Publication

Antibiotic use among dutch pregnant woman and the development of toddler asthma: The influence of confounding

Mulder, B., Pouwels, K. B., Schuiling-Veninga, N. C. M., Bos, J., De Vries, T. W., Jick, S. S. & Hak, E., Oct-2014, In : Pharmacoepidemiology and Drug Safety. 23, S1, p. 20-21 2 p.

Research output: Contribution to journalMeeting AbstractAcademic

APA

Mulder, B., Pouwels, K. B., Schuiling-Veninga, N. C. M., Bos, J., De Vries, T. W., Jick, S. S., & Hak, E. (2014). Antibiotic use among dutch pregnant woman and the development of toddler asthma: The influence of confounding. Pharmacoepidemiology and Drug Safety, 23(S1), 20-21. https://doi.org/10.1002/pds.3701

Author

Mulder, Bianca ; Pouwels, Koen B. ; Schuiling-Veninga, Nynke C.M. ; Bos, Jens ; De Vries, Tjalling W. ; Jick, Susan S. ; Hak, Eelko. / Antibiotic use among dutch pregnant woman and the development of toddler asthma : The influence of confounding. In: Pharmacoepidemiology and Drug Safety. 2014 ; Vol. 23, No. S1. pp. 20-21.

Harvard

Mulder, B, Pouwels, KB, Schuiling-Veninga, NCM, Bos, J, De Vries, TW, Jick, SS & Hak, E 2014, 'Antibiotic use among dutch pregnant woman and the development of toddler asthma: The influence of confounding', Pharmacoepidemiology and Drug Safety, vol. 23, no. S1, pp. 20-21. https://doi.org/10.1002/pds.3701

Standard

Antibiotic use among dutch pregnant woman and the development of toddler asthma : The influence of confounding. / Mulder, Bianca; Pouwels, Koen B.; Schuiling-Veninga, Nynke C.M.; Bos, Jens; De Vries, Tjalling W.; Jick, Susan S.; Hak, Eelko.

In: Pharmacoepidemiology and Drug Safety, Vol. 23, No. S1, 10.2014, p. 20-21.

Research output: Contribution to journalMeeting AbstractAcademic

Vancouver

Mulder B, Pouwels KB, Schuiling-Veninga NCM, Bos J, De Vries TW, Jick SS et al. Antibiotic use among dutch pregnant woman and the development of toddler asthma: The influence of confounding. Pharmacoepidemiology and Drug Safety. 2014 Oct;23(S1):20-21. https://doi.org/10.1002/pds.3701


BibTeX

@article{f4c01956eb474b69afe598d9265da0f5,
title = "Antibiotic use among dutch pregnant woman and the development of toddler asthma: The influence of confounding",
abstract = "Background: Recent studies have reported an increased risk of asthma in children after prenatal exposure to antibiotics, notably during third trimester due to altered vaginal bacterial flora. Associations could have been influenced by unmeasured confounders. Objectives: To assess the association between antibiotic use during pregnancy and the development of toddler asthma with a confounding minimizing crossover(casesibling) design. Secondary we wanted to assess the influence of time-invariant confounding by comparing results with a case-control design. Methods: We conducted this study using a linked mother-infant subset of the University Groningen prescription database IADB.nl. We conducted both a crossover study in which 1,228 children with asthma were compared to their own siblings without asthma, and a traditional matched case-control study. Maternal exposure was defined as at least 1 day of supply of systemic antibiotics during pregnancy. Children were considered to have asthma if they received at least 3 prescriptions for anti-asthma medication within a year before the fifth birthday. Conditional logistic regression was used to estimate crude and adjusted odds ratios (aOR). Sensitivity analyses were performed to estimate the potential influence of unobserved timevarying confounders. Results: The crossover analysis only showed an increase in the toddler's asthma risk if antibiotics were used in the third trimester of pregnancy (aOR 1.37 (95%CI 1.02-1.83)). The matched case-control study yielded a similar increase in the toddlers asthma risk after exposure in the third trimester (aOR 1.40(95%CI 1.15-1.47)). In addition, use of antibiotics, independent of trimester of pregnancy, was associated with an aOR of 1.46 (95%CI 1.33-1.58) in the matched case-control study. Conclusions: Prenatal exposure to antibiotics in the third trimester of pregnancy is associated with a small increased risk of childhood asthma. This association did not appear to be influenced by time-invariant confounders such as genetic predisposition. However the influence of time-variant confounders, such as disease severity, cannot be ruled out.",
keywords = "antibiotic agent, human, pregnant woman, asthma, pharmacoepidemiology, toddler, female, risk management, pregnancy, risk, third trimester pregnancy, child, case control study, prenatal exposure, prescription, crossover procedure, logistic regression analysis, drug therapy, environmental exposure, sibling, vagina flora, data base, university, genetic predisposition, infant, exposure, sensitivity analysis, disease severity, mother, IADB",
author = "Bianca Mulder and Pouwels, {Koen B.} and Schuiling-Veninga, {Nynke C.M.} and Jens Bos and {De Vries}, {Tjalling W.} and Jick, {Susan S.} and Eelko Hak",
year = "2014",
month = oct,
doi = "10.1002/pds.3701",
language = "English",
volume = "23",
pages = "20--21",
journal = "Pharmcoepidemiology and Drug Safety",
issn = "1053-8569",
publisher = "Wiley",
number = "S1",

}

RIS

TY - JOUR

T1 - Antibiotic use among dutch pregnant woman and the development of toddler asthma

T2 - The influence of confounding

AU - Mulder, Bianca

AU - Pouwels, Koen B.

