The role of antimicrobial treatment during pregnancy on the neonatal gut microbiome and the development of atopy, asthma, allergy and obesity in childhood.
Expert Opin Drug Saf. 2019 Feb 11. doi: 10.1080/14740338.2019.1579795.
Milliken S1, Allen RM2, Lamont RF3,4.
1 Department of Obstetrics and Gynaecology , Simpsons Centre for Reproductive Health, Royal Infirmary of Edinburgh , Little France , Edinburgh , UK.
2 Department of Gastroenterology, Division of Medicine , Royal Infirmary of Edinburgh , Little France , Edinburgh , UK.
3 Division of Surgery , University College London, Northwick Park Institute of Medical Research Campus , London , UK .
4 Institute of Clinical Research, University of Southern Denmark , Odense , Denmark.
Studies in both categories of Antibiotics and Pregnancy are listed here:
- Vaginal microbiome varies with race, vitamin D level, preterm birth, etc. - March 2019
- Antibiotics during pregnancy may cause childhood health problems – Feb 2019
- Gut Microbiome is important during pregnancy – Dec 2014
- 1.8X increased risk of Obesity if antibiotics were used during pregnancy – Nov 2014
- 2000 IU vitamin D during pregnancy and 800 IU to infant resulted in less use of antibiotics – RCT April 2014
The use of antibiotics prenatally, during pregnancy, or neonatally may have adverse effects on the neonatal gut microbiome, and adversely affect the development of the infant immune system, leading to the development of childhood atopy, asthma, allergy and obesity. Areas covered: We reviewed new evidence about vaginal eubiosis and dysbiosis from molecular-based, cultivation-independent techniques, and how this affects the neonatal gut microbiome and early development of the immune system in infants. We have considered the association between maternal use of antibiotics and the potentially beneficial role of vitamin D in the development of atopy, asthma, allergy and obesity. We have presented what efforts might be made to reduce the use of antibiotics in pregnancy. Finally, we have also addressed therapeutic interventions such as vaginal "seeding", probiotics, breastfeeding and neonatal dietary supplementation.
Expert opinion: The weakness of the currently available research is that insufficient assessment has been paid to confounding variables. There also remains uncertainty as to whether it is relevant that the mother suffered from the same condition such as asthma, as the purported infant outcome variable, for which she may have received antibiotics. In most studies, there is also a lack of control for the number of antibiotic courses administered, the timing of use, the use of broad spectrum or narrow range antibiotics, the indication for antibiotic use, the dose dependent nature of the effect, the class of antibiotics used, or a varying degree of risk.