Study: Repeated Antibiotic Exposure in Early Childhood Associated with Higher BMI

Jill Murphy, Assistant Editor
Published Online: Tuesday, February 11th, 2020
A cohort study published in JAMA Network Open found that children repeatedly exposed to antibiotics had a significantly higher body mass index (BMI) than those not exposed. With this, the likelihood of obesity increased drastically.
The study recruited 6853 children antenatally during 2009 to 2010; at the 54-month follow-up, 93% of the children had their weight and height measured.
Community pharmacy antibiotic dispensing data were obtained from the New Zealand Pharmaceutical Collection database for children whose parents consented to external data linkage. The analytic samples comprised singletons with 54-month weight and height measurements, community antibiotic dispensing and birth weight data, gestational age greater than 27 weeks, and no congenital anomalies.
The data analysis took place from 2017 to 2018.
The measures taken included the World Health Organization’s BMI-for-age z scores and the International Obesity Task Force overweight and obesity cutoff points that pass through adult BMI values of 25 and 30.
Results found that out of the 5128 singletons, 95% had an antibiotic prescription by 48 months of age, and 9% had obesity at 54 months of age. The adjusted mean BMI-for-age z scores increased significantly with the number of antibiotic dispensings, for 4 to 6, 7 to 9, and more than 9 dispensings.
In addition, receiving more than 9 dispensings was associated with greater likelihood of obesity compared with no exposure. Children whose exposure began in the first year of life had a higher adjusted mean (SD) BMI-for-age z score than those not exposed, whereas those whose exposure commenced after the first year of life did not.
The study authors suggest future research could examine whether interventions such as antibiotic stewardship programs also reduce early childhood obesity, since these programs are designed to reduce overprescribing of antibiotics.
Chelimo C, Camargo CA, Morton SMB, Grant CC. Association of Repeated Antibiotic Exposure Up to Age 4 Years With Body Mass at Age 4.5 Years. JAMA Netw Open. 2020;3(1):e1917577. doi:10.1001/jamanetworkopen.2019.17577.

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