REFERENCE: Jason P. Block, L. Charles Bailey, Matthew W. Gillman, Doug Lunsford, Matthew F.Daley, Ihuoma Eneli, Jonathan Finkelstein, William Heerman, Casie E. Horgan, Daniel S. Hsia, Melanie Jay, Goutham Rao, Juliane S. Reynolds, Sheryl L. Rifas-Shiman, Jessica L. Sturtevant, Sengwee Toh, Leonardo Trasande, Jessica Young, Christopher B. Forrest, on behalf of the PCORnet Antibiotics and Childhood Growth Study Group. Early Antibiotic Exposure and Weight Outcomes in Young Children. Pediatrics, Dec 2018, 142 (6) e20180290; DOI: 10.1542/peds.2018-0290

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OBJECTIVES: To determine the association of antibiotic use with weight outcomes in a large cohort of children.

METHODS: Health care data were available from 2009 to 2016 for 35 institutions participating in the National Patient-Centered Clinical Research Network. Participant inclusion required same-day height and weight measurements at 0 to <12, 12 to <30, and 48 to <72 months of age. We assessed the association between any antibiotic use at <24 months of age with BMI z score and overweight or obesity prevalence at 48 to <72 months (5 years) of age, with secondary assessments of antibiotic spectrum and age-period exposures. We included children with and without complex chronic conditions.

RESULTS: Among 1 792 849 children with a same-day height and weight measurement at <12 months of age, 362 550 were eligible for the cohort. One-half of children (52%) were boys, 27% were African American, 18% were Hispanic, and 58% received ≥1 antibiotic prescription at <24 months of age. At 5 years, the mean BMI z score was 0.40 (SD 1.19), and 28% of children had overweight or obesity. In adjusted models for children without a complex chronic condition at 5 years, we estimated a higher mean BMI z score by 0.04 (95% confidence interval [CI] 0.03 to 0.05) and higher odds of overweight or obesity (odds ratio 1.05; 95% CI 1.03 to 1.07) associated with obtaining any (versus no) antibiotics at <24 months.

CONCLUSIONS: Antibiotic use at <24 months of age was associated with a slightly higher body weight at 5 years of age