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Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study

INTRODUCTION: Antibiotics represent the most common type of medication used during pregnancy and infancy. Antibiotics have been proposed as a possible factor in changes in microbiota composition, which may play a role in the aetiology of autism and attention deficit/hyperactivity disorder (ADHD). Ou...

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Autores principales: Njotto, Lembris L., Simin, Johanna, Fornes, Romina, Odsbu, Ingvild, Mussche, Isabelle, Callens, Steven, Engstrand, Lars, Bruyndonckx, Robin, Brusselaers, Nele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164008/
https://www.ncbi.nlm.nih.gov/pubmed/37087706
http://dx.doi.org/10.1007/s40264-023-01297-1
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author Njotto, Lembris L.
Simin, Johanna
Fornes, Romina
Odsbu, Ingvild
Mussche, Isabelle
Callens, Steven
Engstrand, Lars
Bruyndonckx, Robin
Brusselaers, Nele
author_facet Njotto, Lembris L.
Simin, Johanna
Fornes, Romina
Odsbu, Ingvild
Mussche, Isabelle
Callens, Steven
Engstrand, Lars
Bruyndonckx, Robin
Brusselaers, Nele
author_sort Njotto, Lembris L.
collection PubMed
description INTRODUCTION: Antibiotics represent the most common type of medication used during pregnancy and infancy. Antibiotics have been proposed as a possible factor in changes in microbiota composition, which may play a role in the aetiology of autism and attention deficit/hyperactivity disorder (ADHD). Our aim was to investigate the association between maternal and early-life antibiotic use and autism and ADHD in childhood. METHODS: This Swedish nation-wide population-based cohort study included all first live singleton births (N = 483,459) between January 2006 and December 2016. The association of dispensed antibiotics with autism and ADHD in children aged ≤ 11 years was estimated by applying multivariable logistic regression and generalised estimating equations models. RESULTS: Of the mothers, 25.9% (n = 125,106) were dispensed ≥1 antibiotic during the exposure period (from 3 months pre-conception to delivery), and 41.6% (n = 201,040) of the children received ≥ 1 antibiotic in early life (aged ≤ 2 years). Penicillin was the most prescribed antibiotic class (17.9% of mothers, 38.2% of children). Maternal antibiotic use was associated with an increased risk of autism [odds ratio (OR) = 1.16, 95% confidence interval (CI) 1.09–1.23] and ADHD (OR = 1.29, 95% CI 1.21–1.36) in childhood. Early-life exposure to antibiotics showed an even stronger association [autism (OR = 1.46, 95% CI 1.38–1.55); ADHD (OR = 1.90, 95% CI 1.80–2.00)]. Both maternal and childhood-exposure sub-analyses suggested a dose-response relationship. CONCLUSION: Maternal and early-life antibiotic use was associated with an increased risk of autism and ADHD in childhood. However, differences were noted by exposure period and antibiotic classes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40264-023-01297-1.
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spelling pubmed-101640082023-05-08 Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study Njotto, Lembris L. Simin, Johanna Fornes, Romina Odsbu, Ingvild Mussche, Isabelle Callens, Steven Engstrand, Lars Bruyndonckx, Robin Brusselaers, Nele Drug Saf Original Research Article INTRODUCTION: Antibiotics represent the most common type of medication used during pregnancy and infancy. Antibiotics have been proposed as a possible factor in changes in microbiota composition, which may play a role in the aetiology of autism and attention deficit/hyperactivity disorder (ADHD). Our aim was to investigate the association between maternal and early-life antibiotic use and autism and ADHD in childhood. METHODS: This Swedish nation-wide population-based cohort study included all first live singleton births (N = 483,459) between January 2006 and December 2016. The association of dispensed antibiotics with autism and ADHD in children aged ≤ 11 years was estimated by applying multivariable logistic regression and generalised estimating equations models. RESULTS: Of the mothers, 25.9% (n = 125,106) were dispensed ≥1 antibiotic during the exposure period (from 3 months pre-conception to delivery), and 41.6% (n = 201,040) of the children received ≥ 1 antibiotic in early life (aged ≤ 2 years). Penicillin was the most prescribed antibiotic class (17.9% of mothers, 38.2% of children). Maternal antibiotic use was associated with an increased risk of autism [odds ratio (OR) = 1.16, 95% confidence interval (CI) 1.09–1.23] and ADHD (OR = 1.29, 95% CI 1.21–1.36) in childhood. Early-life exposure to antibiotics showed an even stronger association [autism (OR = 1.46, 95% CI 1.38–1.55); ADHD (OR = 1.90, 95% CI 1.80–2.00)]. Both maternal and childhood-exposure sub-analyses suggested a dose-response relationship. CONCLUSION: Maternal and early-life antibiotic use was associated with an increased risk of autism and ADHD in childhood. However, differences were noted by exposure period and antibiotic classes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40264-023-01297-1. Springer International Publishing 2023-04-23 2023 /pmc/articles/PMC10164008/ /pubmed/37087706 http://dx.doi.org/10.1007/s40264-023-01297-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research Article
Njotto, Lembris L.
Simin, Johanna
Fornes, Romina
Odsbu, Ingvild
Mussche, Isabelle
Callens, Steven
Engstrand, Lars
Bruyndonckx, Robin
Brusselaers, Nele
Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study
title Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study
title_full Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study
title_fullStr Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study
title_full_unstemmed Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study
title_short Maternal and Early-Life Exposure to Antibiotics and the Risk of Autism and Attention-Deficit Hyperactivity Disorder in Childhood: a Swedish Population-Based Cohort Study
title_sort maternal and early-life exposure to antibiotics and the risk of autism and attention-deficit hyperactivity disorder in childhood: a swedish population-based cohort study
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164008/
https://www.ncbi.nlm.nih.gov/pubmed/37087706
http://dx.doi.org/10.1007/s40264-023-01297-1
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