Abstract
The role of prenatal antibiotics exposure in the development of wheezing in infancy has not been clarified yet.
We evaluated whether maternal use of antibiotics in pregnancy increases the risk of childhood wheezing or if possible associations are due to confounders.
We studied 3955 children born to mothers recruited into NINFEA cohort and followed up to the 18 months of age. Information on antibiotics use in the 1st and the 3rd trimester, ever and recurrent wheezing in offspring and potential confounders (maternal socio-demographics, smoking, asthma/atopy, respiratory and genitourinary infections in pregnancy) was collected from questionnaires completed during pregnancy, at 6 and 18 months after delivery.
For the 1st trimester exposure the crude risk ratio (RR) of ever wheezing was 1.37 (95%CI: 1.05-1.80) and it decreased to 1.12 (0.84-1.48) after adjustment. No association was found for recurrent wheezing. For the 3rd trimester exposure the RRs of ever and recurrent wheezing were 1.32 (1.02-1.71) and 1.78 (1.17-2.72) which after adjustment decreased to 1.04 (0.77-1.40) and 1.29 (0.82-2.04), respectively. For both trimesters there was weak or no association between duration of antibiotic use and ever or recurrent wheezing. Analysis on women with genitourinary infections in the 3rd trimester showed an excess risk of wheezing in offspring independent from antibiotic use (adjusted RR: 1.66; 1.28-2.16 and 1.62; 1.10-2.40 for users and non-users, respectively).
The increase in risk of infant wheezing after prenatal exposure to antibiotics could be attributed to the strong role of confounding factors. Genitourinary infections in pregnancy “per se” seem to be a predisposing factor to infant wheezing.
- © 2014 ERS