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Antibiotics in pregnancy increase children's risk of otitis media and ventilation tubes.

https://arctichealth.org/en/permalink/ahliterature283543
Source
J Pediatr. 2017 Apr;183:153-158.e1
Publication Type
Article
Date
Apr-2017
Author
Tine Marie Pedersen
Jakob Stokholm
Jonathan Thorsen
Anna-Rosa Cecilie Mora-Jensen
Hans Bisgaard
Source
J Pediatr. 2017 Apr;183:153-158.e1
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Acute Disease
Age Distribution
Anti-Bacterial Agents - adverse effects - therapeutic use
Child, Preschool
Cohort Studies
Confidence Intervals
Denmark
Female
Humans
Incidence
Infant
Male
Maternal Exposure - adverse effects
Middle Ear Ventilation - methods - statistics & numerical data
Otitis Media - epidemiology - etiology - surgery
Pregnancy
Pregnancy Complications, Infectious - drug therapy
Prenatal Exposure Delayed Effects - epidemiology
Prognosis
Registries
Retrospective Studies
Risk assessment
Sex Distribution
Abstract
To study the association between antibiotic intake in pregnancy and the development of otitis media and placement of ventilation tubes (VTs) in the offspring under the hypothesis that antibiotics in pregnancy may alter the offspring's propensity for disease.
Data from the 700 children in the Copenhagen Prospective Studies on Asthma in Childhood 2010 unselected birth cohort study were used. Information on maternal antibiotic use and other exposures during pregnancy was collected prospectively from interviews and validated in national registries. Otitis media episodes were registered in a prospective diary for 3 years. Information regarding children's VTs was obtained from national registries.
There were 514 children who had diary information and were included in the analysis regarding otitis media episodes. For VTs analysis, 699 children were included. Thirty-seven percent of the mothers received antibiotics during pregnancy, and this was associated with increased risk of otitis media (adjusted hazard ratio 1.30; 95% CI 1.04-1.63; P?=?.02). The risk of receiving VTs was especially associated with third trimester antibiotics (adjusted hazard ratio 1.60; 95% CI 1.08-2.36, P?=?.02). The risk of otitis media increased with increasing number of treatments (per-level adjusted hazard ratio 1.20; 95% CI 1.04-1.40; P?=?.02), but for VTs this association was not significant after adjustment.
Maternal use of antibiotics during pregnancy is associated with an increased risk of otitis media and VT insertions in the offspring. Antibiotics late in pregnancy mainly contributed to these effects, pointing toward potential transmission of an unfavorable microbiome from mother to child.
PubMed ID
28088397 View in PubMed
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Cesarean section changes neonatal gut colonization.

https://arctichealth.org/en/permalink/ahliterature283728
Source
J Allergy Clin Immunol. 2016 Sep;138(3):881-889.e2
Publication Type
Article
Date
Sep-2016
Author
Jakob Stokholm
Jonathan Thorsen
Bo L Chawes
Susanne Schjørring
Karen A Krogfelt
Klaus Bønnelykke
Hans Bisgaard
Source
J Allergy Clin Immunol. 2016 Sep;138(3):881-889.e2
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Adult
Bacteria - isolation & purification
Cohort Studies
Delivery, Obstetric - methods
Denmark
Feces - microbiology
Female
Humans
Infant
Infant, Newborn
Intestines - microbiology
Male
Microbiota
Pregnancy
Trachea - microbiology
Abstract
Delivery by means of cesarean section has been associated with increased risk of childhood immune-mediated diseases, suggesting a role of early bacterial colonization patterns for immune maturation.
We sought to describe the influence of delivery method on gut and airway colonization patterns in the first year of life in the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) birth cohort.
Seven hundred children from the COPSAC2010 birth cohort participated in this analysis. Fecal samples were collected at age 1 week, 1 month, and 1 year, and hypopharyngeal aspirates were collected at age 1 week, 1 month, and 3 months and cultured for bacteria. Detailed information on delivery method, intrapartum antibiotics, and lifestyle factors was obtained by personal interviews.
Seventy-eight percent of the children were born by means of natural delivery, 12% by means of emergency cesarean section, and 9% by means of elective cesarean section. Birth by means of cesarean section was significantly associated with colonization of the intestinal tract by Citrobacter freundii, Clostridium species, Enterobacter cloacae, Enterococcus faecalis, Klebsiella oxytoca, Klebsiella pneumoniae, and Staphylococcus aureus at age 1 week, whereas colonization by Escherichia coli was associated with natural birth. At age 1 month, these differences were less prominent, and at age 1 year, they were not apparent, which was confirmed by means of multivariate data-driven partial least squares analyses. The initial airway microbiota was unaffected by birth method.
Delivery by means of cesarean section was associated with early colonization patterns of the neonatal gut but not of the airways. The differences normalized within the first year of life. We speculate that microbial derangements, as indicated in our study, can demonstrate a possible link between delivery by means of cesarean section and immune-mediated disease.
PubMed ID
27045582 View in PubMed
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