Shannon K. Murphy , Madeline R. Pike , Emily Lipner , Seth D. Maxwell , Barbara A. Cohn , Piera Cirillo , Nickilou Y. Krigbaum , Elizabeth C. Breen , Lauren M. Ellman
{"title":"Contributions of maternal prenatal infection and antibiotic exposure to offspring infection and risk for allergic respiratory conditions through age 5","authors":"Shannon K. Murphy , Madeline R. Pike , Emily Lipner , Seth D. Maxwell , Barbara A. Cohn , Piera Cirillo , Nickilou Y. Krigbaum , Elizabeth C. Breen , Lauren M. Ellman","doi":"10.1016/j.bbih.2024.100892","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To determine if maternal prenatal infection increases risk of offspring postnatal infections through age 5 or diagnosis of respiratory allergy at age 5, independent of prenatal/postnatal antibiotic exposure. To evaluate if frequency of offspring infections mediates an association between prenatal infection and respiratory allergy at age 5.</div></div><div><h3>Study design</h3><div>Secondary data analyses were performed from the Child Health and Development Studies (CHDS), a prospective, longitudinal birth cohort that enrolled pregnant women from 1959 to 1966 (N = 19,044 live births). The sample included a subset of mother-offspring dyads (<em>n</em> = 2062) with abstracted medical record data from the prenatal period through age 5 that included information on antibiotic use, infection, and offspring respiratory allergy.</div></div><div><h3>Results</h3><div>Second trimester maternal infection was associated with an increased risk of offspring infection (IRR = 1.23; 95% CI = 1.09–1.39; <em>p</em> = 0.001). No significant direct associations were detected between prenatal infection and diagnosis of offspring respiratory allergy. Offspring infection (OR = 1.17; 95% CI = 1.13–1.20; <em>p</em> < 0.001) and antibiotic exposure (OR = 1.28; 95% CI = 1.22–1.33; <em>p</em> < 0.001) were significantly associated with a diagnosis of offspring respiratory allergy. Respiratory allergy diagnosis risk was greater with increasing offspring infection exposure and antibiotics. There was a significant indirect effect of second trimester maternal infection on offspring respiratory allergy, due to infections and not antibiotic use, via offspring infection, indicating a partially mediated effect.</div></div><div><h3>Conclusion</h3><div>Prenatal maternal infection may contribute to increase risk for early childhood infections, which in turn, may increase risk for allergic conditions.</div></div>","PeriodicalId":72454,"journal":{"name":"Brain, behavior, & immunity - health","volume":"42 ","pages":"Article 100892"},"PeriodicalIF":3.7000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain, behavior, & immunity - health","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666354624001704","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
To determine if maternal prenatal infection increases risk of offspring postnatal infections through age 5 or diagnosis of respiratory allergy at age 5, independent of prenatal/postnatal antibiotic exposure. To evaluate if frequency of offspring infections mediates an association between prenatal infection and respiratory allergy at age 5.
Study design
Secondary data analyses were performed from the Child Health and Development Studies (CHDS), a prospective, longitudinal birth cohort that enrolled pregnant women from 1959 to 1966 (N = 19,044 live births). The sample included a subset of mother-offspring dyads (n = 2062) with abstracted medical record data from the prenatal period through age 5 that included information on antibiotic use, infection, and offspring respiratory allergy.
Results
Second trimester maternal infection was associated with an increased risk of offspring infection (IRR = 1.23; 95% CI = 1.09–1.39; p = 0.001). No significant direct associations were detected between prenatal infection and diagnosis of offspring respiratory allergy. Offspring infection (OR = 1.17; 95% CI = 1.13–1.20; p < 0.001) and antibiotic exposure (OR = 1.28; 95% CI = 1.22–1.33; p < 0.001) were significantly associated with a diagnosis of offspring respiratory allergy. Respiratory allergy diagnosis risk was greater with increasing offspring infection exposure and antibiotics. There was a significant indirect effect of second trimester maternal infection on offspring respiratory allergy, due to infections and not antibiotic use, via offspring infection, indicating a partially mediated effect.
Conclusion
Prenatal maternal infection may contribute to increase risk for early childhood infections, which in turn, may increase risk for allergic conditions.
目的确定母体产前感染是否会增加后代5岁前的产后感染风险或5岁时诊断出呼吸道过敏的风险,而与产前/产后抗生素暴露无关。研究设计对儿童健康与发展研究(Child Health and Development Studies,CHDS)的二次数据进行了分析,该研究是一项前瞻性纵向出生队列研究,从 1959 年到 1966 年对孕妇进行了登记(N = 19,044 例活产)。样本包括母子二人组(n = 2062)的子集,这些子集具有从产前到 5 岁的病历摘要数据,其中包括抗生素使用、感染和后代呼吸道过敏的信息。产前感染与后代呼吸道过敏诊断之间未发现明显的直接关联。后代感染(OR = 1.17; 95% CI = 1.13-1.20; p <0.001)和抗生素暴露(OR = 1.28; 95% CI = 1.22-1.33; p <0.001)与后代呼吸道过敏诊断显著相关。呼吸道过敏诊断风险随后代感染暴露和抗生素的增加而增加。第二孕期母体感染对后代呼吸道过敏有明显的间接影响,这是由于感染而不是抗生素的使用,通过后代感染而产生的,这表明存在部分中介效应。