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Prenatal exposure to systemic antibacterials and overweight and obesity in Danish schoolchildren: a prevalence study

Abstract

Background/Objective:

Prenatal exposure to antibacterials may permanently dysregulate fetal metabolic patterns via epigenetic pathways or by altering maternal microbiota. We examined the association of prenatal exposure to systemic antibacterials with overweight and obesity in schoolchildren.

Subjects/Methods:

We conducted a prevalence study among Danish schoolchildren aged 7–16 years using data from routine school anthropometric evaluations conducted during 2002–2013. Prenatal exposure to antibacterials was ascertained by using maternal prescription dispensations and infection-related hospital admissions during pregnancy. We defined overweight and obesity among the children using standard age- and sex-specific cutoffs. We computed sex-specific adjusted prevalence ratios (aPRs) of overweight and obesity associated with exposure to prenatal antibacterials, adjusting for maternal age at delivery, marital status, smoking in pregnancy and multiple gestation; we also stratified the analyses by birth weight.

Results:

Among 9886 schoolchildren, 3280 (33%) had prenatal exposure to antibacterials. aPRs associated with the exposure were 1.26 (95% confidence interval (CI): 1.10–1.45) for overweight and 1.29 (95% CI: 1.03–1.62) for obesity. Among girls, aPRs were 1.16 (95% CI: 0.95–1.42) for overweight and 1.27 (95% CI: 0.89 to 1.82) for obesity. Among boys, aPRs were 1.37 (95% CI: 1.13–1.66) for overweight and 1.29 (95% CI: 0.96–1.73) for obesity. The aPR for overweight was higher among schoolchildren with birth weight <3500 g (aPR: 1.30, 95% CI: 1.05–1.61) than in schoolchildren with birth weight 3500 g (aPR: 1.18, 95% CI: 0.95–1.46). Inversely, the association for obesity was higher among schoolchildren with birth weight 3500 g (aPR: 1.35, 95% CI: 1.00–1.81) than among those who were <3500 g at birth (aPR: 1.16, 95% CI: 0.82–1.65).

Conclusions:

Prenatal exposure to systemic antibacterials is associated with an increased risk of overweight and obesity at school age, and this association varies by birth weight.

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Acknowledgements

We thank Jasper Kondrup Christensen, Preben Selgen Pedersen, IT-Centre, and Aalborg Kommune for assistance with data collection. This research was supported by the Clinical Epidemiology Research Foundation, Aarhus University Hospital, Aarhus, Denmark. The study also received support from the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) project, which is supported by the Danish Agency for Science (grant no. 09-067009 and 09-075724), the Danish Health and Medicines Authority, the Danish Diabetes Association and an unrestricted donation from Novo Nordisk A/S. The Department of Clinical Epidemiology, Aarhus University Hospital, receives funding for other studies from companies in the form of research grants to (and administered by) Aarhus University. The Novo Nordisk Foundation Center for Basic Metabolic Research is an independent Research Center at the University of Copenhagen partially funded by an unrestricted donation from the Novo Nordisk Foundation.

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Correspondence to A Mor.

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Mor, A., Antonsen, S., Kahlert, J. et al. Prenatal exposure to systemic antibacterials and overweight and obesity in Danish schoolchildren: a prevalence study. Int J Obes 39, 1450–1455 (2015). https://doi.org/10.1038/ijo.2015.129

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