Journal Article

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

Becker, A B, Azad, M B, Bridgman, S L, Kozyrskyj, A L

2014

Overview

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.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 631/326/22/1290 / 692/420 / 692/698/2741/2135 / 692/699/2743/393 / Adipose tissue / Age / Age of Onset / Anti-Bacterial Agents - administration & dosage / Anti-Bacterial Agents - adverse effects / Antibiotics / Asthma / Babies / Biological and medical sciences / Birth weight / Body Mass Index / Body weight / Breast feeding / Canada - epidemiology / Care and treatment / Child / Child, Preschool / Childhood / Children / Children & youth / Childrens health / Cohort analysis / Cohort Studies / Complications and side effects / Confidence intervals / Disruption / Environmental Exposure - adverse effects / Epidemics / Epidemiology / Exposure / Female / Gender / General aspects / Health care / Health Promotion and Disease Prevention / Humans / Infant / Infant, Newborn / Infants / Internal Medicine / Intestinal microflora / Longitudinal Studies / Male / Medical research / Medical sciences / Medicine / Medicine & Public Health / Medicine, Experimental / Metabolic Diseases / Microbiota / Microbiota - drug effects / Microbiota - immunology / Obesity / Obesity, Abdominal - epidemiology / Obesity, Abdominal - etiology / Obesity, Abdominal - immunology / Overweight / pediatric-original-article / Prevalence / Public Health / Risk Factors / Sex Factors / Statistical analysis / Weight Gain - drug effects / Weight Gain - immunology