Skip to main content
SpringerLink
Log in

Maternal exposure to antibiotics increases the risk of infant eczema before one year of life: a meta-analysis of observational studies

  • Meta-analysis
  • Published:
World Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Background

There are some conflicting evidences showing that maternal exposure to antibiotics may increase the risk of infant eczema. The present study aims to estimate the effect of prenatal antibiotics administration on infant eczema.

Methods

According to the established inclusion criteria, eligible observational studies were collected by comprehensive database search. The qualities of the included studies were assessed using the Newcastle–Ottawa Scale. Effect sizes that were adjusted by multivariable models were extracted and combined. Publication bias was evaluated by visual inspection of funnel plot.

Results

A total of seven observational studies were included. The qualities of the included studies were at moderate or high level. Prenatal antibiotics use was positively associated with eczema before one year of age [odds ratio (OR) = 1.93, 95% confidence interval (CI) 1.35–2.76]. In addition, antibiotics exposure in utero was likely to be related to eczema after one year of age (OR 1.21, 95% CI 0.98–1.49). The exposure to antibiotics during third trimester was not associated with infant eczema (OR 0.97, 95% CI 0.86–1.09).

Conclusions

Maternal exposure to antibiotics is associated with eczema by one-year age and may have a prolonged effect on eczema after 1-year age. The influence of timing of antibiotics exposure during pregnancy needs more studies to clarify.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368:733–43.

    Article  Google Scholar 

  2. Davies E, Rogers NK, Lloyd-Lavery A, Grindlay DJC, Thomas KS. What's new in atopic eczema? An analysis of systematic reviews published in 2015. Part 1: epidemiology and methodology. Clin Exp Dermatol. 2018;43:375–9.

    Google Scholar 

  3. Scudellari M. News feature: cleaning up the hygiene hypothesis. Proc Natl Acad Sci USA. 2017;114:1433–6.

    Article  CAS  Google Scholar 

  4. Bach JF. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med. 2002;347:911–20.

    Article  Google Scholar 

  5. Ahmadizar F, Vijverberg SJH, Arets HGM, de Boer A, Lang JE, Garssen J, et al. Early-life antibiotic exposure increases the risk of developing allergic symptoms later in life: a meta-analysis. Allergy. 2018;73:971–86.

    Article  CAS  Google Scholar 

  6. Ahmadizar F, Ijverberg SJH, Arets HGM, de Boer A, Turner S, Devereux G, et al. Early life antibiotic use and the risk of asthma and asthma exacerbations in children. Pediatr Allergy Immunol. 2017;28:430–7.

    Article  Google Scholar 

  7. Tsakok T, McKeever TM, Yeo L, Flohr C. Does early life exposure to antibiotics increase the risk of eczema? A systematic review. Br J Dermatol. 2013;169:983–91.

    Article  CAS  Google Scholar 

  8. Versporten A, Bielicki J, Drapier N, Sharland M, Goossens H, ARPEC project group. The Worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) point prevalence survey: developing hospital-quality indicators of antibiotic prescribing for children. J Antimicrob Chemother. 2016;71:1106–17.

    Article  CAS  Google Scholar 

  9. Lee SY, Yu J, Ahn KM, Kim KW, Shin YH, Lee KS, et al. Additive effect between IL-13 polymorphism and cesarean section delivery/prenatal antibiotics use on atopic dermatitis: a birth cohort study (COCOA). PLoS One. 2014;9:e96603.

    Article  Google Scholar 

  10. Dom S, Droste JHJ, Sariachvili MA, Hagendorens MM, Oostveen E, Bridts CH, et al. Pre- and post-natal exposure to antibiotics and the development of eczema, recurrent wheezing and atopic sensitization in children up to the age of 4 years. Clin Exp Allergy. 2010;40:1378–87.

    Article  CAS  Google Scholar 

  11. Jedrychowski W, Gałaś A, Whyatt R, Perera F. The prenatal use of antibiotics and the development of allergic disease in one year old infants. A preliminary study. Int J Occup Med Environ Health. 2006;19:70–6.

