TAKING ANTIBIOTICS DURING PREGNANCY INCREASES RISK FOR CHILD BECOMING OBESE
A study just released
by Columbia University's Mailman School of Public Health found that children
who were exposed to antibiotics in the second or third trimester of pregnancy
had a higher risk of childhood obesity at age 7. The research also showed that
for mothers who delivered their babies by a Caesarean section, whether elective
or non-elective, there was a higher risk for obesity in their offspring. Study
findings are published online in the International Journal
of Obesity.
Although previous
studies have shown that antibiotics administered early in life may be
associated with increased risk of obesity in childhood, this is the first study
reporting that maternal antibiotic use in the second or third trimester of
pregnancy increases the risk of offspring obesity. Antibiotics affect microbes
in the mother and may enter fetal circulation via the placenta. Researchers are
beginning to understand that the bacteria that normally inhabit our colon have
important roles in maintaining our health and imbalances in these bacterial
populations can cause a variety of illnesses. Disturbances in the normal,
transmission of bacteria from the mother to the child are thought to place the
child at risk for several health conditions, including obesity.
The study is based on
data of healthy, non-smoking, pregnant women who were recruited for the
Northern Manhattan Mothers and Children Study from prenatal clinics at New
York-Presbyterian Hospital and Harlem Hospital Center between 1998 and 2006. Of
727 mothers enrolled in the study, 436 mothers and their children were followed
until 7 years of age. Of these 436 children, 16 percent had mothers who used
antibiotics in the second or trimester. This work is part of the Columbia
Center for Children's Environmental Health's efforts to understand how to
promote healthy growth and development through out childhood and adolescence.
The children exposed
to antibiotics in this timeframe had an 84-percent higher risk of obesity,
compared with children who were not exposed.
"Our findings on
prenatal antibiotics and risk for offspring obesity are novel, and thus warrant
replication in other prospective cohort studies," said Noel Mueller, PhD,
postdoctoral research fellow at Columbia University's Mailman School of Public
Health and Institute of Human Nutrition. "If these findings hold up, they
suggest new mechanisms through which childhood growth trajectories are influenced
at the earliest stages of development. Our findings should not discourage
antibiotic use when they are medically needed, but it is important to recognize
that antibiotics are currently overprescribed."
Independent of
prenatal antibiotic usage, delivery by Caesarean section was also associated
with a 46-percent higher risk of childhood obesity. The researchers controlled
for maternal age, ethnicity, birth weight, sex, breastfeeding in the first
year, and gestational antibiotics or delivery mode.
"Our findings are
consistent with a series of papers that looked at data on Caesarean section.
While earlier studies suggested that childhood outcomes differ by whether the
Caesarean section was elective or non-elective, we did not observe such
evidence," said Andrew Rundle, DrPH, associate professor of Epidemiology
at the Mailman School of Public Health. "Thus, our findings provide new
evidence in support of the hypothesis that Caesarean section independently
contributes to the risk of childhood obesity."
Similar to antibiotic
use during pregnancy, Caesarean section birth is thought to reduce the normal
transmission of bacteria from the mother to the child and to disturb the
balance of bacteria in the child. "Strategies to reduce medically
unnecessary C-sections and to provide the infant with health promoting bacteria
after C-section need to be researched," noted Dr. Mueller.
"Further research
is needed on how mode of delivery, antibiotic use during pregnancy and other
factors influence the establishment of the ecosystem of bacteria that inhabit
each of us," said Dr. Rundle. "This research will help us understand
how to create an early platform to support the healthy growth and development
of children."
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