. 2019 Jun;43(6):1202-1209.

doi: 10.1038/s41366-018-0316-6. Epub 2019 Jan 22.

Maternal antibiotic use during pregnancy and childhood obesity at age 5 years

William J Heerman¹, Matthew F Daley², Janne Boone-Heinonen³, Sheryl L Rifas-Shiman⁴, L Charles Bailey⁵, Christopher B Forrest⁵, Jessica G Young⁶, Matthew W Gillman^{4

7}, Casie E Horgan⁶, David M Janicke⁸, Chelsea Jenter⁴, Elyse O Kharbanda⁹, Doug Lunsford¹⁰, Mary Jo Messito¹¹, Sengwee Toh⁶, Jason P Block⁴; PCORnet Antibiotics and Childhood Growth Study Group

Collaborators, Affiliations

Collaborators

PCORnet Antibiotics and Childhood Growth Study Group:
David Arterburn, Lauren P Cleveland, Jonathan Finkelstein, Stephanie L Fitzpatrick, Andrea Goodman, Michael Horberg, Jenny Ingber, Kathleen Murphy, Holly Landrum Peay, Pedro Rivera, Juliane S Reynolds, Jessica L Sturtevant, Ivette Torres

Affiliations

¹ Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. bill.heerman@vumc.org.
² Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, 80014, USA.
³ School of Public Health, Oregon Health and Science University/Portland State University, Portland, OR, USA.
⁴ Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
⁵ Applied Clinical Research Center, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
⁶ Therapeutics Research and Infectious Disease Epidemiology Group, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
⁷ Dr. Gillman is now Director of the Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, Bethesda, MD, USA.
⁸ Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
⁹ HealthPartners Institute, Department of Research, Bloomington, MN, USA.
¹⁰ North Fork School District, Utica, OH, USA.
¹¹ Department of Pediatrics, New York University, Bellevue Hospital Center, New York, NY, USA.

PMID: 30670848
PMCID: PMC6788789
DOI: 10.1038/s41366-018-0316-6

Maternal antibiotic use during pregnancy and childhood obesity at age 5 years

William J Heerman et al. Int J Obes (Lond). 2019 Jun.

. 2019 Jun;43(6):1202-1209.

doi: 10.1038/s41366-018-0316-6. Epub 2019 Jan 22.

Authors

Collaborators

PCORnet Antibiotics and Childhood Growth Study Group:
David Arterburn, Lauren P Cleveland, Jonathan Finkelstein, Stephanie L Fitzpatrick, Andrea Goodman, Michael Horberg, Jenny Ingber, Kathleen Murphy, Holly Landrum Peay, Pedro Rivera, Juliane S Reynolds, Jessica L Sturtevant, Ivette Torres

Affiliations

¹ Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. bill.heerman@vumc.org.
² Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, 80014, USA.
³ School of Public Health, Oregon Health and Science University/Portland State University, Portland, OR, USA.
⁴ Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
⁵ Applied Clinical Research Center, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
⁶ Therapeutics Research and Infectious Disease Epidemiology Group, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
⁷ Dr. Gillman is now Director of the Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, Bethesda, MD, USA.
⁸ Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
⁹ HealthPartners Institute, Department of Research, Bloomington, MN, USA.
¹⁰ North Fork School District, Utica, OH, USA.
¹¹ Department of Pediatrics, New York University, Bellevue Hospital Center, New York, NY, USA.

PMID: 30670848
PMCID: PMC6788789
DOI: 10.1038/s41366-018-0316-6

Abstract

Objective: The benefits of antibiotic treatment during pregnancy are immediate, but there may be long-term risks to the developing child. Prior studies show an association between early life antibiotics and obesity, but few have examined this risk during pregnancy.

Subjects: To evaluate the association of maternal antibiotic exposure during pregnancy on childhood BMI-z at 5 years, we conducted a retrospective cohort analysis. Using electronic health record data from seven health systems in PCORnet, a national distributed clinical research network, we included children with same-day height and weight measures who could be linked to mothers with vital measurements during pregnancy. The primary independent variable was maternal outpatient antibiotic prescriptions during pregnancy (any versus none). We examined dose response (number of antibiotic episodes), spectrum and class of antibiotics, and antibiotic episodes by trimester. The primary outcome was child age- and sex-specific BMI-z at age 5 years.

Results: The final sample was 53,320 mother-child pairs. During pregnancy, 29.9% of mothers received antibiotics. In adjusted models, maternal outpatient antibiotic prescriptions during pregnancy were not associated with child BMI-z at age 5 years (β = 0.00, 95% CI -0.03, 0.02). When evaluating timing during pregnancy, dose-response, spectrum and class of antibiotics, there were no associations of maternal antibiotics with child BMI-z at age 5 years.

Conclusion: In this large observational cohort, provision of antibiotics during pregnancy was not associated with childhood BMI-z at 5 years.

PubMed Disclaimer

Conflict of interest statement

Competing interests

The authors have no conflicts of interest to report.

Figures

**Figure 1.. Flow-Diagram of All Cohort Participants**
Of the 137 815 maternal-child pairs identified in the seven health systems, 53 320 mother-child pairs met inclusion criteria for the study.

See this image and copyright information in PMC

References

1. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of Obesity among adults and young: United States, 2011–2014. NCHS Data Brief, no 219. Hyattsville, MD: National Center for Health Statistics; 2015. - PubMed
1. Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk Factors for Childhood Obesity in the First 1,000 Days: A Systematic Review. Am J Prev Med. 2016;50(6):761–79. - PubMed
1. Cox LM, Blaser MJ. Antibiotics in early life and obesity. Nature reviews Endocrinology. 2015;11(3):182–90. - PMC - PubMed
1. Block JP BL, Gillman MW, Lunsford D, Daley MF, Eneli I, Finkelstein J, Heerman WJ, Horgan CE, Hsia DS, Jay M, Rao G, Reynolds JS, Rifas-Shiman SL,,Sturtevant JL, Sengwee T, Trasande L, Young JG, Forrest CB, on behalf of PCORnet Antibiotics and Childhood Growth Study Group. Early Antibiotic Exposure and Weight Outcomes in Young Children. Pediatrics. 2018; In Press. - PMC - PubMed
1. Ailes EC, Summers AD, Tran EL, Gilboa SM, Arnold KE, Meaney-Delman D, et al. Antibiotics Dispensed to Privately Insured Pregnant Women with Urinary Tract Infections - United States, 2014. MMWR Morb Mortal Wkly Rep. 2018;67(1):18–22. - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

Grants and funding

OBS-1505-30699/PCORI/Patient-Centered Outcomes Research Institute/United States

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Maternal antibiotic use during pregnancy and childhood obesity at age 5 years

Collaborators

Affiliations

Maternal antibiotic use during pregnancy and childhood obesity at age 5 years

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical