Antibiotics at birth and later antibiotic courses: effects on gut microbiota

Sofia Ainonen, Mysore V Tejesvi, Md Rayhan Mahmud, Niko Paalanne, Tytti Pokka, Weizhong Li, Karen E Nelson, Jarmo Salo, Marjo Renko, Petri Vänni, Anna Maria Pirttilä, Terhi Tapiainen, Sofia Ainonen, Mysore V Tejesvi, Md Rayhan Mahmud, Niko Paalanne, Tytti Pokka, Weizhong Li, Karen E Nelson, Jarmo Salo, Marjo Renko, Petri Vänni, Anna Maria Pirttilä, Terhi Tapiainen

Abstract

Background: Intrapartum antibiotic prophylaxis (IAP) is widely used, but the evidence of the long-term effects on the gut microbiota and subsequent health of children is limited. Here, we compared the impacts of perinatal antibiotic exposure and later courses of antibiotic courses on gut microbiota.

Methods: This was a prospective, controlled cohort study among 100 vaginally delivered infants with different perinatal antibiotic exposures: control (27), IAP (27), postnatal antibiotics (24), and IAP and postnatal antibiotics (22). At 1 year of age, we performed next-generation sequencing of the bacterial 16S ribosomal RNA gene of fecal samples.

Results: Exposure to the perinatal antibiotics had a clear impact on the gut microbiota. The abundance of the Bacteroidetes phylum was significantly higher in the control group, whereas the relative abundance of Escherichia coli was significantly lower in the control group. The impact of the perinatal antibiotics on the gut microbiota composition was greater than exposure to later courses of antibiotics (28% of participants).

Conclusions: Perinatal antibiotic exposure had a marked impact on the gut microbiota at the age of 1 year. The timing of the antibiotic exposure appears to be the critical factor for the changes observed in the gut microbiota.

Impact: Infants are commonly exposed to IAP and postnatal antibiotics, and later to courses of antibiotics during the first year of life. Perinatal antibiotics have been associated with an altered gut microbiota during the first months of life, whereas the evidence regarding the long-term impact is more limited. Perinatal antibiotic exposure had a marked impact on the infant's gut microbiota at 1 year of age. Impact of the perinatal antibiotics on the gut microbiota composition was greater than that of the later courses of antibiotics at the age of 1 year.

Conflict of interest statement

The authors declare no competing interests.

© 2021. The Author(s).

Figures

Fig. 1. Study design.
Fig. 1. Study design.
IAP refers to intrapartum antibiotic prophylaxis. a Flowchart and comparisons at 1 year of age according to the perinatal antibiotic exposure. b Flowchart and comparisons according to exposure to courses of antibiotics after the perinatal period.
Fig. 2. Relative abundances of the main…
Fig. 2. Relative abundances of the main bacterial phyla and genera of the gut microbiota at 1 year of age.
The gut microbiota of the vaginally delivered term infants at 1 year, according to a perinatal antibiotic exposure and b antibiotic courses for common childhood infections. P values indicate post hoc comparisons (control vs. the various antibiotic groups).
Fig. 3. Krona charts showing the gut…
Fig. 3. Krona charts showing the gut microbiota at one year of age.
a After perinatal antibiotic exposure. b After courses of antibiotics. Summed results for the group in question and the control group.

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Source: PubMed

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