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Infant antibiotic exposure and the development of childhood overweight and central adiposity

Abstract

Background:

Obesity has been associated with disruption of the gut microbiota, which is established during infancy and vulnerable to disruption by antibiotics.

Objectives:

To investigate the association between early-life antibiotic exposure and subsequent development of overweight and central adiposity.

Methods:

Provincial health-care records were linked to clinical and survey data from a Canadian longitudinal birth cohort study. Antibiotic exposure during the first year of life was documented from prescription records. Overweight and central adiposity were determined from anthropometric measurements at ages 9 (n=616) and 12 (n=431). Associations were determined by multiple logistic regression.

Results:

Infants receiving antibiotics in the first year of life were more likely to be overweight later in childhood compared with those who were unexposed (32.4 versus 18.2% at age 12, P=0.002). Following adjustment for birth weight, breastfeeding, maternal overweight and other potential confounders, this association persisted in boys (aOR 5.35, 95% confidence interval (CI) 1.94–14.72) but not in girls (aOR 1.13, CI 0.46–2.81). Similar gender-specific associations were found for overweight at age 9 (aOR 2.19, CI 1.06–4.54 for boys; aOR 1.20, CI 0.53–2.70 for girls) and for high central adiposity at age 12 (aOR 2.85, CI 1.24–6.51 for boys; aOR 1.59, CI 0.68–3.68 for girls).

Conclusions:

Among boys, antibiotic exposure during the first year of life was associated with an increased risk of overweight and central adiposity in preadolescence, indicating that antibiotic stewardship is particularly important during infancy. Given the current epidemic of childhood obesity and the high prevalence of infant antibiotic exposure, further studies are necessary to determine the mechanisms underlying this association, to identify the long-term health consequences, and to develop strategies for mitigating these effects when antibiotic exposure cannot be avoided.

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Acknowledgements

We sincerely thank the SAGE families and research team. We also acknowledge the Manitoba Centre for Health Policy (MCHP) for use of data contained in the Population Health Research Data Repository under project #2012/2013–24. The results and conclusions are those of the authors and no official endorsement by the MCHP, Manitoba Health, or other data providers is intended or should be inferred. This study was supported by the Canadian Institutes of Health Research. At the time of this research, MBA held a Banting Postdoctoral Fellowship and was supported by Alberta Innovates-Health Solutions. ALK held a Research Chair supported by the Women and Children's Health Research Institute/Stollery Children's Hospital Foundation.

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Azad, M., Bridgman, S., Becker, A. et al. Infant antibiotic exposure and the development of childhood overweight and central adiposity. Int J Obes 38, 1290–1298 (2014). https://doi.org/10.1038/ijo.2014.119

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