Neonatal Antibiotics and Food Allergy Are Associated With FGIDs at 4-6 Years of Age

J Pediatr Gastroenterol Nutr. 2022 Jun 1;74(6):770-775. doi: 10.1097/MPG.0000000000003428. Epub 2022 Feb 24.


Objectives: Antibiotics may contribute to the development of functional gastrointestinal disorders (FGIDs). This study aimed to determine whether antibiotics during the first week of life, infantile colic in the first year of life, gut-associated immune markers at 1 year of age, and allergies at 4-6 years of age in term-born children were associated with a higher prevalence of FGIDs at 4-6 years of age.

Methods: A prospective observational cohort of 436 term-born infants was followed up at the age of 4-6 years; 151 received broad-spectrum antibiotics (AB+), and 285 healthy controls (AB-). Validated Questionnaire On Pediatric Gastrointestinal Symptoms-Rome III and International Study of Asthma and Allergy in Childhood questionnaires were sent to parents of 418 available children. The independent t-test, chi-squared test or non-parametric test and logistic multivariate regression analyses were used.

Results: In total, 340 of 418 (81%) questionnaires were completed. Only the presence of functional abdominal pain was significantly higher in AB+ than AB- (4% vs 0.4%, respectively, P = 0.045). Children with food allergy fulfilled significantly more often the criteria for irritable bowel syndrome (IBS) and abdominal migraine (26% vs 9%, P = 0.002 and 7% vs 1%, P = 0.043, respectively) compared to non-allergic children. No differences in FGIDs existed at the age of 4-6 years between children with and without a history of infantile colic. There were significant differences in gut-associated immune markers between children with and without FGIDs.

Conclusion: Antibiotics during the first week of life resulted in a higher risk for functional abdominal pain at 4-6 years. Furthermore, food allergy was associated with IBS and abdominal migraine at 4-6years.

Trial registration: NCT02536560.

Publication types

  • Observational Study

MeSH terms

  • Abdominal Pain / epidemiology
  • Anti-Bacterial Agents / adverse effects
  • Child
  • Child, Preschool
  • Colic* / epidemiology
  • Colic* / etiology
  • Food Hypersensitivity* / complications
  • Gastrointestinal Diseases* / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Irritable Bowel Syndrome* / complications
  • Migraine Disorders* / complications
  • Prevalence
  • Surveys and Questionnaires


  • Anti-Bacterial Agents

Associated data