J Pediatr Gastroenterol Nutr. 2022 Feb 24. doi: 10.1097/MPG.0000000000003428.Online ahead of print.

Kim Kamphorst ^1 2, Arine M Vlieger ², Berthe C Oosterloo ^1 3, Johan Garssen ⁴, Ruurd M van Elburg ¹

Author information

¹Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, dept. Pediatrics, Amsterdam Gastroenterology, Metabolism & Nutrition, Amsterdam Reproduction & Development Amsterdam, the Netherlands.

²St. Antonius Hospital, dept. Pediatrics, Nieuwegein, the Netherlands.

³Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.

⁴Utrecht Institute for Pharmaceutical Sciences, Division Pharmacology, Utrecht University, Utrecht, The Netherlands.

Abstract

Objectives: Antibiotics may contribute to the development of functional gastrointestinal disorders (FGIDs). This study aimed to determine whether antibiotics during the first week of life, infantile colic in the first year of life, gut-associated immune markers at one year of age, and allergies at 4-6 years of age in term born children were associated with a higher prevalence of FGIDs at 4-6 years of age.

Methods: A prospective observational cohort of 436 term-born infants was followed up at the age of 4-6 years; 151 received broad-spectrum antibiotics (AB+), and 285 healthy controls (AB-). Validated ROME III and ISAAC questionnaires were sent to parents of 418 available children. The independent t-test, Chi-squared test or non-parametric test and logistic multivariate regression analyses were used.

Results: In total, 340/418 (81%) questionnaires were completed. Only the presence of functional abdominal pain was significantly higher in AB+ than AB- (4% vs. 0.4% respectively, p = 0.045). Children with food allergy fulfilled significantly more often the criteria for irritable bowel syndrome (IBS) and abdominal migraine (26% vs. 9%, p = 0.002 and 7% vs. 1%, p = 0.043 respectively) compared to non-allergic children. No differences in FGIDs existed at the age of 4-6 years between children with and without a history of infantile colic. There were significant differences in gut-associated immune markers between children with and without FGIDs.

Conclusion: Antibiotics during the first week of life resulted in a higher risk for functional abdominal pain at 4-6 years. Furthermore, food allergy was associated with IBS and abdominal migraine at 4-6 years.