Association Between Antibiotics in the First Year of Life and Celiac Disease

Stine Dydensborg Sander, Anne Marie Nybo Andersen, Joseph A Murray, Øystein Karlstad, Steffen Husby, Ketil Størdal

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background & Aims: The intestinal microbiota is believed to be involved in the pathogenesis of celiac disease, in addition to genetic variants and dietary gluten. The gut microbiota is strongly influenced by systemic antibiotics—especially in early life. We explored the association between exposure to a systemic antibiotic in the first year of life and risk of diagnosed celiac disease. Methods: We performed an observational nationwide register-based cohort study. We included all children born in Denmark from 1995 through 2012 or Norway from 2004 through 2012. Children born in Denmark were followed until May 8, 2015 (age at end of follow-up was 2.3–20.3 years) and children born in Norway were followed until December 31, 2013 (age at end of follow-up was 1–10 years). We collected medical information from more than 1.7 million children, including 3346 with a diagnosis of celiac disease. Exposure to systemic antibiotics was defined as a dispensed systemic antibiotic in the first year of life. Results: Exposure to systemic antibiotics in the first year of life was positively associated with diagnosed celiac disease in the Danish and Norwegian cohorts (pooled odds ratio 1.26, 95% confidence interval 1.16–1.36). We found a dose-dependent relation between an increasing number of dispensed antibiotics and the risk of celiac disease (pooled odds ratio for each additional dispensed antibiotic 1.08, 95% confidence interval 1.05–1.11). No specific type of antibiotic or age period within the first year of life was prominent. Adjustment for hospital admissions with an infectious disease in the first year of life did not change the estimates; adjustment for the number of maternally reported infections in the child in 2 large sub-cohorts decreased the association slightly (pooled odds ratio 1.18, 95% confidence interval 0.98–1.39). Conclusion: In a nationwide study of children in Denmark and Norway, we found exposure to systemic antibiotics in the first year of life to be associated with a later diagnosis of celiac disease. These findings indicate that childhood exposure to systemic antibiotics could be a risk factor for celiac disease.

Original languageEnglish (US)
Pages (from-to)2217-2229
Number of pages13
JournalGastroenterology
Volume156
Issue number8
DOIs
StatePublished - Jun 1 2019

Fingerprint

Celiac Disease
Anti-Bacterial Agents
Denmark
Norway
Odds Ratio
Confidence Intervals
Glutens
Delayed Diagnosis
Communicable Diseases
Cohort Studies
Infection

Keywords

  • Autoimmunity
  • Epidemiology
  • Microbiome
  • Population

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Dydensborg Sander, S., Nybo Andersen, A. M., Murray, J. A., Karlstad, Ø., Husby, S., & Størdal, K. (2019). Association Between Antibiotics in the First Year of Life and Celiac Disease. Gastroenterology, 156(8), 2217-2229. https://doi.org/10.1053/j.gastro.2019.02.039

Association Between Antibiotics in the First Year of Life and Celiac Disease. / Dydensborg Sander, Stine; Nybo Andersen, Anne Marie; Murray, Joseph A; Karlstad, Øystein; Husby, Steffen; Størdal, Ketil.

In: Gastroenterology, Vol. 156, No. 8, 01.06.2019, p. 2217-2229.

Research output: Contribution to journalArticle

Dydensborg Sander, S, Nybo Andersen, AM, Murray, JA, Karlstad, Ø, Husby, S & Størdal, K 2019, 'Association Between Antibiotics in the First Year of Life and Celiac Disease', Gastroenterology, vol. 156, no. 8, pp. 2217-2229. https://doi.org/10.1053/j.gastro.2019.02.039
Dydensborg Sander S, Nybo Andersen AM, Murray JA, Karlstad Ø, Husby S, Størdal K. Association Between Antibiotics in the First Year of Life and Celiac Disease. Gastroenterology. 2019 Jun 1;156(8):2217-2229. https://doi.org/10.1053/j.gastro.2019.02.039
Dydensborg Sander, Stine ; Nybo Andersen, Anne Marie ; Murray, Joseph A ; Karlstad, Øystein ; Husby, Steffen ; Størdal, Ketil. / Association Between Antibiotics in the First Year of Life and Celiac Disease. In: Gastroenterology. 2019 ; Vol. 156, No. 8. pp. 2217-2229.
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