Neonatal antibiotic exposure impairs child growth during the first six years of life by perturbing intestinal microbial colonization

Atara Uzan-Yulzari, Olli Turta, Anna Belogolovski, Oren Ziv, Christina Kunz, Sarah Perschbacher, Hadar Neuman, Edoardo Pasolli, Aia Oz, Hila Ben-Amram, Himanshu Kumar, Helena Ollila, Anne Kaljonen, Erika Isolauri, Seppo Salminen, Hanna Lagström, Nicola Segata, Itai Sharon, Yoram Louzoun, Regina EnsenauerSamuli Rautava, Omry Koren

Research output: Contribution to journalArticlepeer-review

134 Scopus citations

Abstract

Exposure to antibiotics in the first days of life is thought to affect various physiological aspects of neonatal development. Here, we investigate the long-term impact of antibiotic treatment in the neonatal period and early childhood on child growth in an unselected birth cohort of 12,422 children born at full term. We find significant attenuation of weight and height gain during the first 6 years of life after neonatal antibiotic exposure in boys, but not in girls, after adjusting for potential confounders. In contrast, antibiotic use after the neonatal period but during the first 6 years of life is associated with significantly higher body mass index throughout the study period in both boys and girls. Neonatal antibiotic exposure is associated with significant differences in the gut microbiome, particularly in decreased abundance and diversity of fecal Bifidobacteria until 2 years of age. Finally, we demonstrate that fecal microbiota transplant from antibiotic-exposed children to germ-free male, but not female, mice results in significant growth impairment. Thus, we conclude that neonatal antibiotic exposure is associated with a long-term gut microbiome perturbation and may result in reduced growth in boys during the first six years of life while antibiotic use later in childhood is associated with increased body mass index.

Original languageEnglish
Article number443
JournalNature Communications
Volume12
Issue number1
DOIs
StatePublished - Dec 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Funding

We would like to acknowledge Eliisa Löyttyniemi, MSc, for statistical consultation and Dr. Ulla Sankilampi, MD, PhD, for providing the algorithms for anthropometric Z-score calculations. The authors are also grateful to all the families who took part in this study. A grant from the Finnish Society for Pediatric Research (SR). Grants for the PEACHES cohort from the German Federal Ministry of Education and Research and the Foundation for Cardiovascular Prevention in Childhood, Ludwig-Maximilians-Universität München, Munich, Germany (RE).

FundersFunder number
Finnish Society for Pediatric Research
Foundation for Cardiovascular Prevention
Bundesministerium für Bildung und Forschung

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