权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Incidence of atopy and childhood infections in uninfected term newborns with perinatal antibiotic exposure

围产期抗生素暴露的未感染足月新生儿中特应性和儿童期感染的发生率

基本信息

批准号：
9314655
负责人：
Sagori Mukhopadhyay
金额：
$ 15.99万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9314655
关键词：
5 year old Address Admission activity Affect American Antibiotic Therapy Antibiotics Asthma Bacterial Infections Benefits and Risks Bioinformatics Birth Birthing Centers Caring Cell Differentiation process Cessation of life Child Childhood Clinical Clinical Research Communicable Diseases Computerized Medical Record Data Databases Development Diagnosis Discipline of obstetrics Disease Eczema Electronic Health Record Equilibrium Exposure to Food Hypersensitivity Frequencies Future Goals Health Health Care Visit Healthcare High Prevalence Hypersensitivity Immune Immune response Immune system Immunology Incidence Infant Infection Intravenous Investigation Knowledge Life Link Live Birth Measures Mediating Mentors Methods Microbiology Morbidity - disease rate Mothers Necrotizing Enterocolitis Neonatal Neonatology Newborn Infant Office Visits Outcome Pediatric Hospitals Perinatal Perinatal Epidemiology Pharmacy facility Phenotype Philadelphia Physicians Pregnancy Premature Infant Prevention approach Primary Health Care Reporting Resistance Risk Safety Sepsis Services Stimulus System Term Birth Time United States Visit Woman atopy clinical Diagnosis clinical data warehouse clinical practice cohort cost early childhood early onset epidemiology study follow-up gut microbiome infancy intrapartum longitudinal database microbial microbiota neonatal immune system neonate prenatal prevent prophylactic trend

项目摘要

PROJECT SUMMARY/ABSTRACT Multiple clinical studies have found an association between antibiotic exposures in infancy and atopic disorders. Studies have also demonstrated a reduced resistance to subsequent infections after antibiotic therapy for culture-negative infection. Past studies have focused on either prenatal antibiotics given to the mother during pregnancy, or on childhood antibiotics, with little investigation of perinatal antibiotic exposure given to mothers at the time of labor and to neonates immediately after birth. Antibiotic effect on childhood diseases is likely mediated by alteration of host microflora diversity, adversely impacting the development of immune responses. The immediate period after birth is a critical time for immune system interaction with key microflora taxa and alterations are most likely to have enduring effects. Perinatal antibiotics have been shown to cause significant changes in the neonatal gut microbiome that persist for weeks after birth. The increasing use of intrapartum and neonatal antibiotics to prevent early-onset neonatal bacterial infection means that ~30% of newborns are now exposed to antibiotics around the time of birth. This widespread use of perinatal antibiotics may have a significant effect of childhood outcomes of atopic and infectious diseases that has not yet been investigated. We hypothesize that perinatal antibiotic exposures will be associated with a higher incidence of atopic diseases and pediatric office visits due to physician-diagnosed infection. Our first specific aim will address the relationship of perinatal antibiotics to the clinical diagnosis of atopic disorders in the first five years of life. Our second specific aim is to measure the impact of perinatal antibiotics on non-preventative care office visits due to the commonest physician-diagnosed childhood infections. To achieve our aims, we will form a birth cohort of term infants delivered from 2007-2012 at the 2 main birthing centers referring newborns to The Children’s Hospital of Philadelphia (CHOP) pediatric care network. We will leverage CHOP’s large integrated electronic health records from over 31 centers to follow infants from their birthing admissions until 5 years of age and form a detailed longitudinal database spanning obstetrical, neonatal and childhood health care data. Using this database we will determine the difference in incidence of any atopic diagnosis and episodes of non-preventative health visits due to infections among infants with and without exposure to perinatal antibiotics. Perinatal antibiotic exposures are provided to mothers and their newborns with the assumption that they constitute safe approaches to the prevention of a neonatal infection, a low incidence but high morbidity disease. The results of our study may have a profound impact the perceived safety of early antibiotic exposures, and could result in a major revision of newborn clinical practice.

项目总结/文摘