title: Relationship between prenatal antibiotic use and asthma in at-risk children.
abstract: BACKGROUND
  Asthma prevalence has doubled in developed countries during the past 30 years. Pre- and perinatal events are essential in shaping the development of the immune system and systemic antibiotic use during this time could alter the maternal or placental microbiome, leading to an increase in the child's risk of developing asthma.
  
  
  OBJECTIVE
  To determine whether prenatal antibiotic use is associated with asthma and wheezing in children at risk for asthma.
  
  
  METHODS
  Using data from a randomized education intervention of families at risk for asthma from 1998 followed through 2009 in urban Chicago, asthma was defined as ever having a physician asthma diagnosis by year 3 and wheezing in the third year. Logistic regression models controlling for confounders investigated the effect of antibiotic use during pregnancy on these outcomes.
  
  
  RESULTS
  After adjustment, prenatal antibiotic use was a risk factor for asthma (odds ratio 3.1, 95% confidence interval 1.4-6.8) but was only weakly associated with wheezing (odds ratio 1.8, 95% confidence interval 0.9-3.3). Analyses of the effects of timing of prenatal antibiotic use on asthma and wheezing showed the relation remained consistent for antibiotic use later in pregnancy, but the outcomes were not associated with antibiotic use in the first trimester.
  
  
  CONCLUSIONS
  This study suggests prenatal antibiotic use might be associated with the development of asthma in children at risk for asthma. Although the relation with prenatal antibiotics does not hold for wheezing in this study, there might be a trend that could be delineated further within a larger cohort study.
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois. Electronic address: brittany.lapin@gmail.com.
authors.forename: Brittany
authors.initials: B
authors.lastname: Lapin
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Julie
authors.initials: J
authors.lastname: Piorkowski
authors.affiliation: Section of Allergy and Immunology, Georgia Regents University, Augusta, Georgia.
authors.forename: Dennis
authors.initials: D
authors.lastname: Ownby
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Sally
authors.initials: S
authors.lastname: Freels
authors.affiliation: Community Health Sciences Division, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Noel
authors.initials: N
authors.lastname: Chavez
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Eva
authors.initials: E
authors.lastname: Hernandez
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Wagner-Cassanova
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Darlene
authors.initials: D
authors.lastname: Pelzel
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Carmen
authors.initials: C
authors.lastname: Vergara
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Victoria
authors.initials: V
authors.lastname: Persky
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D064307:Microbiota / Q000187:drug effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012135:Respiratory Sounds; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents