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Open Access Research article

Antibiotic exposure in pregnancy and risk of coeliac disease in offspring: a cohort study

Karl Mårild12*, Johnny Ludvigsson3, Yolanda Sanz4 and Jonas F Ludvigsson15

Author Affiliations

1 Dept. Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

2 Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Solna, Sweden

3 Div. of Paediatrics, Department of Clinical and Experimental Medicine, Linköping University, and Östergötland County Council, Linköping, Sweden

4 Microbial Ecology and Nutrition Research Group, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Valencia, Spain

5 Department of Paediatrics, Örebro University Hospital, Örebro, Sweden

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BMC Gastroenterology 2014, 14:75  doi:10.1186/1471-230X-14-75

Published: 14 April 2014

Abstract

Background

The infant microbiota may play a pathogenic role in coeliac disease (CD). Antibiotic treatment in pregnancy is common and could significantly impact the infant microbiota. In this study, we aimed to investigate the association between antibiotic exposure during pregnancy and CD in offspring.

Methods

Prospective questionnaire data on antibiotic exposure in pregnancy were available in 8729 children participating in the All Babies in Southeast Sweden (ABIS) cohort study, and of these 46 developed CD until December 2006. Cox regression estimated hazard ratios (HRs) for CD in the offspring among mothers exposed to antibiotics during pregnancy, with adjustment for parent-reported diary data on breastfeeding, age at gluten introduction and number of infections in the child’s first year of life.

Results

Of the 1836 children exposed to antibiotics during pregnancy, 12 (0.7%) children developed CD as compared with 34/6893 (0.5%) unexposed children (HR = 1.33; 95% CI = 0.69-2.56). Risk estimates remained unchanged after adjustment for breastfeeding, age at gluten introduction and infection load in the child’s first year of life (HR = 1.28; 95% CI = 0.66-2.48).

Conclusions

We found no statistically significant association between antibiotic exposure during pregnancy and CD in offspring. This lack of association may either be true or the result of limited statistical power.

Keywords:
Antibiotics; Celiac disease; Microbiota; Pregnancy