{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T03:49:08Z","timestamp":1785383348392,"version":"3.55.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T00:00:00Z","timestamp":1698451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Penn Skin Biology"},{"name":"NIH\/NIAMS","award":["P30-AR069589"],"award-info":[{"award-number":["P30-AR069589"]}]},{"DOI":"10.13039\/100006920","name":"University of Pennsylvania","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006920","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007928","name":"Perelman School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007928","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Atopic dermatitis (AD) is a common inflammatory disease of the skin that begins early in life and can be lifelong. The purpose of our study was to evaluate whether fetal exposure and\/or early-life exposure of a child to antibiotics increases the risk of early-onset AD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We hypothesize that antibiotic exposure in utero or early in life (e.g. first 90\u2005days) increases the likelihood that children develop\u00a0AD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Utilizing a large, prospectively collected electronic medical records database, we studied the association of antibiotic exposure received in utero or very early in life and the relative risk of onset of AD in a population-based cohort study. Associations were estimated using proportional hazards models as hazard ratios (HRs) with 95% confidence intervals (CIs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The risk of AD in childhood was increased after in utero or early-life antibiotic exposure. For any in utero antibiotic exposure the HR (CI) was 1.38 (1.36\u20131.39). However, penicillin demonstrated the strongest association with AD for both in utero exposure [1.43 (1.41\u20131.44)] and for childhood exposure [1.81 (1.79\u20131.82)]. HRs were higher in children born to mothers without AD than in those with AD pointing to effect modification by maternal AD status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Children born to mothers exposed to antibiotics while in utero had, depending on the mother\u2019s history of AD, approximately a 20\u201340% increased risk of developing AD. Depending on the antibiotic, children who received antibiotics early in life had a 40\u201380% increased risk of developing AD. Our study supports and refines the association between incident AD and antibiotic administration. It also adds population-based support to therapeutic attempts to treat AD by modifying the skin microbiome.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjd\/ljad428","type":"journal-article","created":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T14:57:39Z","timestamp":1698505059000},"page":"58-64","source":"Crossref","is-referenced-by-count":19,"title":["<i>In utero<\/i> or early-in-life exposure to antibiotics and the risk\u00a0of childhood atopic dermatitis, a population-based cohort study"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0023-4176","authenticated-orcid":false,"given":"Zelma Chiesa","family":"Fuxench","sequence":"first","affiliation":[{"name":"Departments of Dermatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7714-3910","authenticated-orcid":false,"given":"Nandita","family":"Mitra","sequence":"additional","affiliation":[{"name":"Biostatistics, Epidemiology 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Dermatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7022-7441","authenticated-orcid":false,"given":"Sin\u00e9ad M","family":"Langan","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0037-7524","authenticated-orcid":false,"given":"Irene","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Primary Care & Population Health, University College London , London , UK"},{"name":"Department of Clinical Epidemiology, Aarhus University , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5509-4428","authenticated-orcid":false,"given":"Ketaki","family":"Bhate","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health, London 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