• 纳入6853名儿童数据,记录系统中登记的48个月之前抗生素处方,并计算年龄别BMI-z分数;
  • 4岁前婴儿抗生素暴露率为95%,而4.5岁肥胖率为9%;
  • 抗生素处方在4次及以上的,BMI-z分数平均值更高,而1-3次的和无抗生素暴露的无统计学差异;
  • 处方数大于9次的儿童,未来肥胖的风险增高3.42倍;
  • 在出生后一年内暴露抗生素的儿童BMI-z分数更高,而在1年后暴露的儿童则无此关联;
  • 儿童抗生素暴露或许是通过改变肠道菌群而增加肥胖风险。

Association of Repeated Antibiotic Exposure Up to Age 4 Years With Body Mass at Age 4.5 Years



01-22, Article

Abstract & Authors:展开

IMPORTANCE: Antibiotic exposures in early life may affect weight by altering gut microbiota, potentially increasing the likelihood of childhood obesity
OBJECTIVE: To examine whether repeated antibiotic exposure by age 48 months is associated with higher body mass index (BMI) at age 54 months
DESIGN, SETTING, AND PARTICIPANTS : This research was undertaken within a prospective cohort study in New Zealand (Growing Up in New Zealand) that recruited 6853 children antenatally during 2009 to 2010. At the 54-month follow-up, 5734 of 6156 children (93%) had their weight and height measured. Community pharmacy antibiotic dispensing data were obtained from the New Zealand Pharmaceutical Collection database for children whose parents consented to external data linkage. The analytic sample comprised singletons with 54-month weight and height measurements, community antibiotic dispensing and birth weight data, gestational age greater than 27 weeks, and no congenital anomalies. Data analysis took place from 2017 to 2018
EXPOSURES: Antibiotic exposure (yes or no), the number of dispensings, age at first exposure, and timing (age) of exposures between birth and age 48 months
MAIN OUTCOMES AND MEASURES : World Health Organization BMI-for-age z scores; and International Obesity Task Force overweight and obesity cutoff points that pass through adult BMI values of 25 and 30.
RESULTS: Of the 5128 singletons (2622 [51%] male; mean [SD] birth weight of 3527 [542] g), 4886 (95%) had an antibiotic prescription by age 48 months and 437 (9%) had obesity at age 54 months. Adjusted mean (SE) BMI-for-age z scores increased significantly with the number of antibiotic dispensings for 4 to 6, 7 to 9, and more than 9 dispensings (unexposed, 0.87 [0.09]; 1-3 exposures, 0.92 [0.06] [P = .57]; 4-6 exposures, 1.06 [0.06] [P = .02]; 7-9 exposures, 1.06 [0.06] [P = .02]; >9 exposures, 1.08 [0.05] [P = .01]). Additionally, receiving more than 9 dispensings was associated with greater likelihood of obesity compared with no exposure (adjusted odds ratio, 2.41; 95% CI, 1.07- 5.41). Children whose exposure began in the first year of life had a higher adjusted mean (SD) BMI-for-age z score than those not exposed (1.06 [0.05] vs 0.89 [0.09]; P = .03), whereas those whose exposure commenced after the first year of life did not (1.02 [0.06] vs 0.89 [0.09]; P = .10).
CONCLUSIONS AND RELEVANCE : In this study, repeated antibiotic exposure in early childhood was associated with higher mean BMI-for-age z score and an increased likelihood of obesity. Future research could examine whether interventions such as antibiotic stewardship programs, which are designed to reduce overprescribing of antibiotics, also reduce early childhood obesity

First Authors:
Carol Chelimo

Correspondence Authors:
Carol Chelimo

All Authors:
Carol Chelimo,Carlos A Camargo,Susan M B Morton,Cameron C Grant

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Is Childhood Antibiotic Exposure Linked to Obesity?