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Prenatal and postnatal exposure to antibiotics and risk of food allergy in the offspring: A nationwide birth cohort study in South Korea

Authors
 Jiyeon Oh  ;  Myeongcheol Lee  ;  Jaeyu Park  ;  Hyeon Jin Kim  ;  Seung Won Lee 4, Masoud Rahmati  ;  Ai Koyanagi  ;  Lee Smith  ;  Min Seo Kim  ;  Guillermo F López Sánchez  ;  Elena Dragioti  ;  Chanyang Min  ;  Nikolaos G Papadopoulos  ;  Youn Ho Shin  ;  Jae Il Shin  ;  Dong Keon Yon 
Citation
 PEDIATRIC ALLERGY AND IMMUNOLOGY, Vol.35(3) : e14114, 2024-03 
Journal Title
PEDIATRIC ALLERGY AND IMMUNOLOGY
ISSN
 0905-6157 
Issue Date
2024-03
MeSH
Anti-Bacterial Agents / adverse effects ; Child ; Cohort Studies ; Female ; Food Hypersensitivity* / prevention & control ; Humans ; Infant ; Infant, Newborn ; Male ; Mothers ; Pregnancy ; Prenatal Exposure Delayed Effects* / chemically induced ; Prenatal Exposure Delayed Effects* / epidemiology
Keywords
antibiotics ; children ; food allergy ; microbiome ; pregnancy
Abstract
Background: There are only preliminary studies examining the associations of postnatal antibiotic exposure with food allergy in childhood, and the effect of antibiotic exposure in utero has not been resolved. Thus, we aimed to investigate the effect of prenatal and postnatal antibiotic exposure on the risk of food allergy in childhood. Methods: Using the nationwide birth cohort in South Korea, all 3,163,206 infants (pairing mother; n = 2,322,735) born in South Korea between 2010 and 2017 were included in the analysis. The primary outcome was the diagnosis of food allergy, and the observation period was between January 1, 2009, and December 31, 2020. We implemented four different designs for the study, which consisted of a full unmatched cohort, 1:1 propensity-matched cohort, sibling comparison cohort, and health screening cohort along with multiple subgroup analyses. Results: During the follow-up period (median 6.92 years [IQR, 4.72–9.00]) of the 3,161,858 infants (52.6% male) in the birth cohort, 29,973 (1.9%) were diagnosed with food allergies. After a 1:1 propensity score matching, the use of antibiotics increased the risk of overall food allergy (prenatal [HR, 1.05; 95% CI, 1.04–1.09] and postnatal [HR, 1.05; 95% CI, 1.01–1.10] periods). The association was more significantly accentuated when antibiotic exposure was used in the short term, and the children were born preterm or with low birthweight; however, a trimester-specific effect was not observed. We observed more pronounced risks of food allergy in the health screening cohort (prenatal, 17%; postnatal, 15%), thus addressing the adverse effects of critical factors including maternal BMI, smoking status, and type of infant feeding. Similar trends were observed across all four differnt cohorts. Conclusion: This study reported a moderate association between early-life antibiotic use and subsequent food allergy during childhood throughout four different designs of analyses. This study suggests that clinicians need to consider the risks and benefits of antibiotics when administering antibiotics to individuals in the prenatal and postnatal periods.
Full Text
https://pubmed.ncbi.nlm.nih.gov/38529692/
DOI
10.1111/pai.14114
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/201076
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