Association of Early Antibiotic Exposure With Childhood Body Mass Index Trajectory Milestones.
Association of Early Antibiotic Exposure With Childhood Body Mass Index Trajectory Milestones.
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DOI：
10.1001/jamanetworkopen.2021.16581
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发表时间：
2021-07-01
影响因子：
13.8
通讯作者：
Block JP
中科院分区：
文献类型：
--
作者：
Aris IM;Lin PD;Rifas-Shiman SL;Bailey LC;Boone-Heinonen J;Eneli IU;Solomonides AE;Janicke DM;Toh S;Forrest CB;Block JP
早期抗生素暴露与儿童期体重指数（BMI）轨迹里程碑模式改变相关吗？这项对183444名儿童的队列研究发现，婴儿期BMI峰值与年龄和BMI大小之间存在小的相关性，48个月前抗生素暴露后儿童早期BMI反弹。这项研究的结果表明，这些与早期抗生素暴露后BMI轨迹里程碑的小关联不应影响处方抗生素的个人决定。过去的研究表明抗生素暴露与儿童体重结果之间存在关联。然而，很少有人记录到儿童早期抗生素暴露后体重指数（BMI）（计算为体重（kg）除以身高（m）的平方）轨迹里程碑模式的变化。在一个大型儿童队列中，研究出生后48个月内抗生素使用与儿童期BMI轨迹里程碑的相关性。这项回顾性队列研究使用了2009年1月1日至2016年12月31日期间参与国家以患者为中心的临床研究网络的26家机构的电子健康记录数据。入选受试者需要在以下每个年龄段进行至少一组有效的当天身高和体重测量：0至5个月、6至11个月、12至23个月、24至59个月和60至131个月（183444名儿童）。数据分析时间为2019年6月1日至2020年6月30日。在0至5、6至11、12至23、24至35和36至47个月大时使用抗生素。BMI峰值和BMI反弹的年龄和幅度。在研究的183444名儿童中（平均年龄，3.3岁[范围，0 - 10.9岁]; 95 228 [51.9%]为男孩; 80 043例[43.6%]为白色个体），78.1%接受任何抗生素治疗，51.0%至少有1次广谱抗生素暴露，65.0%在48月龄之前的任何时间至少有1次窄谱抗生素暴露。在0至5个月大时暴露于任何抗生素（与未暴露相比）与年龄较大（β系数，0.05个月[95% CI，0.02 - 0.08个月]）和峰值BMI较高（β系数，0.09 [95% CI，0.07 - 0.11]）相关。在0至47个月时暴露于任何抗生素（与未暴露相比）与较早的年龄（-0.60个月[95%CI，-0.81至-0.39个月]）和反弹时较高的BMI（β系数，0.02 [95%CI，0.01 - 0.03]）相关。这些关联在至少4次抗生素暴露的儿童中最强。对于那些在24至35个月大时暴露于抗生素的人，BMI反弹时与年龄相关的效应估计值更大（β系数，− 0.63 [95% CI，− 0.83至− 0.43]个月）或36至47个月（β系数，− 0.52 [95% CI，− 0.72至− 0.31]月）（β系数，0.26 [95% CI，0.01 - 0.51]个月）或6 - 11（β系数，0.00 [95% CI，− 0.20 - 0.20]个月）。在这项队列研究中，抗生素暴露与婴儿期和幼儿期BMI轨迹里程碑的统计学显著差异相关，但差异很小。与早期抗生素暴露相关的BMI轨迹里程碑模式改变的风险较小，不太可能成为儿童处方决策的关键因素。这项队列研究使用了来自国家以患者为中心的临床研究网络（PCORnet）抗生素儿童生长研究的数据，以检查一个大型儿童队列中生命前4年抗生素使用与儿童期体重指数轨迹里程碑的关联。
Is early antibiotic exposure associated with altered body mass index (BMI) trajectory milestone patterns in childhood? This cohort study of 183 444 children identified small associations with age and magnitude of BMI at peak in infancy and rebound in early childhood after antibiotic exposure before 48 months of age. The findings of this study suggest these small associations with BMI trajectory milestones after early-life antibiotic exposure should not affect the individual decision to prescribe antibiotics. Past studies have showed associations between antibiotic exposure and child weight outcomes. Few, however, have documented alterations to body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) trajectory milestone patterns during childhood after early-life antibiotic exposure. To examine the association of antibiotic use during the first 48 months of life with BMI trajectory milestones during childhood in a large cohort of children. This retrospective cohort study used electronic health record data from 26 institutions participating in the National Patient-Centered Clinical Research Network from January 1, 2009, to December 31, 2016. Participant inclusion required at