Skip to main content

Main menu

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • For authors
    • Instructions for authors
    • Submit a manuscript
    • Author FAQs
  • Alerts
  • Podcasts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • For authors
    • Instructions for authors
    • Submit a manuscript
    • Author FAQs
  • Alerts
  • Podcasts
  • Subscriptions

Prenatal antibiotic exposure and childhood asthma: a population-based study

Keely Loewen, Barret Monchka, Salaheddin M. Mahmud, Geert 't Jong, Meghan B. Azad
European Respiratory Journal 2018 52: 1702070; DOI: 10.1183/13993003.02070-2017
Keely Loewen
Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, CanadaMax Rady College of Medicine, University of Manitoba, Winnipeg, Canada
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Barret Monchka
Vaccine and Drug Evaluation Centre, Max Rady College of Medicine, University of Manitoba, Winnipeg, CanadaGeorge and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Canada
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Salaheddin M. Mahmud
Vaccine and Drug Evaluation Centre, Max Rady College of Medicine, University of Manitoba, Winnipeg, CanadaGeorge and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, CanadaDept of Community Health Sciences, University of Manitoba, Winnipeg, Canada
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Geert 't Jong
Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, CanadaDept of Pediatrics and Child Health, University of Manitoba, Winnipeg, CanadaDept of Pharmacology, University of Manitoba, Winipneg, Canada
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Meghan B. Azad
Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, CanadaDept of Community Health Sciences, University of Manitoba, Winnipeg, CanadaDept of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Meghan B. Azad
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Abstract

Antibiotic use during infancy alters gut microbiota and immune development and is associated with an increased risk of childhood asthma. The impact of prenatal antibiotic exposure is unclear. We sought to characterise the association between prenatal antibiotic exposure and childhood asthma.

We performed a population-based cohort study using prescription records, hospitalisation records and physician billing claims from 213 661 mother–child dyads born in Manitoba, Canada between 1996 and 2012. Associations were determined using Cox regression, adjusting for maternal asthma, postnatal antibiotics and other potential confounders. Sensitivity analyses evaluated maternal antibiotic use before and after pregnancy.

36.8% of children were exposed prenatally to antibiotics and 10.1% developed asthma. Prenatal antibiotic exposure was associated with an increased risk of asthma (adjusted hazard ratio (aHR) 1.23, 95% CI 1.20–1.27). There was an apparent dose response (aHR 1.15, 95% CI 1.11–1.18 for one course; aHR 1.26, 95% CI 1.21–1.32 for two courses; and aHR 1.51, 95% CI 1.44–1.59 for three or more courses). Maternal antibiotic use during 9 months before pregnancy (aHR 1.27, 95% CI 1.24–1.31) and 9 months postpartum (aHR 1.32, 95% CI 1.28–1.36) were similarly associated with asthma.

Prenatal antibiotic exposure was associated with a dose-dependent increase in asthma risk. However, similar associations were observed for maternal antibiotic use before and after pregnancy, suggesting the association is either not directly causal, or not specific to pregnancy.

Abstract

Maternal antibiotic use is associated with childhood asthma, but the association is not specific to antibiotic use during pregnancy http://ow.ly/G5j230jAzs5

Footnotes

  • Conflict of interest: M.B. Azad reports grants (unrestricted research grants) from Heart and Stroke Foundation of Canada/Canadian Lung Association /Canadian Respiratory Research Network/Allergy, Genes and Environment Network of Centres of Excellence (co-funders), and from Children's Hospital Foundation of Manitoba, during the conduct of the study.

  • Conflict of interest: S.M. Mahmud reports grants (unrestricted research grants) from GlaxoSmithKline, Sanofi Pasteur, Pfizer, Merck and Roche, outside the submitted work.

  • Support statement: This research was supported by the Children's Hospital Foundation of Manitoba, the Heart and Stroke Foundation of Canada, the Canadian Lung Association, the Canadian Respiratory Research Network, and the Allergy, Genes, and Environment (AllerGen) Network of Centres of Excellence. S.M. Mahmud holds a Canada Research Chair in Pharmacoepidemiology. M.B. Azad holds a Canada Research Chair in Developmental Origins of Chronic Disease. The analysis was conducted at the University of Manitoba Vaccine and Drug Evaluation Centre. Funding information for this article has been deposited with the Crossref Funder Registry.

  • Received October 8, 2017.
  • Accepted April 7, 2018.
  • Copyright ©ERS 2018
View Full Text

INDIVIDUALS

Log in using your username and password

– ERS members: log in with your myERS username and password.
– Other users: log in with the credentials you created when you registered.
Forgot your user name or password?
Forgot your username or password?

LIBRARY USERS

Log in through your institution

If your library has a subscription, you may already be logged in via your IP address. Otherwise you may be able to log in via one of the following routes.
You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.
If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.
If you think you should have access, please contact your librarian or email journals@ersnet.org

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

CONTACT US

If you have any questions about the ERS publications website, please contact journals@ersnet.org

PreviousNext
Back to top
View this article with LENS
Vol 52 Issue 1 Table of Contents
European Respiratory Journal: 52 (1)
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Prenatal antibiotic exposure and childhood asthma: a population-based study
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
Print
Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Prenatal antibiotic exposure and childhood asthma: a population-based study
Keely Loewen, Barret Monchka, Salaheddin M. Mahmud, Geert 't Jong, Meghan B. Azad
European Respiratory Journal Jul 2018, 52 (1) 1702070; DOI: 10.1183/13993003.02070-2017

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Prenatal antibiotic exposure and childhood asthma: a population-based study
Keely Loewen, Barret Monchka, Salaheddin M. Mahmud, Geert 't Jong, Meghan B. Azad
European Respiratory Journal Jul 2018, 52 (1) 1702070; DOI: 10.1183/13993003.02070-2017
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Abstract
    • Abstract
    • Introduction
    • Patients and methods
    • Results
    • Discussion
    • Acknowledgements
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Subjects

  • Paediatric pulmonology
  • Asthma and allergy
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

Original articles

  • Fertility treatment among women with asthma
  • Long-term prognosis of patients with SLE-associated PAH
  • Human diaphragm atrophy in ALS not predicted by respiratory measures
Show more Original articles

Asthma

  • Fertility treatment among women with asthma
  • Tralokinumab did not demonstrate OCS-sparing effects in asthma
  • “T2-high” in asthma related to eosinophils, eNO and periostin
Show more Asthma

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About the ERJ

  • Journal information
  • Editorial board
  • Reviewers
  • CME
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Submit a manuscript
  • ERS author centre

For readers

  • Alerts
  • Subjects
  • Collections
  • Podcasts
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Print ISSN:  0903-1936
Online ISSN: 1399-3003

Copyright © 2019 by the European Respiratory Society