Antibiotic Exposure in Early Life and Risk of Type 1 Diabetes: A Meta‐Analysis
Authors' conclusion
This meta-analysis suggests that early-life antibiotic use is associated with an increased risk of T1D, particularly with repeated courses and broad-spectrum agents. However, confidence in these findings is constrained by variability in study design and exposure definitions, as well as the potential for confounding by indication. While the observed associations are modest, they highlight the importance of judicious antibiotic prescribing in early life. Further large, well-designed prospective cohort studies are needed to clarify causality and better disentangle the effects of antibiotics from those of underlying infections.
Study context
- Population
- Children; studies of pre- and postnatal antibiotic use and childhood T1D (PubMed, MEDLINE, Scopus, Web of Science to June 2025)20 studies (11 cohort, 9 case-control)
- Comparison
- Early-life antibiotic exposure vs no exposure
- Outcome
- Childhood T1D
Methodological detailsrandom effects models, subgroup analyses by antibiotic course, class and spectrum, NOS quality assessment, Quality of the evidence was high (NOS)
- Random effects models
- Subgroup analyses by antibiotic course, class and spectrum
- NOS quality assessment
- Quality of the evidence was high (NOS)
Pooled result
As reported in the abstract
Pooled effect size
1.05
95% CI 0.98–1.11
Prenatal exposure
Pooled effect size
1.07
95% CI 1.01–1.14
Postnatal antibiotic exposure
Further pooled results
Postnatal exposure by number of antibiotic courses
| Pooled effect size (95% CI) | |
|---|---|
| ≥ 2 courses | 1.11 (1.02–1.20) |
| ≥ 5 courses | 1.14 (1.00–1.30) |
Postnatal exposure by antibiotic spectrum
| Pooled effect size (95% CI) | |
|---|---|
| Broad-spectrum | 1.13 (1.03–1.23) |
| Narrow-spectrum | 1.08 (0.93–1.26) |
Postnatal exposure by antibiotic class
- No significant associations by antibiotic class
Prenatal exposure by antibiotic spectrum
- No significant associations, likely due to the small number of studies
Mode of obstetric delivery
- Impact remained inconclusive across studies
Original publication
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