least 1 valid set of same-day height and weight measurements at each of the following age periods: 0 to 5, 6 to 11, 12 to 23, 24 to 59, and 60 to 131 months (183 444 children). Data were analyzed from June 1, 2019, to June 30, 2020. Antibiotic use at 0 to 5, 6 to 11, 12 to 23, 24 to 35, and 36 to 47 months of age. Age and magnitude of BMI peak and BMI rebound. Of 183 444 children in the study (mean age, 3.3 years [range, 0-10.9 years]; 95 228 [51.9%] were boys; 80 043 [43.6%] were White individuals), 78.1% received any antibiotic, 51.0% had at least 1 episode of broad-spectrum antibiotic exposure, and 65.0% had at least 1 episode of narrow-spectrum antibiotic exposure at any time before 48 months of age. Exposure to any antibiotics at 0 to 5 months of age (vs no exposure) was associated with later age (β coefficient, 0.05 months [95% CI, 0.02-0.08 months]) and higher BMI (β coefficient, 0.09 [95% CI, 0.07-0.11]) at peak. Exposure to any antibiotics at 0 to 47 months of age (vs no exposure) was associated with an earlier age (−0.60 months [95% CI, −0.81 to −0.39 months]) and higher BMI at rebound (β coefficient, 0.02 [95% CI, 0.01-0.03]). These associations were strongest for children with at least 4 episodes of antibiotic exposure. Effect estimates for associations with age at BMI rebound were larger for those exposed to antibiotics at 24 to 35 months of age (β coefficient, −0.63 [95% CI, −0.83 to −0.43] months) or 36 to 47 (β coefficient, −0.52 [95% CI, −0.72 to −0.31] months) than for those exposed at 0 to 5 months of age (β coefficient, 0.26 [95% CI, 0.01-0.51] months) or 6 to 11 (β coefficient, 0.00 [95% CI, −0.20 to 0.20] months). In this cohort study, antibiotic exposure was associated with statistically significant, but small, differences in BMI trajectory milestones in infancy and early childhood. The small risk of an altered BMI trajectory milestone pattern associated with early-life antibiotic exposure is unlikely to be a key factor during prescription decisions for children. This cohort study uses data from the National Patient-Centered Clinical Research Network (PCORnet) Antibiotics Childhood Growth Study to examine the association of antibiotic use during the first 4 years of life and body mass index trajectory milestones during childhood in a large cohort of children.
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影响因子：
--
作者：
Campbell, Michele Wen-Chien;Williams, Joanne;Wake, Melissa
通讯作者：
Wake, Melissa
DOI：
10.1016/j.jpeds.2018.05.041
发表时间：
2018-10
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Aris IM;Rifas-Shiman SL;Li LJ;Kleinman K;Coull BA;Gold DR;Hivert MF;Kramer MS;Oken E
通讯作者：
Oken E
影响因子：
120.7
作者：
Fleming-Dutra, Katherine E.;Hersh, Adam L.;Hicks, Lauri A.
通讯作者：
Hicks, Lauri A.
DOI：
10.5334/egems.274
发表时间：
2019-04-12
期刊：
EGEMS (Washington, DC)
影响因子：
--
作者：
Lin, Pi-I D;Daley, Matthew F;Block, Jason P
通讯作者：
Block, Jason P
影响因子：
4.9
作者：
Chen, Ling-Wei;Xu, Jia;Lee, Yung Seng
通讯作者：
Lee, Yung Seng