Abstract
BackgroundPrenatal antibiotic exposure has been associated with an altered infant gut microbiome composition and higher risk of childhood obesity, but no studies have examined if prenatal antibiotics simultaneously alter the gut microbiome and adiposity in infants.MethodIn this prospective study (Nurture: recruitment 2013–2015 in North Carolina, United States), we examined in 454 infants the association of prenatal antibiotic exposure (by any prenatal antibiotic exposure; by trimester of pregnancy; by number of courses; by type of antibiotics) with infant age- and sex-specific weight-for-length z score (WFL-z) and skinfold thicknesses (subscapular, triceps, abdominal) at 12 months of age. In a subsample, we also examined whether prenatal antibiotic exposure was associated with alterations in the infant gut microbiome at ages 3 and 12 months.ResultsCompared to infants not exposed to prenatal antibiotics, infants who were exposed to any prenatal antibiotics had 0.21 (95% confidence interval [CI] 0.02, 0.41) higher WFL-z at 12 months, and 0.28 (95% CI 0.02, 0.55) higher WFL-z if they were exposed to antibiotics in the second trimester, after adjustment for potential confounders, birth weight, and gestational age. We also observed a dose-dependent association (P-value for trend = 0.006) with infants exposed to ≥ 3 courses having 0.41 (95% CI 0.13, 0.68) higher WFL-z at 12 months. After further adjustment for delivery method, only second-trimester antibiotic exposure remained associated with higher infant WFL-z (0.27, 95% CI 0.003, 0.54) and subscapular skinfold thickness (0.49 mm, 95% CI 0.11, 0.88) at 12 months. Infants exposed to second-trimester antibiotics versus not had differential abundance of 13 bacterial amplicon sequence variants (ASVs) at age 3 months and 17 ASVs at 12 months (false discovery rate adjusted P-value < 0.05).ConclusionsPrenatal antibiotic exposure in the second trimester was associated with an altered infant gut microbiome composition at 3 and 12 months and with higher infant WFL-z and subscapular skinfold thickness at 12 months.
Highlights
Prenatal antibiotic exposure has been associated with an altered infant gut microbiome composi‐ tion and higher risk of childhood obesity, but no studies have examined if prenatal antibiotics simultaneously alter the gut microbiome and adiposity in infants
After adjusting for potential confounders (Model 1), infants exposed to prenatal antibiotics had 0.23 higher weight-for-length z score (WFL-z) at 12 months, compared to infants who were not exposed
While there were no significant associations of any prenatal antibiotic exposure with infant skinfold thicknesses, subscapular skinfold thickness (SS) + triceps skinfold thickness (TR), or subscapular to triceps skinfold thicknesses (SS/TR) at 12 months after adjusting for confounders (Additional file 2: Table S1), we found that ≥ 3 courses of prenatal antibiotics was associated with 0.68
Summary
Prenatal antibiotic exposure has been associated with an altered infant gut microbiome composi‐ tion and higher risk of childhood obesity, but no studies have examined if prenatal antibiotics simultaneously alter the gut microbiome and adiposity in infants. Despite efforts to prevent obesity, the prevalence of childhood obesity has more than tripled in the past 40 years [1]. It reached a historical high of 18.5% in 2015–2016 in. No studies have examined whether prenatal antibiotics simultaneously affect adiposity and the gut microbiome in infancy To address this gap, we examined associations of prenatal antibiotics with infant weight and adiposity measures at 12 months and, for mechanistic insight, explored associations with the infant gut microbiome at ages 3 and 12 months
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