Is there a link between early antibiotic exposure and autoimmune diseases?
Antibiotics are a type of medication prescribed to fight bacterial infections, such as strep throat, urinary tract infections, and E. coli. This medication is commonly prescribed to young children and is often overused. Past animal research studies suggest that exposing young children to antibiotics may increase the risk of childhood-onset diseases and neurodevelopmental conditions. Previous studies that explored the links between early antibiotic exposure and the development of autoimmune diseases have shown conflicting results.
A new study tackled this connection by restricting confounding variables that may have muddled previous results. The study was conducted by South Korean researchers at Sungkyunkwan University using data from the South Korea National Health Insurance Database. They identified children born from April 2009 to December 2020 and their mothers to analyze autoimmune-related outcomes in two groups: 1) children exposed to antibiotics during pregnancy and 2) children exposed during infancy or early childhood. Then, the researchers compared the two groups to children who had no antibiotic exposure.
The autoimmune-related outcomes the researchers looked for were type 1 diabetes, juvenile idiopathic arthritis, ulcerative colitis, Crohn's disease, systemic lupus erythematosus, and Hashimoto's thyroiditis. Over 2.7 million children were included in the pregnancy cohort, 56.1% of whom were exposed to antibiotics in utero. Researchers adjusted their analysis to account for known risk factors such as genetic predisposition (using sibling matching analyses) and infection (by limiting the analysis to patients with infections). After the analysis, they found no general association between early antibiotic exposure and increased risks of developing any of the six autoimmune diseases. The findings were similar in the infancy cohort, which included more than 3.3 million children, 57.5% of whom received antibiotics.
Although there is no general association between antibiotic exposure during pregnancy or early infancy with increased risk of autoimmune diseases, there is some increased risk for specific populations. For example, children exposed to cephalosporin antibiotics in utero had a moderately elevated risk of Crohn's disease. There was also an elevated risk of Hashimoto's thyroiditis in boys exposed to antibiotics in the early infancy cohort. The authors of this study stated that further research is needed to explore these associations and emphasized the need for doctors to be cautious when prescribing antibiotics during these important developmental stages.
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