AU - Schuiling-Veninga, Nynke C.M.

AU - Bos, Jens

AU - De Vries, Tjalling W.

AU - Jick, Susan S.

AU - Hak, Eelko

PY - 2014/10

Y1 - 2014/10

N2 - Background: Recent studies have reported an increased risk of asthma in children after prenatal exposure to antibiotics, notably during third trimester due to altered vaginal bacterial flora. Associations could have been influenced by unmeasured confounders. Objectives: To assess the association between antibiotic use during pregnancy and the development of toddler asthma with a confounding minimizing crossover(casesibling) design. Secondary we wanted to assess the influence of time-invariant confounding by comparing results with a case-control design. Methods: We conducted this study using a linked mother-infant subset of the University Groningen prescription database IADB.nl. We conducted both a crossover study in which 1,228 children with asthma were compared to their own siblings without asthma, and a traditional matched case-control study. Maternal exposure was defined as at least 1 day of supply of systemic antibiotics during pregnancy. Children were considered to have asthma if they received at least 3 prescriptions for anti-asthma medication within a year before the fifth birthday. Conditional logistic regression was used to estimate crude and adjusted odds ratios (aOR). Sensitivity analyses were performed to estimate the potential influence of unobserved timevarying confounders. Results: The crossover analysis only showed an increase in the toddler's asthma risk if antibiotics were used in the third trimester of pregnancy (aOR 1.37 (95%CI 1.02-1.83)). The matched case-control study yielded a similar increase in the toddlers asthma risk after exposure in the third trimester (aOR 1.40(95%CI 1.15-1.47)). In addition, use of antibiotics, independent of trimester of pregnancy, was associated with an aOR of 1.46 (95%CI 1.33-1.58) in the matched case-control study. Conclusions: Prenatal exposure to antibiotics in the third trimester of pregnancy is associated with a small increased risk of childhood asthma. This association did not appear to be influenced by time-invariant confounders such as genetic predisposition. However the influence of time-variant confounders, such as disease severity, cannot be ruled out.

AB - Background: Recent studies have reported an increased risk of asthma in children after prenatal exposure to antibiotics, notably during third trimester due to altered vaginal bacterial flora. Associations could have been influenced by unmeasured confounders. Objectives: To assess the association between antibiotic use during pregnancy and the development of toddler asthma with a confounding minimizing crossover(casesibling) design. Secondary we wanted to assess the influence of time-invariant confounding by comparing results with a case-control design. Methods: We conducted this study using a linked mother-infant subset of the University Groningen prescription database IADB.nl. We conducted both a crossover study in which 1,228 children with asthma were compared to their own siblings without asthma, and a traditional matched case-control study. Maternal exposure was defined as at least 1 day of supply of systemic antibiotics during pregnancy. Children were considered to have asthma if they received at least 3 prescriptions for anti-asthma medication within a year before the fifth birthday. Conditional logistic regression was used to estimate crude and adjusted odds ratios (aOR). Sensitivity analyses were performed to estimate the potential influence of unobserved timevarying confounders. Results: The crossover analysis only showed an increase in the toddler's asthma risk if antibiotics were used in the third trimester of pregnancy (aOR 1.37 (95%CI 1.02-1.83)). The matched case-control study yielded a similar increase in the toddlers asthma risk after exposure in the third trimester (aOR 1.40(95%CI 1.15-1.47)). In addition, use of antibiotics, independent of trimester of pregnancy, was associated with an aOR of 1.46 (95%CI 1.33-1.58) in the matched case-control study. Conclusions: Prenatal exposure to antibiotics in the third trimester of pregnancy is associated with a small increased risk of childhood asthma. This association did not appear to be influenced by time-invariant confounders such as genetic predisposition. However the influence of time-variant confounders, such as disease severity, cannot be ruled out.

KW - antibiotic agent

KW - human

KW - pregnant woman

KW - asthma

KW - pharmacoepidemiology

KW - toddler

KW - female

KW - risk management

KW - pregnancy

KW - risk

KW - third trimester pregnancy

KW - child

KW - case control study

KW - prenatal exposure

KW - prescription

KW - crossover procedure

KW - logistic regression analysis

KW - drug therapy

KW - environmental exposure

KW - sibling

KW - vagina flora

KW - data base

KW - university

KW - genetic predisposition

KW - infant

KW - exposure

KW - sensitivity analysis

KW - disease severity

KW - mother

KW - IADB

U2 - 10.1002/pds.3701

DO - 10.1002/pds.3701

M3 - Meeting Abstract

VL - 23

SP - 20

EP - 21

JO - Pharmcoepidemiology and Drug Safety

JF - Pharmcoepidemiology and Drug Safety

SN - 1053-8569

IS - S1

ER -

ID: 14307183