Peer-reviewed article
Early-life anti-infective exposure and subsequent neurodevelopmental disorders: a nationwide propensity-matched cohort study
Oh Y, Han S, Ryu V ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether early-life infections and anti-infective medication exposure are associated with neurodevelopmental disorders in South Korean children. Researchers compared children who had five or more infection-related hospital stays in early childhood with children hospitalized for hernia surgery. Children with repeated early infections had higher rates of developmental disorders, attention problems, and intellectual disabilities. The associations increased with more hospitalizations and more antibiotic or antifungal medication exposure.
Key points
- Children with ≥5 infection-related hospitalizations had 1.80 times higher risk of intellectual developmental disorder compared to controls
- Infection-related hospitalizations were associated with 1.59 times higher risk of developmental disorders and 1.57 times higher risk of ADHD
- Dose-response relationships found between infection burden and neurodevelopmental outcomes, and between cumulative antibacterial and antimycotic exposure and these outcomes
- Antiviral medication exposure was not positively associated with neurodevelopmental disorders
- Study included 53,464 matched children from South Korean national health insurance claims data
Limitations
The study relied on health insurance claims data and could not definitively prove that infections caused the neurodevelopmental disorders, as unmeasured confounding factors and differences in healthcare access between groups may explain some findings. The findings should be interpreted cautiously as the researchers acknowledge potential residual confounding.
Abstract
Abstract Early-life severe or recurrent infections may be associated with later neurodevelopmental outcomes, but evidence regarding cumulative infectious burden and class-specific anti-infective exposure remains limited. We conducted a nationwide population-based cohort study using South Korean health insurance claims data. Children born between 2007 and 2014 were followed until June 30, 2021. The infection group included children with repeated infection-related hospitalizations in early childhood (≥ 5 admissions), while the comparison group comprised children hospitalized for inguinal hernia, a non-inflammatory surgical condition. Propensity score matching (1:1) was performed based on sex, age, and early-life comorbidities. Infection burden and anti-infective exposure were quantified by hospitalization frequency and cumulative exposure to antibacterial, antimycotic, and antiviral agents. The matched cohort included 53,464 children. Compared with controls, infection-related hospitalizations were associated with higher incidence of intellectual developmental disorder (HR 1.80), developmental disorders (HR 1.59), attention-deficit/hyperactivity disorder (HR 1.57), and any psychiatric diagnosis (HR 1.57). Dose-response relationships were observed with increasing hospitalization frequency and cumulative exposure to antibacterial and antimycotic agents, whereas antiviral exposure was not positively associated with neurodevelopmental outcomes. These findings should be interpreted cautiously given potential residual confounding and possible differences in healthcare utilization patterns.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
Problem
Early-life severe or recurrent infections may be associated with later neurodevelopmental disorders
- Intervention
- Early-life infection exposure (measured by repeated infection-related hospitalizations and cumulative anti-infective medication exposure)
- Population
- South Korean children born 2007-2014 with repeated infection-related hospitalizations (≥5 admissions) in early childhood
Key finding
Infection-related hospitalizations associated with HR 1.80 for intellectual developmental disorder