Broad-Spectrum Antibiotic Treatment and Subsequent Childhood Type 1 Diabetes: A Nationwide Danish Cohort Study

Studies link antibiotic treatment and delivery by cesarean section with increased risk of chronic diseases through changes of the gut-microbiota. We aimed to evaluate the association of broad-spectrum antibiotic treatment during the first two years of life with subsequent onset of childhood type 1 d...

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Vydáno v:	PloS one Ročník 11; číslo 8; s. e0161654
Hlavní autoři:	Clausen, Tine D., Bergholt, Thomas, Bouaziz, Olivier, Arpi, Magnus, Eriksson, Frank, Rasmussen, Steen, Keiding, Niels, Løkkegaard, Ellen C.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 25.08.2016 Public Library of Science (PLoS)
Témata:	Adolescent Analysis Anti-Bacterial Agents - adverse effects Anti-Bacterial Agents - therapeutic use Antibiotics Antimicrobial agents Biology and Life Sciences Care and treatment Cesarean section Cesarean Section - adverse effects Child Child, Preschool Childhood Children Children & youth Chronic diseases Chronic illnesses Cohort analysis Cohort Studies Complications and side effects Delivery, Obstetric - adverse effects Denmark Development and progression Diabetes Diabetes mellitus Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - epidemiology Dosage and administration Emigration Female Gynecology Health aspects Health risks Hospitals Human health and pathology Humans Immune system Infections Insulin Intestinal microflora Lactation Life Sciences Male Medicine and Health Sciences Microbiota Microbiota (Symbiotic organisms) Mortality Multiple births Obstetrics Pediatrics Penicillin People and Places Personal identification numbers Pharmaceutical sciences Population Pregnancy Proportional Hazards Models Public health Registries Risk Santé publique et épidémiologie Studies Type 1 diabetes Denmark Pregnancy Survival analysis Cox model Antibiotics Penicillin Children Diabetes Mellitus Cesarean section Labor and delivery
ISSN:	1932-6203, 1932-6203
On-line přístup:	Získat plný text
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Shrnutí:	Studies link antibiotic treatment and delivery by cesarean section with increased risk of chronic diseases through changes of the gut-microbiota. We aimed to evaluate the association of broad-spectrum antibiotic treatment during the first two years of life with subsequent onset of childhood type 1 diabetes and the potential effect-modification by mode of delivery. A Danish nationwide cohort study including all singletons born during 1997-2010. End of follow-up by December 2012. Four national registers provided information on antibiotic redemptions, outcome and confounders. Redemptions of antibiotic prescriptions during the first two years of life was classified into narrow-spectrum or broad-spectrum antibiotics. Children were followed from age two to fourteen, both inclusive. The risk of type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 858,201 singletons contributed 5,906,069 person-years, during which 1,503 children developed type 1 diabetes. Redemption of broad-spectrum antibiotics during the first two years of life was associated with an increased rate of type 1 diabetes during the following 13 years of life (HR 1.13; 95% CI 1.02 to 1.25), however, the rate was modified by mode of delivery. Broad-spectrum antibiotics were associated with an increased rate of type 1 diabetes in children delivered by either intrapartum cesarean section (HR 1.70; 95% CI 1.15 to 2.51) or prelabor cesarean section (HR 1.63; 95% CI 1.11 to 2.39), but not in vaginally delivered children. Number needed to harm was 433 and 562, respectively. The association with broad-spectrum antibiotics was not modified by parity, genetic predisposition or maternal redemption of antibiotics during pregnancy or lactation. Redemption of broad-spectrum antibiotics during infancy is associated with an increased risk of childhood type 1 diabetes in children delivered by cesarean section.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Conceived and designed the experiments: TDC TB OB MA FE SR NK ECL.Analyzed the data: OB FE.Contributed reagents/materials/analysis tools: TDC TB OB MA FE SR NK ECL.Wrote the paper: TDC TB OB MA FE SR NK ECL.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0161654