{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:03:33Z","timestamp":1785441813540,"version":"3.56.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","award":["262700"],"award-info":[{"award-number":["262700"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GTN1175744"],"award-info":[{"award-number":["GTN1175744"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prenatal antibiotic exposure and caesarean births are associated with an increased risk of hospitalised infection in children, but few studies have evaluated their impact on less severe infections and possible joint effects. Conversely, longer breastfeeding duration is protective against infections, but whether this effect varies according to previous perinatal exposures has not been explored. These three exposures are all hypothesised to influence the infant microbiome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the individual and joint effects of prenatal antibiotic exposure, caesarean birth, and breastfeeding duration for both the incidence of infections and for hospitalisation for infection up to age three.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were from the Norwegian Mother, Father, and Child Cohort Study (MoBa). The three exposures were prenatal antibiotic exposure, caesarean birth, and breastfeeding duration. Using quasi\u2010Poisson regression, we analysed the number of infections and hospitalisation for infections according to: (1) each exposure individually, (2) combined exposure to prenatal antibiotics and caesarean birth and (3) breastfeeding duration across the strata of prenatal antibiotics and birth mode.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 45,485 children followed from birth to age three, there was weak evidence for an increased number of infections according to the exposures of interest (incidence rate ratio for prenatal antibiotics 1.04, 95% CI 1.02, 1.05; caesarean birth 1.02, 95% CI 1.00, 1.03; breastfeeding &lt;\u20096\u2009months 1.04, 95% CI 1.02, 1.05), while there was an increased risk of hospitalised infection (risk ratio for prenatal antibiotics 1.11, 95% CI 1.05, 1.17; caesarean birth 1.20, 95% CI 1.14, 1.27; breastfeeding &lt;\u20096\u2009months 1.16, 95% CI 1.10, 1.22). Analyses of combined effects showed\u00a0a 1.55\u2010fold (95% CI 1.24, 1.93) increased risk of hospitalisation for infection with all three exposures compared to none.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prenatal antibiotic exposure, caesarean birth and shorter breastfeeding duration were each associated with an increased risk of hospitalisation for infection in early childhood, with higher magnitude when multiple exposures occurred.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ppe.70120","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:16:41Z","timestamp":1772986601000},"page":"608-619","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Joint Effects of Prenatal Antibiotics, Mode of Birth and Breastfeeding Duration on Childhood Infections: The Norwegian\n                    <scp>MoBa<\/scp>\n                    Cohort Study"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5748-4945","authenticated-orcid":false,"given":"Isobel M. F.","family":"Todd","sequence":"first","affiliation":[{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6726-1991","authenticated-orcid":false,"given":"Lars Henning","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1806-1894","authenticated-orcid":false,"given":"Jessica E.","family":"Miller","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics The University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8304-4302","authenticated-orcid":false,"given":"David P.","family":"Burgner","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Department of Paediatrics The University of Melbourne  Parkville Victoria Australia"},{"name":"Department of General Medicine, Infectious Diseases Royal Children's Hospital Melbourne  Parkville Victoria Australia"},{"name":"Faculty of Health, Deakin University  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0568-3774","authenticated-orcid":false,"given":"Maria C.","family":"Magnus","sequence":"additional","affiliation":[{"name":"Centre for Fertility and Health Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010018\u20101079\u2010x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/inf.0000000000000704"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15808"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyx272"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.100860"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264\u2010024\u201001401\u2010z"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed\u20102024\u2010000995"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010046583"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(15)01024\u20107"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12263"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740\u20108709.2008.00176.x"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/mpg.0000000000001539"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15733"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.12.046"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/inf.0000000000001778"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000004112"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr242"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922811410875"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201013009\u20103"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579\u2010025\u201001166\u2010x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41577\u2010023\u201000874\u2010w"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2021.1897210"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000004454"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyl170"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw029"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199901000-00008"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v027.i08"},{"issue":"7","key":"e_1_2_12_29_1","first-page":"3","article-title":"Diagnostic Checking in Regression Relationships","volume":"2","author":"Zeileis A.","year":"2002","journal-title":"R News"},{"key":"e_1_2_12_30_1","first-page":"dyw277","volume-title":"Explanation in Causal Inference: Methods for Mediation and Interaction","author":"VanderWeele T.","year":"2015"},{"key":"e_1_2_12_31_1","unstructured":"\u201cR: A Language and Environment for Statistical Computing. 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