Image showing a concerned mother holding an infant, with subtle medical imagery like antibiotics and neural networks subtly blending into the background. The image should evoke both concern and caution, focusing on the vulnerability of early life and the potential risks of medical treatments.
Antibiotic use during pregnancy and infancy is common, but its potential impact on long-term child development remains unclear. Researchers from South Korea conducted a large-scale cohort study to explore the association between antibiotic exposure during these critical periods and the risk of developing neurodevelopmental disorders in children.
“Neurodevelopmental disorders, such as autism and intellectual disabilities, are becoming more prevalent worldwide,” the researchers explain. These disorders have lasting effects on children’s lives, and understanding their causes is crucial.
Examining the Link Between Antibiotics and Neurodevelopment
The study included over 3.9 million children born between 2009 and 2020, using Korea’s National Health Insurance Service mother-child linked database. “Our study design allowed us to account for familial factors that could confound the results,” says lead researcher Ju-Young Shin.
The analysis focused on four neurodevelopmental disorders: autism spectrum disorder, intellectual disorder, language disorder, and epilepsy. To ensure robust findings, a sibling analysis was also conducted. “This design helps reduce bias from shared genetic or environmental factors within families,” the research team notes.
Key Findings: What the Data Showed
After analyzing the data, the researchers found no substantial association between antibiotic exposure during pregnancy or early infancy and an increased risk of most neurodevelopmental disorders.
“In particular, our results suggest no heightened risk for autism spectrum disorder or intellectual disability related to antibiotic exposure,” says Ahhyung Choi, a co-author of the study. However, a modest increase in the risk of epilepsy was observed among children exposed to antibiotics during early infancy. “This finding, while small, is important and warrants further investigation,” Choi adds.
The researchers also found that children exposed to antibiotics in very early life or for longer periods (more than 15 days) showed slightly elevated risks of neurodevelopmental outcomes, including epilepsy. “Our results emphasize the need for cautious use of antibiotics during these critical developmental periods,” they suggest.
Clinical Implications: Balancing Risks and Benefits
While the study largely dispelled concerns about antibiotics and autism, the researchers recommend careful decision-making when prescribing antibiotics to pregnant women and infants. “Physicians should weigh the potential risks and benefits of antibiotic use during pregnancy and infancy,” says Hyesung Lee, one of the co-authors.
The study’s findings highlight the importance of personalized care. “Long-term use of antibiotics, especially in the early months of life, should be carefully monitored. This might help mitigate potential risks,” Lee advises.
Subgroup and sensitivity analyses supported the robustness of the study’s findings, though the slight association with epilepsy underscores the need for further research. “Our data suggest that the timing and duration of antibiotic exposure might be key factors in understanding any associated risks,” the research team concluded.
Citation:
Choi A, Lee H, Jeong HE, Lee S-Y, Kwon JS, Han JY, Choe YJ, Shin J-Y. Association between exposure to antibiotics during pregnancy or early infancy and risk of autism spectrum disorder, intellectual disorder, language disorder, and epilepsy in children: population based cohort study. BMJ. 2024;385. doi:10.1136/bmj-2023-076885
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