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Pediatrics

Focus on the risks of excess weight and obesity

Overweight & obesity
Pediatrics

Antibiotic-induced intestinal dysbiosis is thought to be the cause of some cases of excess weight in young children. Perinatal exposure or repeated treatments during the first 24 months of life are the main risk factors.

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About this article

Created 18 October 2019
Updated 12 October 2021

LITERATURE-BASED STUDY OF THE RISK OF EXCESS WEIGHT AT AN EARLY AGE

Excess weight or obesity at an early age is one of the metabolic risks associated with impairment of the intestinal microbiota that raises questions. Thirteen observational studies and meta-analyses, meeting previously defined inclusion criteria and identified from a corpus of 4,870 international publications, allowed this issue to be clarified by monitoring bodyweight in 527,504 children exposed to antibiotics in their first 24 months of life.2 This work was fine-tuned by studying in detail the six-month postnatal period, as well as the doses and type of antibiotics administered.

EARLY TREATMENT OR REPEATED CYCLES: INCREASED RISK OF EXCESS WEIGHT

Analysis of the data collected revealed a slight increase in the risk of excess weight or obesity during a postnatal treatment (in the six months after birth; OR [odds ratio]: 1.20) or during repeated administration of antibiotics (more than one treatment; OR: 1.24) before two years of age. Conversely, a single treatment or one occurring after the first six months of life does not appear to impact negatively weight progression. A question remains: is this a direct causal link? Does the effect of the antibiotic cause a weight problem in children? Or it is the opposite? Is childhood obesity likely to be associated with an increased risk of infection resulting in additional antibiotic treatment courses? Those who favor the first hypothesis consider that a detrimental intestinal colonization could play a specific role, in the light of its already documented involvement in the development of metabolic disorders. In any case, the research shows that in the perinatal period antibiotics should be administered with caution.

Sources

2 Rasmussen SH, Shrestha S, Bjerregaard LG, et al. Antibiotic exposure in early life and childhood overweight and obesity: A systematic review and meta-analysis. Diabetes Obes Metab. 2018;20(6):1508-1514. 

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Overweight & obesity Metabolic condition Gut health Children & baby health Antibiotics

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      • Pr. Olivier Goulet : Gastrointestinal disorders in children, the need to act
    Created 18 October 2019
    Updated 12 October 2021

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