Influence of antibiotics given during labour and birth on body mass index z scores in children in the All Our Families pregnancy cohort

The Contributions of delivery mode and intrapartum antibiotic exposure to body mass index among children through 5 years of age

OBJECTIVE

To investigate independent effects of group B Streptococcus (GBS) intrapartum antibiotic prophylaxis (IAP) and cesarean delivery (CD) on body mass index (BMI) during early childhood.

STUDY DESIGN

Retrospective cohort study of infants (n = 157,820) born 2007-2015 in an integrated healthcare system. Exposures were delivery mode (CD or vaginal delivery [VD]) and GBS IAP exposure. CD was further divided into elective CD (without labor or rupture of membrane [ROM]) or unscheduled CD (following labor and/or ROM). BMI over 5 years was compared using non-linear multivariate models with B-splines, adjusted for demographics, maternal medical and obstetrical factors, and childhood antibiotic exposure.

RESULTS

At age 5 years, unscheduled CD without GBS IAP (Δ BMI 0.11 kg/m2, 95 % CI 0.06 to 0.16, p < 0.0001) and unscheduled CD with GBS IAP (Δ BMI 0.24 kg/m2, 95 % CI 0.11 to 0.36 kg/m2, p = 0.0002) were positively associated with higher BMI compared to their VD counterparts, respectively. No BMI difference was observed between children born by elective versus unscheduled CD. GBS IAP exposure was positively associated with increased BMI compared to non-exposed births in both VD (Δ BMI 0.07 kg/m2, 95 % CI 0.02 to 0.13 kg/m2, p = 0.0125) and CD (Δ BMI 0.22 kg/m2, 95 % CI 0.09 to 0.35 kg/m2, p = 0.0009).

CONCLUSIONS

Based on our findings, the widespread administration of GBS IAP and birth by cesarean delivery independently contribute to a significant upshift in body weight early in life that compares to or is higher than the annual increase in BMI in U.S. children on a population level.

Antibiotic Exposure and Childhood Overweight/Obesity: Evidence from Epidemiological and Experimental Studies

Childhood overweight and obesity are nutritional disorders in which children's energy intake exceeds energy consumption for a long period, resulting in the excessive accumulation of body fat and weight that exceeds a certain range. It is one of the most serious public health issues. In recent years, its prevalence has shown a significant upward trend, and 41-80% of childhood obesity can persist into adulthood. Scholars are now more interested in researching this further. Since antibiotics have been used extensively since their discovery, more focus has been paid to the possible risks these medications pose to children who are exposed to them. Recently, some studies have explored the possible link between antibiotic exposure and the prevalence of overweight and obesity in children. However, their findings are inconsistent. Therefore, this review aims to synthesize and summarize the studies related to the effects of antibiotics on childhood obesity, elucidate the possible associations between the two, and provide an in-depth discussion of the potential biological mechanisms by which antibiotics exposure may contribute to childhood obesity.

Intrapartum antibiotic use is associated with higher child body mass index (BMI) z-score at 4 years of age

Early life antibiotic exposure may increase obesity risk. We investigated if prenatal, intrapartum, or childhood antibiotic use is associated with child zBMI score at 4 yrs of age. We included data from the Alberta Pregnancy Outcomes and Nutrition (APrON) study, a prospective cohort study, on maternal and child antibiotic exposure and clinic measures of height and weight at age 4 (n = 408). Prenatal and childhood antibiotic exposure was not associated with zBMI score. Maternal intrapartum antibiotic exposure was associated with a zBMI score increase of 0.12 (95 % CI; 0.04, 0.46) in children at 4 years of age compared to non-exposure intrapartum.

Early-life antibiotic exposure increases the risk of childhood overweight and obesity in relation to dysbiosis of gut microbiota: a birth cohort study

Background

Early-life antibiotic exposure is associated with the development of later obesity through the disruption of gut microbiota in the animal models. However, the related epidemiological evidence is still conflicting.

Methods

A birth cohort was consisted of 2140 mother-infant pairs in Chaoyang District Maternal and Child Health Care Hospital in this study. Here, their available antibiotic exposure during the first one year of life was ascertained using a open-ended questionnaire and related anthropometric parameters from the health screening program. The compositions of gut microbiota were comprehensively analyzed by16S rRNA high throughput sequencing. Then the spearman correlations were performed by the multiple covariance-adjusted regressions between the antibiotic exposure with anthropometric parameters and compositions of gut microbiota.

Results

Among the 2140 subjects, the antibiotic exposure during the first one year of life was 53.04%, mainly by Cephalosporins (53.39%) and Erythromycins(27.67%) for the treatment of respiratory tract infection (79.56%), which were not significantly different among the subgroups. Compared to the control group, both childhood overweight and obesity at two and a half years were higher in the antibiotic exposed group, with higher percents of Faecalibacterium, Agathobacter and Klebsiella, and lower percentage of Bifidobacterium. Moreover, there were positively potential associations between early-life antibiotic exposure with the accelerated anthropometric parameters and disruption of Faecalibacterium, Agathobacter, Klebsiella and Bifidobacterium at two and a half years.

Conclusion

These above results proved that early-life antibiotic exposure was positively associated with the accelerated childhood overweight and obesity from one year to two and a half years by impacting the disorders of Faecalibacterium, Agathobacter, Klebsiella and Bifidobacterium, which would propose the theoretical basis for rationalizing the personalized antibiotic exposure among the infants to truly reflect the fairness of public health.

Supplementary information

The online version contains supplementary material available at 10.1186/s12941-022-00535-1.