Maternal antibiotic exposure and childhood allergies: The Japan Environment and Children's Study

Kouta Okoshi; Kenichi Sakurai; Midori Yamamoto; Chisato Mori; Japan Environment and Children's Study group

doi:10.1016/j.jacig.2023.100137

Maternal antibiotic exposure and childhood allergies: The Japan Environment and Children's Study

J Allergy Clin Immunol Glob. 2023 Jul 6;2(4):100137. doi: 10.1016/j.jacig.2023.100137. eCollection 2023 Nov.

Authors

Kouta Okoshi^{1

2}, Kenichi Sakurai³, Midori Yamamoto⁴, Chisato Mori^{4

5}; Japan Environment and Children's Study group

Collaborators

Japan Environment and Children's Study group:
Michihiro Kamijima⁶, Shin Yamazaki⁷, Yukihiro Ohya⁸, Reiko Kishi⁹, Nobuo Yaegashi¹⁰, Koichi Hashimoto¹¹, Chisato Mori¹², Shuichi Ito¹³, Zentaro Yamagata¹⁴, Hidekuni Inadera¹⁵, Takeo Nakayama¹⁶, Tomotaka Sobue¹⁷, Masayuki Shima¹⁸, Hiroshige Nakamura¹⁹, Narufumi Suganuma²⁰, Koichi Kusuhara²¹, Takahiko Katoh²²

Affiliations

¹ Department of Sustainable Health Science, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.
² Innovation Center, Central Research Laboratory, NIPPN Corporation, Kanagawa, Japan.
³ Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, Japan.
⁴ Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Japan.
⁵ Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
⁶ principal investigator, Nagoya City University, Nagoya, Japan.
⁷ National Institute for Environmental Studies, Tsukuba, Japan.
⁸ National Center for Child Health and Development, Tokyo, Japan.
⁹ Hokkaido University, Sapporo, Japan.
¹⁰ Tohoku University, Sendai, Japan.
¹¹ Fukushima Medical University, Fukushima, Japan.
¹² Chiba University, Chiba, Japan.
¹³ Yokohama City University, Yokohama, Japan.
¹⁴ University of Yamanashi, Chuo, Japan.
¹⁵ University of Toyama, Toyama, Japan.
¹⁶ Kyoto University, Kyoto, Japan.
¹⁷ Osaka University, Suita, Japan.
¹⁸ Hyogo Medical University, Nishinomiya, Japan.
¹⁹ Tottori University, Yonago, Japan.
²⁰ Kochi University, Nankoku, Japan.
²¹ University of Occupational and Environmental Health, Kitakyushu, Japan.
²² Kumamoto University, Kumamoto, Japan.

Abstract

Background: The association of maternal antibiotic exposure during pregnancy with childhood allergic diseases remains unclear.

Objective: We aimed to evaluate the association of maternal exposure to antibiotic use during pregnancy with childhood allergic diseases up to the age of 3 years by using data from a large Japanese birth cohort.

Methods: We analyzed data on 78,678 pregnant women and their offspring aged 0 to 3 years. Prenatal antibiotic exposure was defined as the use of any antimicrobial agent during pregnancy. Information was collected from maternal interviews and medical record transcripts. The outcome variables in this study included preschool asthma, wheezing, food allergy, atopic dermatitis, eczema, allergic rhinoconjunctivitis, and any allergic disease. We used logistic regression analysis to evaluate the association of antibiotic exposure during pregnancy with childhood allergic diseases.

Results: Among the participating mothers, 28.5% used antibiotics during pregnancy. Antibiotic exposure during pregnancy was associated with preschool asthma (adjusted odds ratio [aOR] = 1.12 [95% CI = 1.06-1.19]), wheezing (aOR = 1.11 [95% CI = 1.07-1.15]), allergic rhinoconjunctivitis (aOR = 1.10 [95% CI = 1.03-1.17]) and any allergic disease (aOR = 1.09 [95% CI = 1.05-1.14]) in offspring up to age 3 years. In contrast, maternal antibiotic use was not associated with food allergies, atopic dermatitis, or eczema. Additionally, the significant associations were not influenced by the timing of antibiotic exposure, sex of the infants, or maternal history of allergies.

Conclusion: Maternal antibiotic exposure during pregnancy is associated with an increased risk of childhood respiratory allergies.

Keywords: Antibiotics; allergic rhinoconjunctivitis; atopic dermatitis; birth cohort; childhood allergy; food allergy; pregnancy; preschool asthma.