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dc.contributor.advisorFisher, Jennifer O.
dc.creatorTeneralli, Rachel Ellen
dc.date.accessioned2020-11-03T15:34:00Z
dc.date.available2020-11-03T15:34:00Z
dc.date.issued2018
dc.identifier.urihttp://hdl.handle.net/20.500.12613/2516
dc.description.abstractRates of immune-mediated diseases (IMDs) have rapidly increased. Although the exact etiology has not yet been fully elucidated, disruptions to the microbiome has been proposed as a potential mechanism. We conducted a retrospective, longitudinal, birth cohort study utilizing electronic health records (EHR) to investigate the association between early life antibiotic exposure and the risk of developing juvenile idiopathic arthritis (JIA), pediatric psoriasis, or type 1 diabetes. Incident rate ratios (IRR) were estimated using modified Poisson regression models and adjusted for significant confounders. Children exposed to two or more antibiotics prior to 12 months of age had a 69% increased risk of developing JIA (1.69 IRR, 95% CI [1.04-2.73]), which rose to 97% when exposed prior to 6 months (1.97 IRR, 95% CI [1.11-3.49]). Children exposed to a penicillin antibiotic had a 62% increase in risk for psoriasis (1.62 IRR, 95% CI [1.06-2.49]), which rose slightly to 64% when exposure occurred between 6 and 12 months of age [(1.64 IRR, 95% CI [1.04-2.59]). We found a moderate to strong association between early antibiotic exposure and risk for JIA and psoriasis when exposure was examined by age, frequency, and type of antibiotic, but not for type 1 diabetes. Potential interactions effects between infection and antibiotics with an increased susceptibility to early life infections among children with an IMD was also observed. Overall, children exposed to antibiotics at an early age have an increased probability of developing an IMD after 12 months of age. However, alternative explanations for this association should be considered.
dc.format.extent194 pages
dc.language.isoeng
dc.publisherTemple University. Libraries
dc.relation.ispartofTheses and Dissertations
dc.rightsIN COPYRIGHT- This Rights Statement can be used for an Item that is in copyright. Using this statement implies that the organization making this Item available has determined that the Item is in copyright and either is the rights-holder, has obtained permission from the rights-holder(s) to make their Work(s) available, or makes the Item available under an exception or limitation to copyright (including Fair Use) that entitles it to make the Item available.
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/
dc.subjectEpidemiology
dc.subjectImmunology
dc.subjectPublic Health
dc.subjectAntibiotics
dc.subjectElectronic Health Records (ehr)
dc.subjectJuvenile Idiopathic Arthritis
dc.subjectPediatric Immune-mediated Disease
dc.subjectPsoriasis
dc.subjectType 1 Diabetes
dc.titleEXAMINING THE RELATIONSHIP BETWEEN EARLY LIFE ANTIBIOTIC EXPOSURE AND RISK OF AN IMMUNE MEDIATED DISEASE DURING CHILDHOOD THROUGH ADOLESCENCE
dc.typeText
dc.type.genreThesis/Dissertation
dc.contributor.committeememberCoffman, Donna L.
dc.contributor.committeememberHart, Chantelle Nobile
dc.contributor.committeememberTucker, Carole A.
dc.contributor.committeememberBailey, Charles L.
dc.description.departmentPublic Health
dc.relation.doihttp://dx.doi.org/10.34944/dspace/2498
dc.ada.noteFor Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu
dc.description.degreePh.D.
refterms.dateFOA2020-11-03T15:34:00Z


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