Maternal antibiotic exposure alters the newborn metabolomic profile and increases the risk of respiratory infections in offspring: A 13-year longitudinal birth cohort study.
prospective_cohort · Level II
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- Record sourced from PubMed, PMID 42372831.
- Also identified by DOI 10.1016/j.jaci.2026.05.034.
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Abstract
Maternal antibiotic exposure during pregnancy has been associated with early childhood infection proneness, but the underlying mechanisms remain unknown. Longitudinal birth cohort studies with long follow-up and multiomics data are lacking. We investigated the association between prenatal antibiotics and offspring infection risk as well as its potential mechanisms. The Danish population-based COPSAC<sub>2010</sub> cohort with 663 mother-child pairs was followed from pregnancy until child age 13 years. Detailed infection diaries were reviewed for age 0-3 years for common infections (cold, tonsillitis, otitis media, fever, gastrointestinal infections, and pneumonia), and moderate-to-severe (hospital diagnoses) infections were registered until age 13 years. We analyzed maternal antibiotic exposure versus risk of offspring infection risk with assessments of newborn child blood metabolome, gut and airway (age 1 week and 1 month) microbiome, and airway cytokine profiles (age 1 month). We adjusted for genetic, environmental, and socioeconomic factors. Children whose mothers were exposed to antibiotics during pregnancy had a higher risk of infections until age 13 years, with an adjusted incidence rate ratio of 1.75 (95% confidence interval, 1.19-2.57; P = .005), and pneumonia, with an adjusted incidence rate ratio of 1.81 (95% confidence interval, 1.10-2.99; P = .015). Maternal antibiotic exposure-related changes in the newborn child metabolome profile associated with increased child pneumonia, tonsilitis, and fever risk. Both number and types of maternal antibiotic treatments affected offspring infection risk. There were no noticeable findings for microbiome, genetics, and airway cytokine profiling. Maternal antibiotics during pregnancy increased long-term risk of childhood respiratory infection risk following a dose-response pattern, which was linked to newborn metabolomic alterations.