Antibiotics in Pregnancy & Early Infancy: Minimal Autoimmune risk, But Caution Advised
A large, nationwide study in Korea investigated whether antibiotic use during pregnancy or early infancy is linked to an increased risk of autoimmune diseases in children. The findings offer reassurance: treating actual infections with antibiotics during these periods does not appear to considerably raise the overall risk of autoimmune conditions.
Researchers analyzed data from a large cohort, carefully comparing children exposed to antibiotics for infections with unexposed siblings and using advanced statistical methods to account for potential biases. Thay examined risks for a range of autoimmune diseases including type 1 diabetes, juvenile idiopathic arthritis, CrohnS disease, lupus, and autoimmune thyroiditis (Hashimoto’s).Key findings include:
No overall increased risk: Antibiotic exposure during pregnancy and early infancy was not associated with a higher risk of most autoimmune diseases.
Sibling studies support findings: Comparing siblings with differing antibiotic exposure reinforced the lack of association, controlling for shared genetics and habitat.
Subtle signals warrant further investigation: The study identified some potential, modest associations:
Crohn’s Disease: Exposure to broad-spectrum antibiotics (especially cephalosporins) during pregnancy, notably in the first or second trimester, and multiple prescriptions, showed a slight increase in risk.
Autoimmune Thyroiditis: A slightly higher risk was observed in male infants exposed very early in life (within the first two months).
Robust methodology: The study employed rigorous methods to minimize bias,focusing on children who had documented infections and controlling for confounding factors.
What this means for families and doctors:
The study suggests that antibiotics, when used appropriately to treat infections, are unlikely to increase a child’s long-term risk of autoimmune disease. Though,clinicians should continue to prescribe antibiotics judiciously,considering the specific antibiotic class and timing,and remain vigilant for potential signals identified in the subgroup analyses. Further research is needed to confirm these subtle associations.
Source: choi, E.-Y., et al. (2025). Exposure to antibiotics during pregnancy or early infancy and the risk of autoimmune disease in children: A nationwide cohort study in Korea. PLoS Medicine. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004677