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| |  Pre- and Postnatal Antimicrobial Exposure Increases Asthma Risk in Children: Presented at EAACI By Sara Freeman LONDON -- June 10, 2010 -- Pre- and postnatal exposure to antimicrobial agents could play a role in the development of childhood asthma, according to the results of a study presented here at the 29th Congress of the European Academy of Allergy and Clinical Immunology (EAACI). Johanna Metsälä, MD, National Institute for Health and Welfare, Helsinki, Finland, reported data on 20,272 children born between 1996 and 2004 who were diagnosed with asthma by 2006 and prescribed anti-asthmatic medication. Data were matched to a control group of 20,272 children who were of the same age and demographic disposition but who were not diagnosed or treated for asthma by 2006. Many studies have assessed postnatal exposure to antibiotics and the risk of asthma in children, with inconsistent findings in all but the largest of studies, Dr. Metsälä said on June 6. Few studies have looked at prenatal exposure and there is limited information on the use of antibiotics by both the mother and child. Four Finnish databases were used to obtain the necessary raw data for the study. The Special Reimbursement Register was used to identify children with asthma treated with anti-asthmatic medications and the Population Register was used to select a matched control population. The Drug Prescription Register was used to determine antimicrobial and anti-asthmatic drug use, and the Medical Birth Register was used to identify maternal background and perinatal factors. Analyses were performed separately for children diagnosed before age 3 (n = 13,582 case-control pairs) and >= 3 years of age (n = 6,690 case-control pairs). Adjusted odds ratios (aOR) for the overall use of antimicrobials by the mother and risk of asthma in the child were 1.30 for children aged younger than 3 years and 1.14 for those aged 3 years or older. There was a higher risk of asthma in both age groups if the children had themselves used antibiotics (aOR = 3.83 and 3.64, respectively). There was a trend for greater antimicrobial use by the mother to result in a higher asthma risk in the child, with almost all classes of antibiotics increasing the risk of asthma. The risk of asthma was also raised with the child's increasing use of antimicrobial medications purchased before the diagnosis. The strongest association was with the use of macrolide antibiotics, but the use of >=3 cephalosporins, sulphonamides, trimethoprim, or amoxicillin, also significantly elevated the asthma risk. "A dose-response relationship between prenatal and postnatal exposure and the risk of asthma in the child was seen," said Dr. Metsälä. "The strength of the observed associations varied according to the age at diagnosis, exposure period, and the type of antimicrobial." [Presentation title: Pre- and Postnatal Exposure to Antimicrobials and the Risk of Asthma in Childhood - A Register-Based Case-Control Study Nested in the Finnish Population. Abstract 32]
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