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Antibiotics reduce the diversity and composition of the gut microbiota, leading to poor developmental outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To investigate the relationship between age at first exposure to antibiotics and cognitive and behavioural development at 4.5\u00a0years while controlling for multiple confounders, including otitis media.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Study participants were 5589 children enrolled in the broadly generalisable Growing Up in New Zealand cohort study, with antibiotic exposure data, maternal antenatal information, and age 4.5-year behaviour and cognitive outcome data. Children were categorised as first exposed to antibiotics according to the following mutually exclusive ages: 0\u20132\u00a0months; 3\u20135\u00a0months; 6\u20138\u00a0months; 9\u201311\u00a0months; 12\u201354\u00a0months or not exposed by 54\u00a0months. Developmental outcome measures included the Strengths and Difficulties Questionnaire, Luria hand clap task, and the Peabody Picture Vocabulary Test-III.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In univariate analysis, there was an evident dose\u2013response relationship where earlier exposure to antibiotics in the first year of life was associated with behavioural difficulties, lower executive function scores, and lower receptive language ability. After adjusting for confounders, pairwise comparisons showed that first antibiotic exposure between birth and 3\u00a0months or between 6 and 9\u00a0months was associated with lower receptive vocabulary. Antibiotic exposure at any age prior to 12\u00a0months was associated with increases in behavioural difficulties scores at 4.5\u00a0years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Following adjustment for socioeconomic factors and otitis media, there is evidence that antibiotic exposure during potentially sensitive windows of development is associated with receptive language and behaviour later in childhood.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00213-023-06351-5","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T08:02:46Z","timestamp":1679040166000},"page":"1143-1150","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Age at first exposure to antibiotics and neurodevelopmental outcomes in childhood"],"prefix":"10.1007","volume":"240","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4942-8887","authenticated-orcid":false,"given":"Rebecca F.","family":"Slykerman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Underwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hobbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen E.","family":"Waldie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"6351_CR1","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/j.bbi.2019.05.035","volume":"80","author":"A-K Aatsinki","year":"2019","unstructured":"Aatsinki A-K, Lahti L, Uusitupa H-M, Munukka E, Keskitalo A, Nolvi S, O\u2019Mahony S, Pietil\u00e4 S, Elo LL, Eerola E (2019) Gut microbiota composition is associated with temperament traits in infants. 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