Antibiotic timing, spectrum, and cumulative dose during pregnancy and infancy on risk of asthma

妊娠期和婴儿期抗生素使用时机、范围和累积剂量对哮喘风险的影响

• 批准号: 9170444
• 负责人: PINGSHENG WU
• 金额: $ 11.85万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-05 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9170444
• 关键词: 6 year old; Address; Age; Antibiotics; Asthma; Birth; Child; Childhood; Childhood Asthma; Chronic Disease; Clinical; Cohort Studies; Decision Making; Developed Countries; Development; Dose; Ecology; Equilibrium; Expert Opinion; Exposure to; Genetic Predisposition to Disease; Infant; Infection; Life; Medicaid; Morbidity - disease rate; Mothers; Patients; Pharmaceutical Preparations; Play; Policy Maker; Population; Pregnancy; Pregnancy Trimesters; Prevalence; Prevention; Prevention strategy; Primary Prevention; Public Health; Recommendation; Research; Research Design; Research Infrastructure; Risk; Risk Factors; Role; Specific qualifier value; Staging; Subgroup; Tennessee; Testing; Time; Vagina; cohort; cost; experience; high risk; infancy; microbial colonization; microbiome; modifiable risk; neonate; pathogenic bacteria; population based; response

Project summary Significance: Antibiotic administration during pregnancy and has been demonstrated to alter microbiome diversity and further is associated with an increased risk of childhood asthma. It is unknown, however, whether timing, spectrum of antibiotics, and cumulative exposure have a differential role in the development of asthma. Specific Aims: We hypothesize that greater cumulative exposure of certain groups of antibiotics during definable critical susceptible period(s) of pregnancy and infancy increases the risk of childhood asthma. To identify the critical time period(s) when cumulative exposure of certain antibiotics increases the risk of childhood asthma, we will determine 1) whether timing, spectrum, and cumulative exposure of antibiotics during pregnancy and infancy are associated with an increased risk of childhood asthma; 2) whether combinations of the susceptible time period(s), spectrum of antibiotics, and cumulative exposure during pregnancy and infancy are associated with an increased risk of childhood asthma. Research Design: We will conduct a population based cohort study using the Tennessee Medicaid population, a subset of the established PRIMA cohort (Prevention of RSV: Impact on Morbidity and Asthma; R01 HS018454-01 PI Hartert) of 148,700 mother-child dyads. In aim 1, we will estimate the critical time periods, the spectrum of antibiotic activity, and the cumulative exposure individually on the risk of childhood asthma. In aim 2, the combination of timing, spectrum, and cumulative exposure of antibiotics on the risk of childhood asthma will be analyzed. In all aims, subgroup analyses by maternal asthma status will be conducted to differentiate the antibiotic effect from genetic predisposition to asthma. Impact: As a lifelong chronic disease, there is currently no primary prevention strategy available for asthma. Antibiotics are widely used to treat infection. Our results of identification of critical exposure period(s), safe minimum duration of antibiotics at each development stage of pregnancy and infancy, and “lower risk” antibiotics are of great clinical value. Findings of the study will provide clinicians, patients and policy makers additional information in decision making of antibiotic use.

项目总结