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TOPLINE:

Children exposed to antibiotics during birth may have an increased risk of developing autoimmune diseases in childhood, research showed.

METHODOLOGY:

• Researchers conducted a prospective study of 45,575 children from Northern Finland who were vaginally delivered between 2007 and 2018.
• A total of 21% of the children were exposed to intrapartum antibiotics, meaning their mothers received an intravenous antibiotic in the 24 hours before birth.
• Intrapartum antibiotics are widely used to prevent early-onset group B streptococcal (GBS) disease in newborns. Studies have shown treatment alters the development of the child's gut microbiota, although the significance of the effect is unknown.

TAKEAWAY:

• A total of 601 children (1.3%) received a diagnosis of an autoimmune disease, such as type 1 diabetes, rheumatoid diseases, inflammatory bowel diseases, and autoimmune diseases of the eye or thyroid gland, during about 5 years of follow-up.
• Intrapartum exposure to antibiotics was associated with a 28% increased risk for autoimmune diseases in an analysis that adjusted for maternal and neonatal covariates (95% CI, 1.02-1.62).
• No significant association was found between intrapartum exposure to antibiotics and the risk for allergic or obstructive airway diseases.

IN PRACTICE:

"As intrapartum antibiotic exposure is highly effective in preventing early-onset GBS disease in newborn infants, we emphasize that the observed association should not be interpreted as a causal relationship," the authors of the study wrote. "This finding, however, supports the efforts to develop more specific GBS disease prevention strategies such as maternal immunization to replace antibiotic use in the future."

SOURCE:

The study was led by Sofia Ainonen, MD, with the University of Oulu in Oulu, Finland. It was published online on February 16 in the American Journal of Obstetrics and Gynecology.

LIMITATIONS:

Whether alterations to the gut microbiome from antibiotic exposure affect the development of the immune system is not well known. Alternatively, GBS in mothers may influence the risk for immune-related diseases, the researchers noted. Longer-term outcomes are not yet known.

DISCLOSURES:

The research was supported by Finnish medical foundations and research funds.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.