Accepted for/Published in: JMIR Research Protocols
Date Submitted: Sep 6, 2024
Open Peer Review Period: Sep 16, 2024 - Nov 11, 2024
Date Accepted: Jan 21, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Antibiotics-use in utero and early-life and risk of chronic childhood conditions in New Zealand: a methods protocol using linked data.
ABSTRACT
Background:
The incidence of many common chronic childhood conditions has increased globally in the past few decades. A potential role for antibiotic-(over)-use has been suggested with dysbiosis of the gut microbiome hypothesised to play a key role.
Objective:
This linkage study will assess the role of antibiotic-use in utero and in early-life in the development of Type 1 Diabetes (T1D), Attention Deficit Hyperactive Disorder (ADHD) and Inflammatory Bowel Disease (IBD).
Methods:
The study design involves several retrospective cohort studies using linked administrative health and social data from Statistics New Zealand’s Integrated Data Infrastructure. It uses data for all children, and their mothers, born in New Zealand between October 2005 and December 2010 (n=334,204). Children’s antibiotics-use are identified for four time periods (pregnancy, ≤1 year, ≤2 years, and ≤5 years) and the development of T1D, ADHD, and IBD is measured from the end of the antibiotics-use periods until death, emigration, or the end of the follow-up period (2021), whichever came first. Children who emigrated or died before the end of the antibiotics-use period are excluded. Cox proportional hazards regression models are used whilst adjusting for a range of potential confounders.
Results:
As of September 2024, data linkage has been completed, involving the integration of antibiotic exposure and outcome variables for 315,789 children. Preliminary analyses show that both prenatal and early life antibiotic consumptions is associated with T1D. Full analyses for all three outcomes will be completed by the end of 2025.
Conclusions:
These studies, using detailed, complete, and systematically collected antibiotic prescription data, will provide critical new knowledge regarding the role of antibiotics in the development of common chronic childhood conditions. Thus, it has the potential to contribute to the development of primary prevention strategies, through, for example, targeted changes in antibiotic-use.
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