Early life antibiotic-use and risk of childhood type 1 diabetes: a nationwide cohort study utilising data linkage
Main finding · T1D by prenatal antibiotic exposureResult — go to the resultHazard ratio 1.20 CI 1.05–1.38Authors' conclusion
In conclusion, antibiotic use during both prenatal and early childhood is associated with an increased risk of T1D.
Study context
- Population
- All children born 2005–2010 in New Zealand, followed until 2021; prenatal and first-5-years antibiotic use from linked data
- Participants
- 315,789 children
- Exposure
- Prenatal and early-childhood antibiotic use vs no use
- Outcome
- T1D diagnosis (from birth for prenatal exposure; from age 5 for early-childhood exposure)
- Follow-up
- Until 2021
Methodological detailsdata linkage, Cox proportional hazard regression adjusted for parental and perinatal factors
- Data linkage
- Cox proportional hazard regression adjusted for parental and perinatal factors
Main finding
T1D by prenatal antibiotic exposure
Hazard ratio
1.20
CI 1.05–1.38
≥ 1 coursevs 0
HR 1.20 (CI 1.05–1.38)
As reported in the abstract
- Prenatal use as continuous variable, HR
- 1.05 (95% CI 1.03-1.08)
- Positive trend across 0, ≤ 1, ≤ 2, ≥ 3 prenatal courses
- P = 0.0008
- Postnatal use as continuous variable, HR (1.02-1.03)
- 1.02
- Postnatal use 0 vs ≥ 1 course, HR (1.00-2.63)
- 1.62
- Dose-response trend across 0, ≤ 4, ≤ 7, ≤ 12, ≥ 13 postnatal courses
- P = 0.0017
Observational data: associations, not effects.
Further findings
Antibiotic use and T1D incidence
- Antibiotic use (≥ 1 course), pregnant mothers
- 29.2%
- Antibiotic use (≥ 1 course), children 0-5 years
- 96.3%
- T1D diagnosed
- 0.36% (n = 1,131)
- T1D diagnosed after age 5 years
- 0.28% (n = 906)
Antibiotic class
- Strongest associations for moderate and broad-spectrum antibiotics in both periods
- Higher T1D risk with prenatal penicillin and cephalosporins/cephamycins, and postnatal exposure to all classes except tetracyclines
Original publication
Early life antibiotic-use and risk of childhood type 1 diabetes: a nationwide cohort study utilising data linkage. Pediatr Diabetes. Published 24 June 2026. doi:10.
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