University of Oulu

Figueiredo, RAO, Kajantie, E, Neuvonen, PJ, Rounge, TB, Weiderpass, E, Viljakainen, H. Lifetime antimicrobial use is associated with weight status in early adolescence—A register‐based cohort study. Pediatric Obesity. 2021; 16:e12727.

Lifetime antimicrobial use is associated with weight status in early adolescence : a register‐based cohort study

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Author: de Oliveira Figueiredo, Rejane Augusta1,2; Kajantie, Eero3,4,5,6; Neuvonen, Pertti J.7;
Organizations: 1Folkhälsan Research Center, Helsinki, Finland
2Faculty of Medicine, University of Helsinki, Helsinki, Finland
3National Institute for Health and Welfare, Helsinki and Oulu, Finland
4Children's Hospital, Helsinki University Hospital and University of Helsinki, Finland
5PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Finland
6Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
7Department of Clinical Pharmacology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
8Department of Research, Cancer Registry of Norway, Oslo, Norway
9Department of Informatics, University of Oslo, Oslo, Norway
10International Agency for Research on Cancer, World Health Organization, Lyon, France
11Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.2 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-03-10


Background: Antimicrobial agents (AMs) are the most prescribed drugs to children. Early and repeated exposure to AMs in infancy is associated with increased risk of childhood overweight and obesity.

Aims: We extended the investigation of AMs use, from birth to early adolescence, and evaluated their association with weight status.

Materials and Methods: A total of 10093 children from Finnish Health in Teens cohort (Fin‐HIT) with register‐based data on AMs purchases and measured weight status at the mean age of 11.2 y (SD 0.82) were included in the study. The key exposures were the number AM purchases at a given age or the sum of these during the entire follow‐up time to describe lifetime exposure / use. Outcome was weight status in early adolescence defined with International Obesity Task Force cut‐offs for the age‐ and sex‐specific body mass index. Odds Ratio (OR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression.

Results: Of children, 73.7% were normal weight, 11.1% thin and 15.2% overweight/obese. AMs use was highest during the second year of life, when 65% of all children used AMs, but thereafter decreased with age. The highest mean purchases and prevalence at any given age along with the highest lifetime use were consistently seen among overweight children. Each episode of AMs use throughout life increased the risk of being overweight in adolescence [OR = 1.02 (1.02–1.03)]. However, there was an inverse association between AMs use and thinness [OR = 0.98 (0.97–0.99)].

Discussion: Despite a high prevalence of AMs use during the early years, lifetime‐use was associated with weight status in early adolescence in a dose response manner.

Conclusion: Future studies should address mechanisms underlying the relationship between AM use and weight.

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Series: Pediatric obesity
ISSN: 2047-6302
ISSN-E: 2047-6310
ISSN-L: 2047-6302
Volume: 16
Issue: 3
Article number: e12727
DOI: 10.1111/ijpo.12727
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3142 Public health care science, environmental and occupational health
Funding: The project has received financial support from the Swedish Cultural Foundation in Finland, Päivikki ja Sakari Sohlberg Foundation, Medicinska Understödsföreningen Liv och Hälsa and Folkhälsan Research Foundation.
Copyright information: © 2020 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.