CONTRIBUTIONS OF PRENATAL INFECTION AND ANTIBIOTIC EXPOSURE TO OFFSPRING INFECTION AND ASTHMA RISK

Abstract

Increasing evidence from both animal and human research implicates prenatal infection in the development of long-lasting disruptions in immune function of offspring, including an increased risk of infection and allergic disorders, such as asthma. Infection, specifically during early life, also has been repeatedly associated with subsequent risk of asthma in childhood. Moreover, antibiotic exposure, during both the pre- and post-natal period, has been linked with several of these immune-related health outcomes. The aim of the current study was to investigate the role of maternal infection during pregnancy in relation to the development of offspring infection and subsequent asthma risk. Further, we considered the confounding factors of pre- and postnatal antibiotic exposure in the context of offspring infection and asthma inception. Participants (N=2062) were pregnant women and their offspring prospectively enrolled in a longitudinal birth cohort study with follow-up data through childhood. Extensive health information, including data on illness episodes and antibiotic exposures, was obtained from medical records for both mothers and their offspring. Results indicated that second trimester prenatal infection was associated with an increased risk of offspring infection from birth through age five. Both offspring infection and antibiotic exposure from birth through age five were significantly associated with a diagnosis of asthma in children at age five. Offspring infection was found to mediate the relationship between mothers’ second trimester infection and offspring asthma. Sensitivity analyses suggested that our results primarily were due to infections and not antibiotic use, given that findings were replicated when restricting analyses to samples of mothers and offspring without antibiotic exposure. These findings suggest fetal origins of offspring infection and asthma risk.