encouraged for primary prevention of childhood AD.

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“…Animal models have supported this concept by showcasing the positive correlation between antibiotic and antifungal treatment and enhanced asthma severity ( 203 , 252 – 254 ). Moreover, several studies report an association between prenatal and early life antibiotic exposure in humans and increased risk of asthma development ( 251 , 255 – 260 ). Additionally, antibiotic treatment causes longer hospitalization stays and higher costs ( 261 ), and have not proven to be beneficial in alleviating asthma exacerbations in adults ( 262 ).…”

Section: Current Treatment Strategies For Asthma Symptom Prevention A...mentioning

confidence: 99%

Impact of Therapeutics on Unified Immunity During Allergic Asthma and Respiratory Infections

Flores-Torres

Samarasinghe

2022

Front. Allergy

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Graphical AbstractInterplay between infectious agents and allergic milieu. Respiratory infections caused by viruses, bacteria and fungi play an important role in asthma pathogenesis. The immune milieu in allergic asthma may be both defective and protective during respiratory infections. Some bacteria are linked to steroid-resistant neutrophilic asthma and an aberrant immune response. Thermotolerant fungi generally induces a T2 immune response in asthma and are linked to asthma severity and higher corticosteroid requirement. Steroid-resistant neutrophilic asthma is associated with increased airway bacterial burden and reduced bacterial diversity. Corticosteroids and antibiotics induce dysbiosis in asthmatics, which may cause immune system alterations. Biologics and antivirals may be beneficial in some patients. However, the effect of eosinophil depletion on antiviral immunity in asthmatics remains unknown. Influenza and COVID-19 vaccination are recommended in asthmatics, but pneumococcal vaccine benefits are still under debate.

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Maternal antibiotic exposure during pregnancy and the risk of allergic diseases in childhood: A meta‐analysis

Cited by 33 publications

References 60 publications

Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses

Early life exposures and the risk of inflammatory bowel disease: Systematic review and meta-analyses

Prepregnancy BMI, gestational weight gain and risk of childhood atopic dermatitis: A systematic review and meta‐analysis

Impact of Therapeutics on Unified Immunity During Allergic Asthma and Respiratory Infections

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