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- Leong, Karen S. W., et al.
(author)
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Associations of Prenatal and Childhood Antibiotic Exposure With Obesity at Age 4 Years
- 2020
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In: JAMA Network Open. - : AMER MEDICAL ASSOC. - 2574-3805. ; 3:1
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Journal article (peer-reviewed)abstract
- Importance Although antibiotics are associated with obesity in animal models, the evidence in humans is conflicting. Objective To assess whether antibiotic exposure during pregnancy and/or early childhood is associated with the development of childhood obesity, focusing particularly on siblings and twins. Design, Setting, and Participants This cross-sectional national study included 284 & x202f;211 participants (132 & x202f;852 mothers and 151 & x202f;359 children) in New Zealand. Data analyses were performed for 150 & x202f;699 children for whom data were available, 30 & x202f;696 siblings, and 4188 twins using covariate-adjusted analyses, and for 6249 siblings and 522 twins with discordant outcomes using fixed-effects analyses. Data analysis was performed November 2017 to March 2019. Exposure Exposure to antibiotics during pregnancy and/or early childhood. Main Outcomes and Measures The main outcome is odds of obesity at age 4 years. Anthropometric data from children born between July 2008 and June 2011 were obtained from the B4 School Check, a national health screening program that records the height and weight of 4-year-old children in New Zealand. These data were linked to antibiotics (pharmaceutical records) dispensed to women before conception and during all 3 trimesters of pregnancy and to their children from birth until age 2 years. Results The overall study population consisted of 132 & x202f;852 mothers and 151 & x202f;359 children (77 & x202f;610 [51.3%] boys) who were aged 4 to 5 years when their anthropometrical measurements were assessed. Antibiotic exposure was common, with at least 1 course dispensed to 35.7% of mothers during pregnancy and 82.3% of children during the first 2 years of life. Results from covariate-adjusted analyses showed that both prenatal and early childhood exposures to antibiotics were independently associated with obesity at age 4 years, in a dose-dependent manner. Every additional course of antibiotics dispensed to the mothers yielded an adjusted odds ratio (aOR) of obesity in their children (siblings) of 1.02 (95% CI, 0.99-1.06), which was similar to the odds across pregnancy for the whole population (aOR, 1.06; 95% CI, 1.04-1.07). For the child's exposure, the aOR for the association between antibiotic exposure and obesity was 1.04 (95% CI, 1.03-1.05) among siblings and 1.05 (95% CI, 1.02-1.09) among twins. However, fixed-effects analyses of siblings and twins showed no associations between antibiotic exposure and obesity, with aORs of 0.95 (95% CI, 0.90-1.00) for maternal exposure, 1.02 (95% CI, 0.99-1.04) for child's exposure, and 0.91 (95% CI, 0.81-1.02) for twins' exposure. Conclusions and Relevance Although covariate-adjusted analyses demonstrated an association between antibiotic exposure and odds of obesity, further analyses of siblings and twins with discordant outcomes showed no associations. Thus, these discordant results likely reflect unmeasured confounding factors. Question Is antibiotic exposure during pregnancy and/or during early childhood associated with the development of childhood obesity? Findings This cross-sectional national study of 284 & x202f;211 participants (132 & x202f;852 mothers and 151 & x202f;359 children) in New Zealand found that both prenatal and early childhood exposures to antibiotics were independently associated with obesity at age 4 years in a dose-dependent manner. However, fixed-effects analyses of siblings and twins with discordant outcomes showed no associations between antibiotic exposure and obesity. Meaning Although judicious use of antibiotics is necessary, antibiotics are unlikely to be a major contributor to childhood obesity. This cross-sectional study of mothers and their children in New Zealand assesses whether exposure to antibiotics during pregnancy and/or early childhood is associated with the development of childhood obesity.
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| 2. |
- Shackleton, Nichola, et al.
(author)
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Decomposing ethnic differences in body mass index and obesity rates among New Zealand pre-schoolers
- 2019
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In: International Journal of Obesity. - : NATURE PUBLISHING GROUP. - 0307-0565 .- 1476-5497. ; 43:10, s. 1951-1960
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Journal article (peer-reviewed)abstract
- Objective To determine the extent to which ethnic differences in BMI Z-scores and obesity rates could be explained by the differential distribution of demographic (e.g. age), familial (e.g. family income), area (e.g. area deprivation), parental (e.g. immigration status), and birth (e.g. gestational age) characteristics across ethnic groups. Methods We used data on 4-year-old children born in New Zealand who attended the B4 School Check between the fiscal years of 2010/2011 to 2015/2016, who were resident in the country when the 2013 census was completed (n = 253,260). We implemented an Oaxaca-Blinder decomposition to explain differences in BMI Z-score and obesity between Maori (n = 63,061) and European (n = 139,546) children, and Pacific (n = 21,527) and European children. Results Overall, 15.2% of the children were obese and mean BMI Z-score was 0.66 (SD = 1.04). The Oaxaca-Blinder decomposition demonstrated that the difference in obesity rates between Maori and European children would halve if Maori children experienced the same familial and area level conditions as Europeans. If Pacific children had the same characteristics as European children, differences in obesity rates would reduce by approximately one third, but differences in mean BMI Z-scores would only reduce by 16.1%. Conclusion The differential distribution of familial, parental, area, and birth characteristics across ethnic groups explain a substantial percentage of the ethnic differences in obesity, especially for Maori compared to European children. However, marked disparities remain.
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