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Research raises alarm on antibiotic use during pregnancy

New research shows antibiotic treatment during pregnancy may increase susceptibility to inflammatory bowel disease in newborns

November 25, 2015 — 

The use of antibiotics during pregnancy near the time of delivery is a common practice to prevent infections in newborns. But the use of antibiotics has raised some concerns in other clinical situations in which a clear benefit has not been demonstrated.

New research published in PLOS ONE from a team led by Dr. Jean-Eric Ghia, assistant professor of immunology and internal medicine at the University of Manitoba and researcher at the Children’s Hospital Research Institute of Manitoba, shows that antibiotics during pregnancy (antepartum) may affect the microbial compositions of the newborn intestine, and subsequently its susceptibility to gastrointestinal diseases. In this context, although antepartum antibiotics are short-term, they are given at a critical time when newborn acquisition of bacteria – which is also known to influence the initial immune system development – is just beginning.

Two pink pills on a white table

New research by U of M professors argues antibiotics should be used sparingly by pregnant women. / Photo: Michael Mortensen, Flickr

The use of broad-spectrum antibiotics in the perinatal period has been shown to alter the expression of genes involved in gastrointestinal tract development, and antibiotics given to pregnant mothers in the days before delivery have been shown to significantly alter the composition of the preterm newborn microbiota, reducing intestinal microbial diversity.

As a result, antepartum antibiotic exposure may have far-reaching implications on neonatal immune system maturation. Over the past 10 years, new data has demonstrated that changes in the composition of the newborn indigenous microbiota may have the potential to influence childhood development and also their risk of disease, including ulcerative colitis (UC). Over 100,000 Canadians suffer from UC and the number is increasing every year.

Despite the high association between the impacts of perinatal or neonatal antibiotic use on the microbial colonization and future risk for asthma, other allergic reactions and disease conditions, the effects of antepartum antibiotic use on the process of intestinal microbiota development and future susceptibility to UC remain elusive are poorly understood.

Researcher Peris Munyaka, a PhD student under Ghia and the department of animal science’s Dr. Ehsan Khafipour, along with her colleagues, evaluated the compositional and functional alterations of fecal and colon mucosa-associate microbiota and the susceptibility to colitis in mice that were exposed to antepartum antibiotics and treated with dextran sulfate sodium to induce acute colitis later in life.

First, they demonstrated that the effects of antepartum antibiotic treatment in the colonization and composition of offspring gut microbiota can last for a relatively longer period of time and that the shifts in the gut microbiota resulting from antepartum use of antibiotics enhance susceptibility of the offspring to experimental colitis. Mice born by antibiotic exposed mothers are more susceptible to colitis later in life.

Second, they showed that the abundance of specific group of bacteria are highly correlated with antepartum antibiotic exposure and may serve as microbial signatures of dysbiosis as a result of indirect exposure to antibiotics.

For patients, the findings are significant in that they illustrate a strong link between antepartum antibiotic treatment and the subsequent effect on offspring.

“This novel observation is of potential clinical importance and it suggests that antepartum use of antibiotics should be used sparingly when possible,” says Ghia. “This study extends the recent data from the Children Hospital Research Institute of Manitoba, the University of Manitoba IBD Clinical and Research Centre and other groups, where children who received antibiotics in the first year of life had a greater risk of asthma and obesity, atopic diseases, irritable bowel syndrome, and IBD. Most importantly, it also suggests that a new therapeutic approach may be the use of specific probiotics, which may impact on perinatal-associated dysbiosis of the mother and the offspring born to antibiotic exposed mothers.”

Read the research article here.

Research at the University of Manitoba is partially supported by funding from the Government of Canada Research Support Fund.

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