Early-life antibiotic use and risk of asthma and eczema: results of a discordant twin study.
Eur Respir J
; 55(4)2020 04.
Article
em En
| MEDLINE
| ID: mdl-32139457
ABSTRACT
RATIONALE Early-life antibiotic use has been associated with the development of atopic diseases, but the aetiology remains unclear. To elucidate the aetiology, we used a discordant twin design to control for genetic and environmental confounding. METHODS:
We conducted a retrospective cohort study in twins aged 3-10â years from the Netherlands Twin Register (NTR, n=35â365) and a replication study in twins aged 9â years from the Childhood and Adolescent Twin Study in Sweden (CATSS, n=7916). Antibiotic use was recorded at age 0-2â years. Doctor-diagnosed asthma and eczema were reported by parents when children were aged 3-12â years in both cohorts. Individuals were included in unmatched analyses and in co-twin control analyses with disease discordant twin pairs.RESULTS:
Early-life antibiotic use was associated with increased risk of asthma (NTR OR 1.34, 95% CI 1.28-1.41; CATSS OR 1.45, 95% CI 1.34-1.56) and eczema (NTR OR 1.08, 95% CI 1.03-1.13; CATSS OR 1.07, 95% CI 1.01-1.14) in unmatched analyses. Co-twin analyses in monozygotic and dizygotic twin pairs showed similar results for asthma (NTR OR 1.54, 95% CI 1.20-1.98; CATSS OR 2.00, 95% CI 1.28-3.13), but opposing results for eczema in the NTR (OR 0.99, 95% CI 0.80-1.25) and the CATSS (OR 1.67, 95% CI 1.12-2.49). The risk of asthma increased for antibiotics prescribed for respiratory infections (CATSS OR 1.45, 95% CI 1.34-1.56), but not for antibiotics commonly used for urinary tract/skin infections (CATSS OR 1.02, 95% CI 0.88-1.17).CONCLUSION:
Children exposed to early-life antibiotic use, particularly prescribed for respiratory infections, may be at higher risk of asthma. This risk can still be observed when correcting for genetic and environmental factors. Our results could not elucidate whether the relationship between early-life antibiotic use and eczema is confounded by familial and genetic factors.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Asma
/
Eczema
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Humans
/
Infant
/
Newborn
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article