title: Early Life Antibiotic Exposure and Weight Development in Children.
abstract: To examine the timing, frequency, and type of antibiotic exposure during the first 10 years of life in association with (over)weight across this period in a cohort of 979 children.
  
  
  
  Within the Child, Parents and Health: Lifestyle and Genetic Constitution Birth Cohort Study, antibiotic exposure record was obtained from general practitioners. Anthropometric outcomes (age- and sex-standardized body mass index, weight and height z-scores, and overweight) were measured repeatedly at 7 time points during the first 10 years of life. Generalized estimating equations method was used for statistical analysis.
  
  
  
  After adjusting for confounding factors, children exposed to one course of antibiotics compared with none in the first 6 months of life had increased weight- (adjusted generalized estimating equations estimates [adjβ] 0.24; 95% CI 0.03-0.44) and height (adjβ 0.23; 95% CI 0.0002-0.46) z-scores; exposure to ≥2 courses during the second year of life was associated with both increased weight (adjβ 0.34; 95% CI 0.07-0.60), and height z-scores (adjβ 0.29; 95% CI -0.003 to 0.59). Exposure later in life was not associated with anthropometric outcomes. Associations with weight z-scores were mainly driven by exposure to broad- (≥2 courses: adjβ 0.11; 95% CI 0.003-0.22) and narrow-spectrum β-lactams (1 course: adjβ 0.18; 95% CI 0.005-0.35) during the follow-up period. Specific antibiotic used was not associated with body mass index z-scores and overweight.
  
  
  
  Repeated exposure to antibiotics early in life, especially β-lactam agents, is associated with increased weight and height. If causality of obesity can be established in future studies, this further highlights the need for restrictive antibiotic use and avoidance of prescriptions when there is minimal clinical benefit.
authors.affiliation: Top Institute Food and Nutrition, Wageningen, The Netherlands; Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands. Electronic address: catherine.akwimbakwa@maastrichtuniversity.nl.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Mbakwa
authors.affiliation: Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
authors.forename: Lotte
authors.initials: L
authors.lastname: Scheres
authors.affiliation: Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands; Department of Medical Microbiology, Maastricht University Medical Center, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht and CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
authors.forename: John
authors.initials: J
authors.lastname: Penders
authors.affiliation: Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Mommers
authors.affiliation: Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
authors.forename: Carel
authors.initials: C
authors.lastname: Thijs
authors.affiliation: Department of Epidemiology, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands; CARIM School for Cardiovascular Diseases, and Maastricht Center for Systems Biology (MaCSBio), Maastricht, The Netherlands.
authors.forename: Ilja C W
authors.initials: IC
authors.lastname: Arts
mesh_terms: D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000494:pharmacology; D001827:Body Height / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: antimicrobial agents; childhood overweight; gut microbiota