The Impact of Antibiotic Exposure during Prenatal and Infant Period on Childhood Overweight and Obesity: A Meta-Analysis of Population-Based Cohort Studies

Abstract

Background/Aim: Studies have reported inconsistent results concerning the association of antibiotic exposure during prenatal and infant period with childhood overweight/obesity. We performed a meta-analysis to examine whether antibiotics exposure in early life increases the risk of childhood overweight/obesity. Methods: PubMed, Embase, Medline and Web of Science were searched using different combinations of two groups of keywords: ‘antibiotic(s)’ and ‘overweight/obesity/weight gain/adipogenesis/adiposity/body mass’. Cohort studies that reported the association of antibiotics use during prenatal or infant period (0-2 years) with childhood (3–12 years) overweight/obesity were eligible. Where possible, adjusted risk estimates were pooled using a random effects model; otherwise unadjusted estimates were pooled. Statistical heterogeneity was assessed with I2 statistics; the values of 25%, 50% and 75% were considered to indicate low, medium and high heterogeneity, respectively. We conducted a subgroup analysis to identify the sources of heterogeneity according to the gender of children. Results: In total, eight cohort studies were identified and sex-specific risk estimates were included in the meta-analysis. The overall pooled odds ratio (OR) of childhood overweight/obesity for pregnant women and infant exposed to antibiotics compared with those who are not exposed to antibiotics was 1.19 (95%confidence interval (CI) 1.08, 1.31; I2=85%); In subgroup analysis, the overall pooled OR was 1.52 for boys (1.20, 1.93; I2=22%) and 1.15 for girls (0.90, 1.46; I2=0%). The ORs for childhood overweight and obesity tended to be lower for females compared with males. Conclusions: Our results indicated that antibiotic exposure during prenatal and infant period was moderately associated with childhood overweight and obesity. Gender difference could be explained by the generally lower risk of overweight in girls. Further research might be needed to better understand the mechanism of gender difference on the antibiotics–overweight/obesity relationship. This finding has public health implications, given the antibiotic abuse in many countries.