Postnatal Antibiotics for Maternal Indications May Heighten Childhood Asthma Risk

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Early-life antibiotic exposure administered for maternal indications may increase the risk of childhood asthma, according to research to be presented at the 2025 American Academy of Allergy, Asthma & Immunology (AAAAI) / World Allergy Organization (WAO) Joint Congress, being held February 28 - March 3, 2025.

“We aimed to further explore the association between early-life antibiotic exposure and childhood asthma while mitigating the potential contributions by focusing on very early postnatal antibiotic exposure for maternal indications in otherwise healthy infants,” lead author Eyal Kristal, MD, of Soroka University Medical Center in Israel, said in a press release.² “Our results demonstrate that postnatal antibiotic therapy for maternal indication, not confounded by infants’ infections, was associated with an increased childhood asthma risk.”

Kristal and colleagues conducted a retrospective review of electronic medical records for 14 807 healthy full-term children born between 2006 and 2018 to mothers with a positive group B streptococcus (GBS) vaginal culture. Among these children, 311 received antibiotic treatment shortly after birth for maternal indications. To minimize confounding by infant infections, researchers excluded children with postnatal respiratory symptoms, pneumonia, or a positive blood or cerebrospinal fluid culture. The primary outcome was asthma diagnosis by age 6 years, compared between offspring treated and not treated with antibiotics in the first week of life.¹

“We fitted a quasi-poisson regression model to assess the unique contribution of antibiotic treatment to asthma diagnosis, controlling for ethnicity, mode of delivery, birth weight, gender, maternal asthma, maternal antibiotic use during pregnancy, and socioeconomic status,” Kristal wrote in the study abstract.¹

Results from a regression model demonstrated that the risk ratio (RR) for asthma was 1.3 (95% CI, 1.04–1.6; P = .018), and in a propensity model, the RR was 1.31 (95% CI, 1.01–1.69; P = .039).The analysis also identified associations between antibiotic therapy and increased use of short-acting beta-agonists as well as the presence of allergic rhinitis.¹

The findings suggest that antibiotic exposure during the immediate postnatal period may have long-term respiratory implications. Although further research is needed to clarify the underlying mechanisms, these results could inform treatment considerations during pregnancy and in the early neonatal period, ultimately supporting improved patient care.^1,2

References:

1. Kristal E. Isolated perinatal antibiotic exposure due to maternal GBS and the risk for childhood asthma. J Allergy Clin Immunol. 2025;155(2). AB22. https://www.jacionline.org/pb-assets/Health%20Advance/journals/ymai/AAAAI_2025_February28-1738868845313.pdf
2. Isolated early-life antibiotic exposure is associated with increased risk of childhood asthma. News release. AAAAI. February 10, 2025. Accessed February 12, 2025. https://www.aaaai.org/about/news/news/2025/antibiotic