Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study.

Autor: Njotto LL; Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Data Science Institute, Hasselt University, Diepenbeek, Belgium.; Department of Mathematics and ICT, College of Business Education (CBE), Dar es Salaam, Tanzania., Simin J; Department of Microbiology, Tumour and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Solnavägen 9, 171 77, Stockholm, Sweden., Fornes R; Department of Microbiology, Tumour and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Solnavägen 9, 171 77, Stockholm, Sweden., Odsbu I; Division of Mental and Physical Health, Department of Mental Disorders, The Norwegian Institute of Public Health, Oslo, Norway., Mussche I; Child and Youth Psychiatry, Centre for Ambulatory Revalidation (CAR) Ascendre, Eeklo/Wetteren, Belgium., Callens S; Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium.; Global Health Institutet, Antwerp University, Antwerp, Belgium.; Department of Head and Skin, Ghent University, Ghent, Belgium., Engstrand L; Department of Microbiology, Tumour and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Solnavägen 9, 171 77, Stockholm, Sweden., Bruyndonckx R; Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Data Science Institute, Hasselt University, Diepenbeek, Belgium.; Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium., Brusselaers N; Department of Microbiology, Tumour and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Solnavägen 9, 171 77, Stockholm, Sweden. nele.brusselaers@ki.se.; Global Health Institute, Antwerp University, Antwerp, Belgium. nele.brusselaers@ki.se.; Department of Head and Skin, Ghent University, Ghent, Belgium. nele.brusselaers@ki.se.
Jazyk: angličtina
Zdroj: Drug safety [Drug Saf] 2023 May; Vol. 46 (5), pp. 467-478. Date of Electronic Publication: 2023 Apr 23.
DOI: 10.1007/s40264-023-01297-1
Abstrakt: Introduction: Antibiotics represent the most common type of medication used during pregnancy and infancy. Antibiotics have been proposed as a possible factor in changes in microbiota composition, which may play a role in the aetiology of autism and attention deficit/hyperactivity disorder (ADHD). Our aim was to investigate the association between maternal and early-life antibiotic use and autism and ADHD in childhood.
Methods: This Swedish nation-wide population-based cohort study included all first live singleton births (N = 483,459) between January 2006 and December 2016. The association of dispensed antibiotics with autism and ADHD in children aged ≤ 11 years was estimated by applying multivariable logistic regression and generalised estimating equations models.
Results: Of the mothers, 25.9% (n = 125,106) were dispensed ≥1 antibiotic during the exposure period (from 3 months pre-conception to delivery), and 41.6% (n = 201,040) of the children received ≥ 1 antibiotic in early life (aged ≤ 2 years). Penicillin was the most prescribed antibiotic class (17.9% of mothers, 38.2% of children). Maternal antibiotic use was associated with an increased risk of autism [odds ratio (OR) = 1.16, 95% confidence interval (CI) 1.09-1.23] and ADHD (OR = 1.29, 95% CI 1.21-1.36) in childhood. Early-life exposure to antibiotics showed an even stronger association [autism (OR = 1.46, 95% CI 1.38-1.55); ADHD (OR = 1.90, 95% CI 1.80-2.00)]. Both maternal and childhood-exposure sub-analyses suggested a dose-response relationship.
Conclusion: Maternal and early-life antibiotic use was associated with an increased risk of autism and ADHD in childhood. However, differences were noted by exposure period and antibiotic classes.
(© 2023. The Author(s).)
Databáze: MEDLINE
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