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Master of Public Health

Early Antibiotic Exposure and Weight Outcomes in Young Children

AUTHORS

Block JP , Bailey LC , Gillman MW , Lunsford D , Daley MF , Eneli I , Finkelstein J , Heerman W , Horgan CE , Hsia DS , Jay M , Rao G , Reynolds JS , Rifas-Shiman SL , Sturtevant JL , Toh S , Trasande L , Young J , Forrest CB , , . Pediatrics. 2018 10 31; 142(6).

ABSTRACT

: media-1vid110.1542/5839981580001PEDS-VA_2018-0290 OBJECTIVES: To determine the association of antibiotic use with weight outcomes in a large cohort of children.

METHODS: Health care data were available from 2009 to 2016 for 35 institutions participating in the National Patient-Centered Clinical Research Network. Participant inclusion required same-day height and weight measurements at 0 to <12, 12 to <30, and 48 to <72 months of age. We assessed the association between any antibiotic use at <24 months of age with BMI score and overweight or obesity prevalence at 48 to <72 months (5 years) of age, with secondary assessments of antibiotic spectrum and age-period exposures. We included children with and without complex chronic conditions.

RESULTS: Among 1 792 849 children with a same-day height and weight measurement at <12 months of age, 362 550 were eligible for the cohort. One-half of children (52%) were boys, 27% were African American, 18% were Hispanic, and 58% received ≥1 antibiotic prescription at <24 months of age. At 5 years, the mean BMI score was 0.40 (SD 1.19), and 28% of children had overweight or obesity. In adjusted models for children without a complex chronic condition at 5 years, we estimated a higher mean BMI score by 0.04 (95% confidence interval [CI] 0.03 to 0.05) and higher odds of overweight or obesity (odds ratio 1.05; 95% CI 1.03 to 1.07) associated with obtaining any (versus no) antibiotics at <24 months.

CONCLUSIONS: Antibiotic use at <24 months of age was associated with a slightly higher body weight at 5 years of age.

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