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Early Antibiotic Exposure and Risk of Psychiatric Increased Sensitivity of Central Serotenergic Neurons to Corticosteroids Following Maternal Immune Activation: Significane for Mood Disorders and Neurocognitive Outcomes: Results of a Systematic Review and Meta-Analysis
The microbiota-gut-brain axis plays a significant role in mental health, particularly during early life when disturbances in the intestinal microbiota may negatively affect neurodevelopment. This study investigates the long-term safety of early antibiotic exposure on psychiatric and neurocognitive outcomes. This systematic review and meta-analysis aims to fill a critical research gap regarding the association between in-utero and early childhood antibiotic exposure (ages 0-2) and subsequent psychiatric issues. A systematic review and meta-analysis of studies comparing antibiotic exposure in early life to unexposed controls was performed, utilizing MEDLINE, PsychINFO, and EMBASE databases. Quality assessments were conducted using the GRADE and Newcastle-Ottawa Scale. Thirty studies involving 7,047,853 participants were included. Weak associations were found between in-utero antibiotic exposure and later development of Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). Early-childhood exposure correlated with increased likelihood of ADHD, ASD, and Major Depressive Disorder (MDD). However, sibling-controlled studies showed no associations between either exposure period and later ASD or ADHD, while no MDD studies utilized sibling controls. The meta-analyses were rated very low certainty due to methodological heterogeneity, except for childhood antibiotic exposure and later ASD (sibling-controlled), which was rated low certainty. Discussion & Conclusions: The findings indicate weak evidence for the association between antibiotic exposure in early life and neurodevelopmental outcomes. These associations were diminished in sibling-controlled studies, suggesting that genetic and familial confounding may account for observed correlations. Future research should prioritize sibling-controlled designs to enhance validity.
Year: 2025
