EARLY postnatal antibiotic exposure has been associated with an increased risk of childhood asthma, but this link is often confounded by underlying respiratory infections. A new population-based study assessed asthma risk in children who received antibiotics in the first week of life solely due to maternal indications, eliminating infection-related bias.
Electronic medical records were screened to identify healthy full-term infants born between 2006–2018 to mothers with a positive group B streptococcus vaginal culture. Infants with postnatal respiratory symptoms, pneumonia, or positive blood or cerebrospinal fluid cultures were excluded. The primary outcome was an asthma diagnosis by 6 years of age, compared between antibiotic-treated and non-treated infants. A quasi-Poisson regression model was used to assess the independent effect of antibiotic exposure, adjusting for ethnicity, mode of delivery, birth weight, gender, maternal asthma, maternal antibiotic use during pregnancy, and socioeconomic status. A propensity-matched model was also applied, matching treated infants 1:3 with non-treated infants based on the same covariates.
Among 14,807 infants, 311 received antibiotics in the first week of life. Postnatal antibiotic exposure was associated with a significantly higher risk of asthma (relative risk: 1.3, 95% CI: 1.04–1.6, P=0.018). This association remained significant in the propensity-matched analysis (relative risk: 1.31, 95% CI: 1.01–1.69, P=0.039). Secondary outcomes also showed significant associations, with increased use of short-acting beta-agonists (P=0.043) and higher rates of allergic rhinitis (P=0.011) in the antibiotic-treated group.
These findings suggest that postnatal antibiotic exposure, even when not related to infant infections, may increase the risk of developing childhood asthma. Further research is needed to explore potential mechanisms and guide antibiotic stewardship in newborn care.
Ada Enesco, EMJ
Reference
Kristal E. Isolated perinatal antibiotic exposure due to maternal GBS and the risk for childhood asthma. Abstract 070. 2025 AAAAI/WAO Joint Congress. 28 February-3 March, 2025.