    PubMed  Google Scholar 

  12. Mckeever TM, Lewis SA, Smith C, Hubbard R. The importance of prenatal exposures on the development of allergic disease: a birth cohort study using the West Midlands General Practice Database. Am J Respir Crit Care Med. 2002;166:827–32.

    Article  Google Scholar 

  13. Timm S, Schlünssen V, Olsen J, Ramlau-Hansen CH. Prenatal antibiotics and atopic dermatitis among 18-month-old children in the Danish National Birth Cohort. Clin Exp Allergy. 2017;47:929–36.

    Article  CAS  Google Scholar 

  14. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.

    Article  Google Scholar 

  15. Stang A. Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–5.

    Article  Google Scholar 

  16. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.

    Article  CAS  Google Scholar 

  17. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.

    Article  Google Scholar 

  18. Dersimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.

    Article  CAS  Google Scholar 

  19. Bisgaard H, Halkjaer LB, Hinge R, Giwercman C, Palmer C, Silveira L, et al. Risk analysis of early childhood eczema. J Allergy Clin Immunol. 2009;123:1355–60.e5.

    Google Scholar 

  20. Sariachvili M, Droste J, Dom S, Wieringa M, Vellinga A, Hagendorens M, et al. Is breast feeding a risk factor for eczema during the first year of life? Pediatr Allergy Immunol. 2007;18:410–7.

    Article  Google Scholar 

  21. Zeissig S, Blumberg RS. Life at the beginning: perturbation of the microbiota by antibiotics in early life and its role in health and disease. Nat Immunol. 2014;15:307–10.

    Article  CAS  Google Scholar 

  22. Zou ZH, Liu D, Li HD, Zhu DP, He Y, Hou T, et al. Prenatal and postnatal antibiotic exposure influences the gut microbiota of preterm infants in neonatal intensive care units. Ann Clin Microbiol Antimicrob. 2018;17:9.

    Article  Google Scholar 

  23. Korpela K, Salonen A, Vepsäläinen O, Suomalainen M, Kolmeder C, Varjosalo M, et al. Probiotic supplementation restores normal microbiota composition and function in antibiotic-treated and in caesarean-born infants. Microbiome. 2018;6:182.

    Article  Google Scholar 

  24. Cuello-Garcia CA, Brozek JL, Fiocchi A, Pawankar R, Yepes-Nunez JJ, Terracciano L, et al. Probiotics for the prevention of allergy: a systematic review and meta-analysis of randomized controlled trials. J Allergy Clin Immunol. 2015;136:952–61.

    Article  Google Scholar 

  25. Mulder B, Pouwels KB, Schuiling-Veninga CC, Bos HJ, de Vries TW, Jick SS, et al. Antibiotic use during pregnancy and asthma in preschool children: the influence of confounding. Clin Exp Allergy. 2016;46:1214–26.

    Article  CAS  Google Scholar 

  26. Ortqvist AK, Lundholm C, Kieler H, Ludvigsson JF, Fall T, Ye W, et al. Antibiotics in fetal and early life and subsequent childhood asthma: nationwide population based study with sibling analysis. BMJ. 2014;349:g6979.

    Article  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Dermatology, Jingzhou First People’s Hospital, Shashi District, No. 8 Hangkong Road, Jingzhou, 434000, China

    Fa-Qing Huang, Chang-Yu Lu, Shi-Ping Wu, Shao-Zhi Gong & Yan Zhao

Authors
  1. Fa-Qing Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chang-Yu Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shi-Ping Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shao-Zhi Gong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yan Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

FQH and CYL contributed to the study design. All authors collected the data and performed the data analysis, and prepared the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Fa-Qing Huang.

Ethics declarations

Ethical approval

Not needed.

Conflict of interest

All the authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, FQ., Lu, CY., Wu, SP. et al. Maternal exposure to antibiotics increases the risk of infant eczema before one year of life: a meta-analysis of observational studies. World J Pediatr 16, 143–151 (2020). https://doi.org/10.1007/s12519-019-00301-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12519-019-00301-y

Keywords

Search

Navigation