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.
International Registered Report Identifier (IRRID): DERR1-10.2196/66184