Antibiotics during pregnancy may increase asthma risk in children, study by Kiwi finds

The Malaghan Institute of Medical Research, Wellington. Photo / Provided

Children whose mothers take antibiotics during pregnancy are at higher risk of developing asthma, according to a New Zealand-led study.

A team from the Malaghan Institute of Medical Research in Wellington assessed the results of 27 studies conducted over the past 20 years.

Malaghan Institute postdoctoral fellow Dr Alissa Cait, who led the study, said there was a “statistically significant” increase in the risk of developing wheezing, asthma, dermatitis or food allergies if antibiotics were used during pregnancy.

The results, published in May in the Allergywere consistent regardless of the trimester in which the antibiotics were prescribed and were true for all classes of antibiotics except cephalosporins.

Cait said the findings could add another factor to consider when prescribing antibiotics during pregnancy.

“I don’t think I would ever recommend that if a woman needed antibiotics, you wouldn’t give her antibiotics,” she said.

“But I think maybe there could be a little more weighing of the pros and cons…just give the disadvantages of antibiotics a little more weight and weigh them when prescribing a prescription.”

The study was led by Dr Alissa Cait, a postdoctoral fellow at the Malaghan Institute.  Photo / Provided
The study was led by Dr Alissa Cait, a postdoctoral fellow at the Malaghan Institute. Photo / Provided

While the results were significant, Cait said they were also limited by the types of studies that were undertaken.

“We found that studies investigating this topic were not necessarily representative of the wider population, so it was difficult to estimate the true effect of these antibiotics.”

She said the most effective and precise studies are randomized and placebo-controlled, which is often not possible in research on humans.

“What we did was look at women who had received antibiotics during pregnancy because they needed them, and what the outcome was in the offspring,” she said.

“The limitation of that is that we’re really only looking at a correlation. There could be other explanations for why they develop an allergic disease.

“One of the studies we looked at, they hypothesized that it wasn’t really about the antibiotics themselves, but about the mother’s propensity to get sick – whether a mother was more likely to ‘need antibiotics.’

For this reason, Cait recommends further field research before making any recommendations.

It also opens up some interesting questions about why this phenomenon is happening, which area she is most interested in.

“I’m really interested in understanding this mechanism – how come a pregnant woman taking antibiotics five years later could make that baby more susceptible to disease?”

“I think it probably has something to do with how antibiotics affect the microbiome, and how microbiomes are passed from mother to infant, and then how those microbiomes interact with the immune system and the immune system in development.”

“So that’s really what I would like to work on next, and where I think the most interesting part of this question is.”

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