产前接触抗生素与儿童传染病--一项基于人群的队列研究。

IF 9.7 1区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL EBioMedicine Pub Date : 2024-10-30 DOI:10.1016/j.ebiom.2024.105426
Mikael Hakkola, Sofia Ainonen, Eveliina Ronkainen, Minna Honkila, Marika Paalanne, Tytti Pokka, Eero Kajantie, Niko Paalanne, Terhi Ruuska-Loewald
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引用次数: 0

摘要

背景:产前使用抗生素可预防新生儿B组链球菌疾病。我们假设,产前接触抗生素会影响肠道微生物组的发育,因此与儿童传染病的发生有关:这项人群研究的队列包括 2007-2018 年在芬兰北部阴道分娩的婴儿。我们使用了与国家综合登记册相链接的结构化电子病历。主要结果是儿童从出生到五岁期间因传染病导致急诊就诊、医院门诊就诊或住院的次数:对9733名产前接触过抗生素的儿童(48.8%为女童)和35842名未接触过抗生素的儿童(49.9%为女童)进行了分析。接触产前抗生素与 7-28 天(调整后发病率比 [aIRR] 1.30,95% CI 1.10-1.54)和 1-2 岁(调整后发病率比 1.10,95% CI 1.02-1.18)的感染性疾病发病风险增加有关。尿路感染的发生与产前抗生素的接触有关,而对青霉素敏感的病原体引起的严重感染的发生与产前抗生素的接触成反比:解释:母体产前使用抗生素与后代感染性疾病的发生有关。观察到的关联似乎取决于细菌病原体及其对青霉素的抗菌敏感性:芬兰儿科研究基金会、Alma och K.A. Snellman基金会、猎户座研究基金会、Päivikki和Sakari Sohlberg基金会、芬兰医学基金会、芬兰科学院。
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Intrapartum antibiotic exposure and infectious diseases in childhood - a population-based cohort study.

Background: Intrapartum antibiotics are used to prevent group B streptococcus disease in newborn infants. We hypothesised that intrapartum antibiotic exposure is associated with the occurrence of childhood infectious diseases because it influences the development of the gut microbiome.

Methods: The cohort for this population-based study comprised vaginally delivered children born in Northern Finland in 2007-2018. We used structured electronic medical records linked to comprehensive national registers. Primary outcome was the number of infectious disease episodes leading to an emergency room visit, outpatient hospital visit, or hospitalisation from birth until five years of age.

Findings: Analyses were performed on 9733 children (48.8% girls) exposed to intrapartum antibiotics and on 35,842 unexposed children (49.9% girls). Exposure to intrapartum antibiotics was associated with increased risk of any infectious disease episode at the ages 7-28 days (adjusted incidence rate ratio [aIRR] 1.30, 95% CI 1.10-1.54) and 1-2 years (aIRR 1.10, 95% CI 1.02-1.18). The occurrence of urinary tract infections was associated with the exposure to intrapartum antibiotics whereas the occurrence of severe infections caused by pathogens susceptible to penicillin was reversely associated with the exposure to intrapartum antibiotics.

Interpretation: Maternal intrapartum antibiotics were associated with the occurrence of infectious diseases in the offspring. The observed associations appeared to depend on bacterial pathogens and their antimicrobial susceptibility to penicillin.

Funding: Pediatric Research Foundation, Alma och K.A. Snellman Foundation, Orion Research Foundation, Päivikki and Sakari Sohlberg Foundation, Finnish Medical Foundation, Academy of Finland, Finland.

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来源期刊
EBioMedicine
EBioMedicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
17.70
自引率
0.90%
发文量
579
审稿时长
5 weeks
期刊介绍: eBioMedicine is a comprehensive biomedical research journal that covers a wide range of studies that are relevant to human health. Our focus is on original research that explores the fundamental factors influencing human health and disease, including the discovery of new therapeutic targets and treatments, the identification of biomarkers and diagnostic tools, and the investigation and modification of disease pathways and mechanisms. We welcome studies from any biomedical discipline that contribute to our understanding of disease and aim to improve human health.
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