Early life exposure to infection, anti-infectives and altered immune activity have been associated with elevated risk of some psychiatric disorders. However, the risk from exposure in fetal life has been proposed to be confounded by familial factors. The hypothesis of this study is that antibiotic drug exposure during the fetal period and the first two postnatal years is associated with risk for later development of psychiatric disorders in children. All births in Finland between 1996 and 2012, 1 million births, were studied for antibiotic drug exposure: mothers during pregnancy and the children the first two postnatal years. The children were followed up for a wide spectrum of psychiatric diagnoses and psychotropic drug treatment until 2014. Cox proportional hazards modeling was used to estimate effects of antibiotic drug exposure on offspring psychiatric disorders. Modestly (10-50%) increased risks were found on later childhood development of sleep disorders, ADHD, conduct disorder, mood and anxiety disorders, and other behavioral and emotional disorders with childhood onset (ICD-10 F98), supported by increased risks also for childhood psychotropic medication. The prenatal exposure effects detected were not explained by explored familial confounding, nor by registered maternal infections. To conclude, this longitudinal nation-wide study shows that early life antibiotic drug exposure is associated with an increased risk for childhood development of psychopathology. Given the high occurrence of early-life antibiotic exposure, these findings are of public health relevance. Whether the associations reflect effects of the antibiotic drug use or of the targeted infections remains to be explored further.

中文翻译：

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早期接触抗生素药物和精神疾病的风险：一项基于人群的研究。

生命早期接触感染，抗感染药和免疫活性改变与某些精神疾病的风险增加有关。然而，已经有人提出将胎儿生活中的暴露风险与家庭因素混淆。这项研究的假设是，胎儿期和出生后头两年的抗生素药物暴露与儿童以后发生精神疾病的风险有关。研究人员研究了1996年至2012年期间芬兰的所有婴儿出生情况，即100万例婴儿的抗生素药物暴露情况：怀孕期间的母亲和出生后头两年的儿童。对该儿童进行了广泛的精神科诊断和精神药物治疗随访，直至2014年。使用Cox比例风险建模来评估抗生素药物暴露对后代精神病的影响。在儿童期后期出现的睡眠障碍，注意力缺陷多动障碍，行为障碍，情绪和焦虑症以及其他儿童期发作的行为和情感障碍（ICD-10 F98）中，患轻度（10-50％）的风险也有所增加，这也得到了风险增加的支持用于儿童精神药物。所探明的产前暴露影响并未通过探索性的家庭混杂因素或注册的孕产妇感染来解释。总而言之，这项纵向的全国性研究表明，早期服用抗生素药物与儿童期心理病理发展的风险增加有关。考虑到生命早期抗生素暴露的高发生率，这些发现与公共卫生有关。