Childhood Antibiotic Use Linked To Higher BMI At Age 3 Interview with:

Melissa N. Poulsen, PhD, MPH</strong> Postdoctoral Fellow Johns Hopkins Bloomberg School of Public Health Geisinger Center for Health Research

Dr. Melissa N. Poulsen

Melissa N. Poulsen, PhD, MPH
Postdoctoral Fellow
Johns Hopkins Bloomberg School of Public Health
Geisinger Center for Health Research What is the background for this study?

Response: Several past studies report positive associations between early childhood antibiotic use (particularly in the first year of life) and body mass index (BMI) later in childhood. Studies have also observed positive associations with prenatal antibiotic use and BMI, but without information on childhood antibiotics, such studies cannot rule out an underlying causal relationship between prenatal antibiotic exposure and early childhood antibiotic use.

No study to date has concurrently evaluated prenatal and early childhood antibiotic exposure. We used mother-child linked electronic health record data to determine whether prenatal and childhood antibiotic use are independently associated with BMI at age 3 years. What are the main findings?

Response: Our findings indicate that childhood antibiotic use is related to higher BMI at age 3 years, but that prenatal exposure to antibiotics is not. Consistent with several past studies, we found an association between antibiotic use in the first year of life and child BMI, suggesting that this period of time may very well represent a critical exposure period. However, we also found strong associations between cumulative antibiotic use through age 3 and child BMI, which highlights the potential risk associated with multiple antibiotic exposures in childhood. What should readers take away from your report?

Response: Our findings are most concerning when thinking about the population-level impact of antibiotic use on childhood BMI, particularly because antibiotics are such a common exposure. Shifting the population’s BMI distribution to the higher values reflected in our data would increase the number of children in the overweight and obese tail of the distribution. Adjusting clinical practices — avoiding broad spectrum antibiotics, limiting repeated antibiotic exposure, and eliminating antibiotic use in cases that lack evidence of efficacy — could mitigate this risk. What recommendations do you have for future research as a result of this study?

Response: Moving forward, studies of the gut microbiota over time are needed to understand how antibiotics affect the composition and stability of the developing microbiota, and to provide more evidence for the causality of our findings.

No disclosures. Thank you for your contribution to the community.


Early-Life Use of Antibiotics a Modifiable Factor for Obesity?
Poulsen MN, et al. Obesity. 2017;doi:10.1002/oby.21719.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on February 1, 2017 by Marie Benz MD FAAD