title: Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study.
abstract: The role of prenatal antibiotic exposure in the development of childhood wheezing is debated. We evaluated whether this association could potentially be explained by confounding factors.Antibiotic use in the first and third trimester of pregnancy, wheezing in children aged ≤18 months and confounding factors were assessed in singletons participating in the NINFEA (Nascita e Infanzia: gli Effetti dell'Ambiente) birth cohort (n=3530 for first-trimester exposure and n=3985 for third-trimester exposure).There was no evidence of an association between antibiotic exposure in the first trimester of pregnancy and ever-wheezing (adjusted risk ratio (RR) 1.02, 95% CI 0.80-1.30) or recurrent wheezing (RR 0.99, 95% CI 0.54-1.82). For the third-trimester exposure, the crude RRs (95% CI) of ever-wheezing and recurrent wheezing were 1.34 (1.10-1.64) and 2.72 (1.80-4.11), respectively, which decreased to 1.12 (0.90-1.39) and 2.09 (1.32-3.29) after adjustment. The RRs of wheezing after genitourinary infections during pregnancy were increased independently of antibiotic treatment.In conclusion, the association between prenatal antibiotic exposure and infant wheezing could be largely explained by confounding factors, in particular respiratory infections during pregnancy. An excess risk of wheezing after antibiotic exposure during the third trimester of pregnancy remains after adjustment.
authors.affiliation: Dept of Medical Sciences, University of Turin, Turin, Italy CPO Piemonte, Turin, Italy maja_popovic@hotmail.com.
authors.forename: Maja
authors.identifier: http://orcid.org/0000-0003-4500-6572
authors.initials: M
authors.lastname: Popovic
authors.affiliation: Unit of Epidemiology, "Anna Meyer" Children's University Hospital, Florence, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Rusconi
authors.affiliation: Dept of Medical Sciences, University of Turin, Turin, Italy CPO Piemonte, Turin, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Zugna
authors.affiliation: CPO Piemonte, Turin, Italy AOU Città della Salute e della Scienza, Turin, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Galassi
authors.affiliation: Dept of Medical Sciences, University of Turin, Turin, Italy CPO Piemonte, Turin, Italy AOU Città della Salute e della Scienza, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Merletti
authors.affiliation: Dept of Medical Sciences, University of Turin, Turin, Italy CPO Piemonte, Turin, Italy AOU Città della Salute e della Scienza, Turin, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Migliore
authors.affiliation: CPO Piemonte, Turin, Italy AOU Città della Salute e della Scienza, Turin, Italy.
authors.forename: Morena
authors.initials: M
authors.lastname: Trevisan
authors.affiliation: Dept of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Nannelli
authors.affiliation: Dept of Woman and Child Health, Paediatrics and Neonatology Division, Ospedale Versilia, Viareggio, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Gagliardi
authors.affiliation: Dept of Medical Sciences, University of Turin, Turin, Italy CPO Piemonte, Turin, Italy AOU Città della Salute e della Scienza, Turin, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Richiardi
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011264:Pregnancy Trimesters; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D012044:Regression Analysis; D012135:Respiratory Sounds / Q000209:etiology*; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents