Abstract
BackgroundIncreasing evidence shows that antibiotic use in pregnancy may increase the risk of childhood asthma but epidemiologic studies are still limited and findings are inconsistent. Meanwhile, exclusive and prolonged breastfeeding may prevent children from allergic diseases. We aimed to assess the association between prenatal antibiotic use and the risk of childhood asthma, and explore whether breastfeeding modifies the risk.MethodsWe conducted a case-control study in Shanghai, China, from June 2015 to January 2016. A total of 634 asthma cases and 864 controls aged 3–12 years were included. Multiple logistic regressions were used to estimate crude and adjusted odds ratios (aOR).ResultsThe prevalence of antibiotic use in pregnancy in the cases and controls was 7.1 and 3.5%, respectively. A significant association between prenatal antibiotic use and childhood asthma was observed (aOR: 1.7, 95% CI: 1.0–2.9), particularly in boys (aOR: 2.2, 95% CI: 1.1–4.4) and children with family history of allergic disorders (aOR: 3.1, 95% CI: 1.2–8.4). However, this association existed only in children who were not breastfed exclusively in the first six months of life (aOR 2.6, 95% CI 1.3–5.1) but not in children who were exclusively breastfed (aOR 0.9, 95% CI 0.4–2.1). Likewise, exclusive breastfeeding also decreased the association between antibiotic use in pregnancy and asthma in boys and in children with family histories of allergic diseases.ConclusionsAntibiotic use in pregnancy was a risk factor for childhood asthma. However, this risk may be attenuated by exclusive breastfeeding in the first six months of life, especially among high-risk children.
Highlights
Increasing evidence shows that antibiotic use in pregnancy may increase the risk of childhood asthma but epidemiologic studies are still limited and findings are inconsistent
We examined the association between antibiotic exposure in pregnancy and childhood asthma
When the subjects were stratified by feeding patterns, the association became non-significant among children with exclusive breastfeeding within the first six months of life, whereas the association became stronger in children without exclusive breastfeeding
Summary
Increasing evidence shows that antibiotic use in pregnancy may increase the risk of childhood asthma but epidemiologic studies are still limited and findings are inconsistent. Limited evidence suggests that maternal use of antibiotics in pregnancy may increase the risk of asthma in childhood [4,5,6,7,8]. It was postulated that the composition of pathogenic and beneficial microbiota of newborns and, the development of infant. Several other factors, such as male gender and family history of allergic disorders, have long been found to be risk factors for childhood asthma [12]. The sex-based differences in childhood asthma has been hypothesized as due to sex difference in intrauterine gonadal steroid production and disadvantage of male in response to some in utero stress factors than female [15, 16]
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