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Volume 12
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10.3390/antibiotics12060967
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Article

Duration of Neonatal Antibiotic Exposure in Preterm Infants in Association with Health and Developmental Outcomes in Early Childhood

by
Nancy Deianova
1,2,3,*,
Nanne K. de Boer
4,
Hafsa Aoulad Ahajan
1,
Cilla Verbeek
1,
Cornelieke S. H. Aarnoudse-Moens
5,
Aleid G. Leemhuis
5,
Mirjam M. van Weissenbruch
5,
Anton H. van Kaam
5,
Daniel C. Vijbrief
6,
Chris V. Hulzebos
7,
Astrid Giezen
8,
Veerle Cossey
9,
Willem P. de Boode
10,
Wouter J. de Jonge
11,
Marc A. Benninga
1,
Hendrik J. Niemarkt
3 and
Tim G. J. de Meij
1,2
1
Department of Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
2
Department of Pediatric Gastroenterology, Amsterdam UMC Location University of Amsterdam, Amsterdam Reproduction & Development Research Institute, 1105 AZ Amsterdam, The Netherlands
3
Department of Neonatology, Máxima Medical Center, 5504 DB Veldhoven, The Netherlands
4
Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands
5
Department of Neonatology, Emma Children’s Hospital, Amsterdam Reproduction and Development Research Institute, 1105 AZ Amsterdam, The Netherlands
6
Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children’s Hospital, 3584 CX Utrecht, The Netherlands
7
Department of Neonatology, Beatrix Children’s Hospital, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
8
Department of Neonatology, Isala Hospital, Amalia Children’s Center, 8025 AB Zwolle, The Netherlands
9
Department of Neonatology, University Hospitals Leuven, 3000 Leuven, Belgium
10
Department of Neonatology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children’s Hospital, 6525 XZ Nijmegen, The Netherlands
11
Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
 
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*
Author to whom correspondence should be addressed.
Antibiotics 2023, 12(6), 967; https://doi.org/10.3390/antibiotics12060967
Submission received: 24 April 2023 / Revised: 22 May 2023 / Accepted: 24 May 2023 / Published: 26 May 2023
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
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Abstract

Over 90% of preterm neonates are, often empirically, exposed to antibiotics as a potentially life-saving measure against sepsis. Long-term outcome in association with antibiotic exposure (NABE) has insufficiently been studied after preterm birth. We investigated the association of NABE-duration with early-childhood developmental and health outcomes in preterm-born children and additionally assessed the impact of GA on outcomes. Preterm children (GA < 30 weeks) participating in a multicenter cohort study were approached for follow-up. General expert-reviewed health questionnaires on respiratory, atopic and gastrointestinal symptoms were sent to parents of children > 24 months’ corrected age (CA). Growth and developmental assessments (Bayley Scales of Infant and Toddler Development (BSID) III) were part of standard care assessment at 24 months’ CA. Uni- and multivariate regressions were performed with NABE (per 5 days) and GA (per week) as independent variables. Odds ratios (OR) for health outcomes were adjusted (aOR) for confounders, where appropriate. Of 1079 infants whose parents were approached, 347 (32%) responded at a mean age of 4.6 years (SD 0.9). In children with NABE (97%), NABE duration decreased by 1.6 days (p < 0.001) per week of gestation. Below-average gross-motor development (BSID-III gross-motor score < 8) was associated with duration of NABE (aOR = 1.28; p = 0.04). The aOR for constipation was 0.81 (p = 0.04) per gestational week. Growth was inversely correlated with GA. Respiratory and atopic symptoms were not associated with NABE, nor GA. We observed that prolonged NABE after preterm birth was associated with below-average gross-motor development at 24 months’ CA, while a low GA was associated with lower weight and stature Z-scores and higher odds for constipation.
Keywords: neonatal antibiotic exposure; preterm; psychomotor development; atopy; pediatric constipation; growth neonatal antibiotic exposure; preterm; psychomotor development; atopy; pediatric constipation; growth

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MDPI and ACS Style

Deianova, N.; de Boer, N.K.; Aoulad Ahajan, H.; Verbeek, C.; Aarnoudse-Moens, C.S.H.; Leemhuis, A.G.; van Weissenbruch, M.M.; van Kaam, A.H.; Vijbrief, D.C.; Hulzebos, C.V.; et al. Duration of Neonatal Antibiotic Exposure in Preterm Infants in Association with Health and Developmental Outcomes in Early Childhood. Antibiotics 2023, 12, 967. https://doi.org/10.3390/antibiotics12060967

AMA Style

Deianova N, de Boer NK, Aoulad Ahajan H, Verbeek C, Aarnoudse-Moens CSH, Leemhuis AG, van Weissenbruch MM, van Kaam AH, Vijbrief DC, Hulzebos CV, et al. Duration of Neonatal Antibiotic Exposure in Preterm Infants in Association with Health and Developmental Outcomes in Early Childhood. Antibiotics. 2023; 12(6):967. https://doi.org/10.3390/antibiotics12060967

Chicago/Turabian Style

Deianova, Nancy, Nanne K. de Boer, Hafsa Aoulad Ahajan, Cilla Verbeek, Cornelieke S. H. Aarnoudse-Moens, Aleid G. Leemhuis, Mirjam M. van Weissenbruch, Anton H. van Kaam, Daniel C. Vijbrief, Chris V. Hulzebos, and et al. 2023. "Duration of Neonatal Antibiotic Exposure in Preterm Infants in Association with Health and Developmental Outcomes in Early Childhood" Antibiotics 12, no. 6: 967. https://doi.org/10.3390/antibiotics12060967

APA Style

Deianova, N., de Boer, N. K., Aoulad Ahajan, H., Verbeek, C., Aarnoudse-Moens, C. S. H., Leemhuis, A. G., van Weissenbruch, M. M., van Kaam, A. H., Vijbrief, D. C., Hulzebos, C. V., Giezen, A., Cossey, V., de Boode, W. P., de Jonge, W. J., Benninga, M. A., Niemarkt, H. J., & de Meij, T. G. J. (2023). Duration of Neonatal Antibiotic Exposure in Preterm Infants in Association with Health and Developmental Outcomes in Early Childhood. Antibiotics, 12(6), 967. https://doi.org/10.3390/antibiotics12060967

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