Effects of early-life antibiotic use on emotional and behavioral development trajectories in preschool children

Background

Limited research exists on the link between antibiotic use and emotion and behavior, particularly the lack of continuous emotional and behavioral assessment. Emotions and behaviors reflect key modifiable dimensions of brain function and evolve during childhood growth and development. This paper aimed to examine the antibiotic use (yes/no), categories and duration in association with preschool children's emotional and behavioral development trajectory.

Methods

Based on Ma'anshan-Anhui Birth Cohort, 1147 mother-child pairs were included in the study. Parents or guardians reported the children's antibiotic use before age 3, including whether antibiotics were used and the types and duration of antibiotics use. The trajectories of children's emotional and behavioral development were fitted using scores from the Strengths and Difficulties Questionnaire (SDQ) at 48, 60, and 72 months.

Results

A total of 23.3 % (268/1147) of children had used antibiotics in the past three months. Children's antibiotic use significantly related with high level of hyperactivity. The use of β-lactam antibiotics, especially non-penicillin, was associated with the risk of high level hyperactivity at a dose-response pattern in duration. Children's combined use of β-lactam and macrolides was related with increased risk of high level hyperactivity, total difficulties and emotional symptoms.

Conclusions

Children's antibiotic use before age 3 is observed to be associated with hyperactivity development, especially using β-lactam antibiotics with a relatively long duration. The combined use of β-lactam and macrolides may increase the development of hyperactivity, total difficulties and emotional symptoms.