Celiac.com 08/27/2014 - Can antibiotic exposure in pregnancy increase the risk of celiac disease in children? Some researchers suspect that infant microbiota play a pathogenic role in celiac disease. The idea that antibiotic treatment in pregnancy could significantly impact the infant microbiota, and thus influence the development of celiac disease, has led many to ponder the possible connection.

Photo: CC--Kelly HunterTo get a clearer picture, a research team recently set out to study the effects on offspring of antibiotic exposure in pregnancy.

The team included Karl Mårild, Johnny Ludvigsson, Yolanda Sanz, and Jonas F. Ludvigsson. They are variously affiliated with the Deptartment of Medical Epidemiology and Biostatistics, Karolinska Institutet in Stockholm, the Astrid Lindgren Children's Hospital at Karolinska University Hospital in Solna, Sweden, the Division of Paediatrics in the Department of Clinical and Experimental Medicine at Linköping University, Östergötland County Council in Linköping, Sweden, the Department of Paediatrics of Örebro University Hospital in Örebro, Sweden, and the Microbial Ecology and Nutrition Research Group at the Institute of Agrochemistry and Food Technology of the National Research Council (IATA-CSIC) in Valencia, Spain.

The team started by reviewing existing data on antibiotic exposure in pregnancy in 8,729 children recorded in the All Babies in Southeast Sweden (ABIS) cohort study. Through December 2006, 46 of the 8,729 had developed celiac disease. The team then used Cox regression to estimate celiac disease hazard ratios (HRs) in children whose mothers received antibiotics during pregnancy. The ratios were adjusted based on parent-reported diary data on breastfeeding, age at gluten introduction, and the number of infections in the child's first year of life.

Of the 1,836 children exposed to antibiotics during pregnancy, 12 (0.7%) children developed celiac disease 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).

When all the data were factored, the team found no statistically significant connection between antibiotic exposure during pregnancy and celiac disease in offspring. The team suggests that this data may present an accurate picture, or it may be that they simply lack the statistical power to make a clear connection.

Further studies are likely needed before researchers can confidently conclude that there is no connection between antibiotic exposure in pregnancy and celiac disease in offspring.

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