The association between antibiotic use in infancy and childhood overweight or obesity: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 30035851 · doi:10.1111/obr.12717
What was done
The authors searched CINAHL, Cochrane CENTRAL, Embase, and MEDLINE for studies examining the association between infant antibiotic exposure (<24 months of age) and subsequent childhood weight change, overweight, or obesity. Eligible studies comparing exposed to unexposed infants were synthesized narratively, and meta-analysis was performed where possible (specifically on datasets comparing the earliest age of exposure to any antibiotic with overweight or obesity at the latest outcome age).
What was found
From 17 articles representing 15 unique studies, meta-analysis of 12 sets of results found that infant antibiotic exposure was associated with a small increase in the odds of childhood overweight or obesity (pooled odds ratio 1.05, 95% CI 1.00-1.11). The strongest associations were reported in boys versus girls and in children exposed to multiple antibiotic courses or broad-spectrum agents.
Why it matters
This review quantifies the clinical evidence linking early-life antibiotic exposure to later childhood weight gain, demonstrating a statistically marginal overall association.
Limits
The review synthesized observational studies, leaving risk of residual confounding by indication, maternal BMI, socioeconomic status, or diet. The effect estimate is very small with the lower confidence interval bound touching 1.00. The abstract does not provide total participant numbers, specific numerical effect sizes for subgroups, or measures of between-study heterogeneity.
Cited by
- supports Repeated antibiotic use in early infancy increases a child's risk for obesity.