Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 28:14:e66184.
doi: 10.2196/66184.

Antibiotic Use In Utero and Early Life and Risk of Chronic Childhood Conditions in New Zealand: Protocol for a Data Linkage Retrospective Cohort Study

Sharan Ram  1 , Marine Corbin  1 , Andrea 't Mannetje  1 , Amanda Eng  1 , Amanda Kvalsvig  2 , Michael G Baker  2 , Jeroen Douwes  1
Affiliations

Antibiotic Use In Utero and Early Life and Risk of Chronic Childhood Conditions in New Zealand: Protocol for a Data Linkage Retrospective Cohort Study

Sharan Ram et al. JMIR Res Protoc. .

Abstract

Background: The incidence of many common chronic childhood conditions has increased globally in the past few decades, which has been suggested to be potentially attributed to antibiotic overuse leading to dysbiosis in the gut microbiome.

Objective: This linkage study will assess the role of antibiotic use in utero and in early life in the development of type 1 diabetes (T1D), attention-deficit/hyperactive disorder (ADHD), and inflammatory bowel disease.

Methods: The study design involves several retrospective cohort studies using linked administrative health and social data from Statistics New Zealand's Integrated Data Infrastructure. It uses data from all children who were born in New Zealand between October 2005 and December 2010 (N=334,204) and their mothers. Children's antibiotic use is identified for 4 time periods (at pregnancy, at ≤1 year, at ≤2 years, and at ≤5 years), and the development of T1D, ADHD, and inflammatory bowel disease is measured from the end of the antibiotic use periods until death, emigration, or the end of the follow-up period (2021), whichever came first. Children who emigrated or died before the end of the antibiotic use period are excluded. Cox proportional hazards regression models are used while adjusting for a range of potential confounders.

Results: As of September 2024, data linkage has been completed, involving the integration of antibiotic exposure and outcome variables for 315,789 children. Preliminary analyses show that both prenatal and early life antibiotic consumption is associated with T1D. Full analyses for all 3 outcomes will be completed by the end of 2025.

Conclusions: This series of linked cohort studies using detailed, complete, and systematically collected antibiotic prescription data will provide critical new knowledge regarding the role of antibiotics in the development of common chronic childhood conditions. Thus, this study has the potential to contribute to the development of primary prevention strategies through, for example, targeted changes in antibiotic use.

International registered report identifier (irrid): DERR1-10.2196/66184.

Keywords: antibiotics; chronic childhood conditions; data linkage; early childhood; routine data; study protocol.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

References

    1. Jasser-Nitsche Hildegard, Bechtold-Dalla Pozza Susanne, Binder E, Bollow E, Heidtmann B, Lee-Barkley Young Hee, Raile K, de Sousa G, Schramm U, Holl RW. Comorbidity of inflammatory bowel disease in children and adolescents with type 1 diabetes. Acta Paediatr. 2021 Apr;110(4):1353–1358. doi: 10.1111/apa.15643. https://europepmc.org/abstract/MED/33119925 - DOI - PMC - PubMed
    1. Ward ZJ, Yeh JM, Reddy CL, Gomber A, Ross C, Rittiphairoj T, Manne-Goehler J, Abdalla AT, Abdullah MA, Ahmed A, Ankotche A, Azad K, Bahendeka S, Baldé N, Jain SM, Kalobu JC, Karekezi C, Kol H, Prasannakumar KM, Leik SK, Mbanya JC, Mbaye MN, Niang B, Paturi VR, Raghupathy P, Ramaiya K, Sethi B, Zabeen B, Atun R. Estimating the total incidence of type 1 diabetes in children and adolescents aged 0–19 years from 1990 to 2050: a global simulation-based analysis. The Lancet Diabetes & Endocrinology. 2022 Dec;10(12):848–858. doi: 10.1016/s2213-8587(22)00276-5. - DOI - PubMed
    1. Ogle GD, James S, Dabelea D, Pihoker C, Svennson J, Maniam J, Klatman EL, Patterson CC. Global estimates of incidence of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Atlas, 10th edition. Diabetes Res Clin Pract. 2022 Jan;183:109083. doi: 10.1016/j.diabres.2021.109083.S0168-8227(21)00442-3 - DOI - PubMed
    1. Patterson CC, Karuranga S, Salpea P, Saeedi P, Dahlquist G, Soltesz G, Ogle GD. Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice. 2019 Nov;157:107842. doi: 10.1016/j.diabres.2019.107842. - DOI - PubMed
    1. Ilic I, Ilic M. Global incidence of attention deficit/hyperactivity disorder among children. Biology and Life Sciences Forum. 2022;19(1):6–10. doi: 10.3390/IECBS2022-12942. - DOI

MeSH terms

Substances