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Deianova N, de Boer NK, Aoulad Ahajan H, Verbeek C, Aarnoudse-Moens CSH, Leemhuis AG, van Weissenbruch MM, van Kaam AH, Vijbrief DC, Hulzebos CV, Giezen A, Cossey V, de Boode WP, de Jonge WJ, Benninga MA, Niemarkt HJ, de Meij TGJ. Duration of Neonatal Antibiotic Exposure in Preterm Infants in Association with Health and Developmental Outcomes in Early Childhood. Antibiotics (Basel) 2023; 12:967. [PMID: 37370287 DOI: 10.3390/antibiotics12060967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Over 90% of preterm neonates are, often empirically, exposed to antibiotics as a potentially life-saving measure against sepsis. Long-term outcome in association with antibiotic exposure (NABE) has insufficiently been studied after preterm birth. We investigated the association of NABE-duration with early-childhood developmental and health outcomes in preterm-born children and additionally assessed the impact of GA on outcomes. Preterm children (GA < 30 weeks) participating in a multicenter cohort study were approached for follow-up. General expert-reviewed health questionnaires on respiratory, atopic and gastrointestinal symptoms were sent to parents of children > 24 months' corrected age (CA). Growth and developmental assessments (Bayley Scales of Infant and Toddler Development (BSID) III) were part of standard care assessment at 24 months' CA. Uni- and multivariate regressions were performed with NABE (per 5 days) and GA (per week) as independent variables. Odds ratios (OR) for health outcomes were adjusted (aOR) for confounders, where appropriate. Of 1079 infants whose parents were approached, 347 (32%) responded at a mean age of 4.6 years (SD 0.9). In children with NABE (97%), NABE duration decreased by 1.6 days (p < 0.001) per week of gestation. Below-average gross-motor development (BSID-III gross-motor score < 8) was associated with duration of NABE (aOR = 1.28; p = 0.04). The aOR for constipation was 0.81 (p = 0.04) per gestational week. Growth was inversely correlated with GA. Respiratory and atopic symptoms were not associated with NABE, nor GA. We observed that prolonged NABE after preterm birth was associated with below-average gross-motor development at 24 months' CA, while a low GA was associated with lower weight and stature Z-scores and higher odds for constipation.
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Affiliation(s)
- Nancy Deianova
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Department of Pediatric Gastroenterology, Amsterdam UMC Location University of Amsterdam, Amsterdam Reproduction & Development Research Institute, 1105 AZ Amsterdam, The Netherlands
- Department of Neonatology, Máxima Medical Center, 5504 DB Veldhoven, The Netherlands
| | - Nanne K de Boer
- Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Hafsa Aoulad Ahajan
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Cilla Verbeek
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Cornelieke S H Aarnoudse-Moens
- Department of Neonatology, Emma Children's Hospital, Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Aleid G Leemhuis
- Department of Neonatology, Emma Children's Hospital, Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Mirjam M van Weissenbruch
- Department of Neonatology, Emma Children's Hospital, Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Anton H van Kaam
- Department of Neonatology, Emma Children's Hospital, Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Daniel C Vijbrief
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, 3584 CX Utrecht, The Netherlands
| | - Chris V Hulzebos
- Department of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Astrid Giezen
- Department of Neonatology, Isala Hospital, Amalia Children's Center, 8025 AB Zwolle, The Netherlands
| | - Veerle Cossey
- Department of Neonatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Willem P de Boode
- Department of Neonatology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children's Hospital, 6525 XZ Nijmegen, The Netherlands
| | - Wouter J de Jonge
- Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Marc A Benninga
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Hendrik J Niemarkt
- Department of Neonatology, Máxima Medical Center, 5504 DB Veldhoven, The Netherlands
| | - Tim G J de Meij
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
- Department of Pediatric Gastroenterology, Amsterdam UMC Location University of Amsterdam, Amsterdam Reproduction & Development Research Institute, 1105 AZ Amsterdam, The Netherlands
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