본문 바로가기
KERD
논문KCI 등재

Prenatal and Perinatal Antibiotic Exposure and Long-Term Outcome

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류소아과학

초록

Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection–related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.

Abstract

Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection–related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.

참고문헌 (36)

  1. Bookstaver PB, "A review of antibiotic use in pregnancy", Pharmacotherapy, 35, pp.1052~1062 (2015)
  2. Ghouri F, "A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy", BMC Pregnancy Childbirth, 18, pp.99~ (2018)
  3. Soma-Pillay P, "Physiological changes in pregnancy", Cardiovasc J Afr, 27, pp.89~94 (2016)
  4. Chong CYL, "Factors affecting gastrointestinal microbiome development in neonates", Nutrients, 10, pp.274~ (2018)
  5. Walker WA, "Bacterial colonization of the newborn gut, immune development, and prevention of disease", Nestle Nutr Inst Workshop Ser, 88, pp.23~33 (2017)
  6. Alhasan MM, "Antibiotic use during pregnancy increases offspring asthma severity in a dose-dependent manner", Allergy, 75, pp.1979~1990 (2020)
  7. Hu Y, "Different immunological responses to early-life antibiotic exposure affecting autoimmune diabetes development in NOD mice", J Autoimmun, 72, pp.47~56 (2016)
  8. Tormo-Badia N, "Antibiotic treatment of pregnant non-obese diabetic mice leads to altered gut microbiota and intestinal immunological changes in the offspring", Scand J Immunol, 80, pp.250~260 (2014)
  9. Champagne-Jorgensen K, "Prenatal low-dose penicillin results in long-term sex-specific changes to murine behaviour, immune regulation, and gut microbiota", Brain Behav Immun, 84, pp.154~163 (2020)
  10. Gonzalez-Perez G, "Maternal antibiotic treatment impacts development of the neonatal intestinal microbiome and antiviral immunity", J Immunol, 196, pp.3768~3779 (2016)
  11. Degroote S, "Maternal gut and fetal brain connection : Increased anxiety and reduced social interactions in Wistar rat offspring following peri-conceptional antibiotic exposure", Prog Neuropsychopharmacol Biol Psychiatry, 71, pp.76~82 (2016)
  12. O’Connor R, "Maternal antibiotic administration during a critical developmental window has enduring neurobehavioural effects in offspring mice", Behav Brain Res, 404, pp.113156~ (2021)
  13. Zhang Q, "Physiological and behavioral responses in offspring mice following maternal exposure to sulfamonomethoxine during pregnancy", Neurosci Lett, 624, pp.8~16 (2016)
  14. Cunha AJLA, "Use of antibiotics during pregnancy is associated with infection in children at four years of age in Portugal", Acta Paediatr, 110, pp.1911~1915 (2021)
  15. Pedersen TM, "Antibiotics in pregnancy increase children’s risk of otitis media and ventilation tubes", J Pediatr, 183, pp.153~158 (2017)[DOI]
  16. Miller JE, "Maternal antibiotic exposure during pregnancy and hospitalization with infection in offspring : a population-based cohort study", Int J Epidemiol, 47, pp.561~571 (2018)
  17. Örtqvist AK, "Fetal and early life antibiotics exposure and very early onset inflammatory bowel disease : a population-based study", Gut, 68, pp.218~225 (2019)
  18. Timm S, "Prenatal antibiotics and atopic dermatitis among 18-month-old children in the Danish National Birth Cohort", Clin Exp Allergy, 47, pp.929~936 (2017)
  19. Wohl DL, "Intrapartum antibiotics and childhood atopic dermatitis", J Am Board Fam Med, 28, pp.82~89 (2015)
  20. Higgins D, "Infant wheezing and prenatal antibiotic exposure and mode of delivery : a prospective birth cohort study", J Asthma, 58, pp.770~781 (2021)
  21. Metsälä J, "Prenatal and post-natal exposure to antibiotics and risk of asthma in childhood", Clin Exp Allergy, 45, pp.137~145 (2015)
  22. Mulder B, "Antibiotic use during pregnancy and asthma in preschool children : the influence of confounding", Clin Exp Allergy, 46, pp.1214~1226 (2016)
  23. Loewen K, "Prenatal antibiotic exposure and childhood asthma : a population-based study", Eur Respir J, 52, pp.1702070~ (2018)
  24. Turi KN, "Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma", Clin Infect Dis, 72, pp.455~462 (2022)
  25. Metzler S, "Association between antibiotic treatment during pregnancy and infancy and the development of allergic diseases", Pediatr Allergy Immunol, 30, pp.423~433 (2019)
  26. Baron R, "The relationship of prenatal antibiotic exposure and infant antibiotic administration with childhood allergies : a systematic review", BMC Pediatr, 20, pp.312~ (2020)
  27. Huang FQ, "Maternal exposure to antibiotics increases the risk of infant eczema before one year of life : a meta-analysis of observational studies", World J Pediatr, 16, pp.143~151 (2020)
  28. Cassidy-Bushrow AE, "Prenatal antimicrobial use and early-childhood body mass index", Int J Obes(Lond), 42, pp.1~7 (2018)
  29. Baron R, "The relationship of prenatal and infant antibiotic exposure with childhood overweight and obesity : a systematic review", J Dev Orig Health Dis, 11, pp.335~349 (2020)
  30. Mor A, "Prenatal exposure to systemic antibacterials and overweight and obesity in Danish schoolchildren : a prevalence study", Int J Obes(Lond), 39, pp.1450~1455 (2015)
  31. Wan S, "Impact of exposure to antibiotics during pregnancy and infancy on childhood obesity : a systematic review and meta-analysis", Obesity(Silver Spring), 28, pp.793~802 (2020)
  32. Leong KSW, "Associations of prenatal and childhood antibiotic exposure with obesity at age 4 years", JAMA Netw Open, 3, pp.e1919681~ (2020)
  33. Jess T, "Antibiotic use during pregnancy and childhood overweight : a population-based nationwide cohort study", Sci Rep, 9, pp.11528~ (2019)
  34. Zimmermann P, "Effect of intrapartum antibiotics on the intestinal microbiota of infants : a systematic review", Arch Dis Child Fetal Neonatal Ed, 105, pp.201~208 (2020)
  35. Metz TD, "Exposure to group B Streptococcal antibiotic prophylaxis and early childhood body mass index in a vaginal birth cohort", J Matern Fetal Neonatal Med, 33, pp.3318~3323 (2020)
  36. Hamad AF, "Prenatal antibiotics exposure and the risk of autism spectrum disorders : a population-based cohort study", PLoS One, 14, pp.e0221921~ (2019)

관련 논문AI추천

이 간행물의 다른 논문 (3건)