PLoS One

Early-life antibiotics not linked to childhood autoimmunity

September 1, 2025

Study details: This nationwide cohort study used Korea’s National Health Insurance Service data (2008–2021) to examine over 2.7 million mother-child pairs with infection diagnoses. Researchers compared children exposed to antibiotics during pregnancy or early infancy with unexposed peers, adjusting for confounding using inverse probability of treatment weighting and sibling-matched analyses. Outcomes included six autoimmune diseases: T1DM, juvenile idiopathic arthritis, IBD (UC and Crohn's disease), systemic lupus erythematosus, and Hashimoto’s thyroiditis.

Results: Across both pregnancy and infancy analyses, antibiotic exposure showed no significant association with autoimmune disease risk. Hazard ratios for all conditions were close to 1.0, with p-values >0.05. Subgroup findings suggested a slight increase in Crohn’s disease risk with maternal cephalosporin use during early pregnancy, and a modest rise in autoimmune thyroiditis among male infants or those exposed in the first two months.

Clinical impact: These findings offer reassurance that antibiotic use during pregnancy or infancy, when clinically indicated, doesn’t increase overall autoimmune risk in children. Clinicians should continue to prescribe antibiotics judiciously and remain aware of potential subgroup-specific risks that warrant further investigation.

Source:

Choi EY, et al. (2025, August 21). PLoS Med. Exposure to antibiotics during pregnancy or early infancy and the risk of autoimmune disease in children: A nationwide cohort study in Korea. https://pubmed.ncbi.nlm.nih.gov/40839560/