Early antibiotics, mode of delivery and social-emotional problems in childhood: The FinnBrain Birth Cohort Study

Abstract

Objective Both early life antibiotics and the mode of delivery have been associated with multiple somatic health outcomes but less is known about their possible psychosocial outcomes. The aim of this study was to study whether early antibiotic treatments and mode of delivery are associated with social and emotional problems in children. Studies have shown that modulating gut microbiota may have sex-specific effects on brain-related and behavioral outcomes, therefore we expected that these exposures would associate with child outcomes in a sex-specific manner. Methods Subjects (n=1766) were recruited from the FinnBrain Birth Cohort study in Finland. Register data on mode of delivery, mother's prenatal antibiotics and child antibiotics was combined with questionnaire data to investigate the associations between the mode of delivery and antibiotic treatments on child social and emotional problems in cohort population. Social and emotional problems were measured with Brief Infant-Toddler Social and Emotional Assessment at 2 years and Strengths and Difficulties Questionnaire at 5 years. The associations were analyzed using non-parametric Wilcoxon rank sum test or Kruskal-Wallis test. Results Neither the mode of delivery nor early life antibiotic treatments were associated with social and emotional problems in children. Sex-stratified analyses yielded similar results. The combined exposure of mode of delivery and early antibiotic use yielded nonsignificant associations. Conclusions Our data did not support the hypothesis of the associations between birth mode and early antibiotics and child social-emotional problems. Longitudinal studies focusing on clinically severe phenotypes and specific risk groups might gain better understanding of this topic.

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