Impact of Exposure to Antibiotics During Pregnancy and Infancy on Childhood Obesity: A Systematic Review and Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational cohort and case-control studies
PubMed 32129005 · doi:10.1002/oby.22747
What was done
A systematic review and meta-analysis of observational studies searched PubMed, Embase, and the Cochrane Library through April 18, 2019, to evaluate associations between antibiotic exposure during pregnancy or infancy and subsequent childhood overweight or obesity. Study quality was assessed with AMSTAR 2, and data were meta-analyzed using Stata 12.0.
What was found
Twenty-three observational studies with 1,253,035 participants were included: - Overall prenatal antibiotic exposure was not significantly associated with childhood overweight or obesity (exact numerical estimate not reported in abstract). - Antibiotic exposure during the second trimester was associated with increased risk of childhood overweight or obesity (risk ratio = 1.13; 95% CI: 1.06–1.22; P = 0.001). - Antibiotic exposure during infancy was associated with increased risk of childhood overweight or obesity (risk ratio = 1.14; 95% CI: 1.06–1.23; P = 0.001).
Why it matters
This review synthesizes evidence indicating a modest 13% to 14% relative increase in childhood overweight or obesity risk following antibiotic exposure during the second trimester of pregnancy and in infancy.
Limits
Included evidence is entirely observational, precluding causal inference and leaving open confounding by indication (the underlying infection) and maternal or childhood diet and lifestyle factors. The abstract does not provide effect sizes for overall prenatal exposure, nor data on specific antibiotic types, dosages, or durations.
Cited by
- supports Repeated antibiotic use in early infancy increases a child's risk for obesity.