Association of prenatal and intrapartum antibiotic exposure with autism spectrum disorder in offspring : a population-based study from British Columbia
department or school: Medicine, Faculty of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Nitschke, Amanda
issued: 2022-10-19T17:47:49Z
issued: 2022
related degree: Master of Science - MSc
degree grantor: University of British Columbia
description: Background: Antibiotics are among the most used medications during pregnancy, and while their short-term benefits are clear, their potential long-term effects are underexplored. Antibiotic exposure induces changes in the maternal microbiome, which could in turn influence the development of the infant’s microbiome with implications for neurodevelopment. This thesis examined the associations of 1) intrapartum antibiotic exposure and 2) prenatal antibiotic exposure with autism spectrum disorder (ASD) in offspring. Methods: Using multiple linked population-level datasets, we examined everyone who delivered a live singleton term infant in British Columbia, Canada between April 1st 2000 and December 31st 2014. To examine the associations among pregnant individuals treated for the same indication, we studied sub-cohorts of those diagnosed 1) as group B streptococcus-positive, and 2) with urinary tract infections. Cox proportional hazards models were used to estimate unadjusted and adjusted hazard ratios. Sensitivity analyses were conducted to examine the impact of different classes of antibiotics, and to assess for dose-response and temporal relationships. Additionally, potential effect modification was examined based on sex and mode of delivery. To account for unmeasured confounding, we ran a conditional logistic regression of discordant sibling pairs. Results: We found no association between intrapartum antibiotic administration and ASD in offspring. In contrast, we observed a small statistically significant increase in risk of ASD associated with prenatal antibiotic exposure. In particular, highest risk was observed if exposure took place during the second trimester, to penicillins or other beta lactams, and for 15 days or longer. Among the cohort restricted to pregnant individuals diagnosed with UTIs, findings showed a positive association between prenatal antibiotics and ASD with an increased effect size; yet, this association was no longer statistically significant, …
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/82897
note: ASSOCIATION OF PRENATAL AND INTRAPARTUM ANTIBIOTIC EXPOSURE WITH AUTISM SPECTRUM DISORDER IN OFFSPRING: A POPULATION-BASED STUDY FROM BRITISH COLUMBIA by Amanda Nitschke B.HSc, University of Ottawa, 2018 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in The Faculty of Graduate and Postdoctoral Studies (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) October 2022 © Amanda Nitschke, 2022 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the thesis entitled: Association of prenatal and intrapartum antibiotic exposure with autism spectrum disorder in offspring: A population-based study from British Columbia submitted by Amanda Nitschke in partial fulfillment of the requirements for the degree of Master of Science in Population and Public Health Examining Committee: Dr. Tim F. Oberlander, Professor, Faculty of Medicine, Department of Pediatrics, UBC Co-supervisor Dr. Gillian E. Hanley, Associate Professor, Faculty of Medicine, Department of Obstetrics and Gynaecology, UBC Co-supervisor Dr. Bruce Vallance, Professor, Faculty of Medicine, Department of Pediatrics, UBC Supervisory Committee Member Dr. Sarka Lisonkova, Associate Professor, Faculty of Medicine, Department of Obstetrics and Gynaecology, UBC Additional Examiner iii Abstract Background Antibiotics are among the most used medications during pregnancy, and while their short-term benefits are clear, their potential long-term effects are underexplored. Antibiotic exposure induces changes in the maternal microbiome, which could in turn influence the development of the infant’s microbiome with implications for neurodevelopment. This thesis examined the associations of 1) intrapartum antibiotic exposure and 2) prenatal antibiotic exposure with autism spectrum disorder (ASD) in offspring. Methods Using multiple linked population-level datasets, we exami…
has type: Thesis/Dissertation
date issued: 2022-11
is shown at: 10.14288/1.0421325
language: eng
degree discipline: Population and Public Health
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Oberlander, Tim F.
contributor: Hanley, Gillian E.
type: Text
identifier URI: http://hdl.handle.net/2429/82897