Peripartum Antibiotics Exposure and the Risk of Autoimmune and Autism Disorders in the Offspring

Jehad Almasri; Ahmed Barazi; Katherine S King; Marina R S Walther-Antonio; Zhen Wang; Mohammad H Murad; Joseph A Murray; Imad Absah

doi:10.1055/s-0041-1732485

Peripartum Antibiotics Exposure and the Risk of Autoimmune and Autism Disorders in the Offspring

Avicenna J Med. 2021 Aug 12;11(3):118-125. doi: 10.1055/s-0041-1732485. eCollection 2021 Jul.

Authors

Jehad Almasri¹, Ahmed Barazi², Katherine S King³, Marina R S Walther-Antonio⁴, Zhen Wang¹, Mohammad H Murad¹, Joseph A Murray⁵, Imad Absah²

Affiliations

¹ Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota, United States.
² Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States.
³ Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States.
⁴ Microbiome Program, Center for Individualized Medicine, Division of Obstetrics and Gynecology, Department of Surgery, Mayo Clinic, Rochester, Minnesota, United States.
⁵ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States.

Abstract

Background As the use of antibiotics during the peripartum period increases, the incidence of autoimmune disorders and autism spectrum disorders (ASDs) is also increasing. In this study, we aim to assess if antibiotic exposure during the peripartum period affects the incidence of autoimmune diseases and ASD in the offspring. Methods We identified children (< 18 years of age) born in Olmsted County from January 1, 2003 through December 31, 2012. Offspring with celiac disease (CD), inflammatory bowel disease (IBD), or ASD diagnoses were matched to two controls on birth date, index date, mother's age at delivery, and sex. Data from the mother's medical records were retrieved to determine peripartum antibiotics use. Results A total of 242 cases and 484 matched controls were included in this study. Median age at the last follow-up was 11.3 years (range: 0.5-14.9), 73% were males in both groups. Odds of CD diagnosis was not statistically different between vaginal delivery with antibiotics compared with vaginal delivery with no antibiotics (odds ratio [OR] = 0.76, 95% confidence interval [CI]: 0.32-1.85), similarly in IBD (OR = 2.41, 95% CI: 0.53-10.98) and ASD (OR = 1.00, 95% CI:0.55-1.79). Preeclampsia or eclampsia was associated with offspring CD (OR = 3.20, 95% CI: 1.05-9.78). Smoking history and diabetes mellitus were associated with offspring ASD (OR = 1.84, 95% CI: 1.22-2.77 and OR = 2.01, 95% CI: 1.03-3.91, respectively). Conclusion In this cohort, we found no statistically significant association between peripartum antibiotics exposure and the development of CD, IBD, or ASD.

Keywords: antibiotics exposure in pregnancy; autism; autoimmune disease; microbiome.

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