Peer-reviewed article
Antibiotic mixture exposure in meconium affects child neurodevelopment via altering early-life gut microbiome and metabolome.
Yuhan Zhou, Feng Wang, Yingya Zhao, Hang Wang, Wenjuan Ma et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined 300 mother-infant pairs from China to understand how antibiotic exposure during pregnancy affects child development. Researchers measured antibiotics in newborn meconium (first stool) and tracked child development using standardized assessments at 2, 6, 12, and 24 months. Higher prenatal antibiotic exposure was linked to lower developmental scores, particularly at 6 months, across all developmental domains. The study identified changes in gut bacteria (specifically Lactobacillus) and certain metabolites as potential mechanisms linking antibiotic exposure to developmental delays.
Key points
- Each increase in antibiotic burden was associated with a 4.49-point lower total developmental score at 6 months
- Higher antibiotic exposure was linked to lower scores across all five developmental domains (language, motor, adaptive, cognitive, personal-social)
- Strongest associations were observed at 6 months of age, with weaker associations at other timepoints
- Lactobacillus bacteria and a specific metabolite (2-14,15-EG) were identified as potential biological pathways linking antibiotic exposure to developmental effects
- The three most common antibiotics detected were chlortetracycline, penicillin, and chloramphenicol
Limitations
The study is observational and cannot prove causation; the authors state their findings are hypothesis-generating and require independent replication, longitudinal validation, and experimental studies before causal mechanisms can be established. The study measures only associations and cannot rule out confounding factors or other explanations for the observed developmental differences.
Abstract
Previous evidence has established associations of antibiotic exposure in early life with neurodevelopmental disorders. However, previous studies have often relied on self-reported or record-based exposure measures that may not accurately reflect internal fetal exposure, and few have integrated prenatal exposure biomarkers with infant microbiome, metabolome, and longitudinal neurodevelopmental data. This study included 300 mother-infant pairs from the Shanghai Maternal-Child Pairs Cohort. Meconium samples were used to quantify concentrations of 18 antibiotics using high-performance liquid chromatography (HPLC). Neurodevelopmental outcomes were assessed using Ages and Stages Questionnaires (ASQ) at 2, 6, 12, and 24 months of age. Multi-omics profiling of 6-month fecal samples was conducted, employing 16S rRNA gene amplicon sequencing and HPLC-based metabolomics. Linear and logistic regression models, negative binomial regression, interpretable machine learning algorithms, metabolome-wide association/pathway analyses and high-dimensional mediation modeling were used. Our study population demonstrated predominant exposure to three antibiotics: chlortetracycline, penicillin, and chloramphenicol. Each interquartile range (IQR) increase in meconium-measured antibiotic burden was associated with a lower total ASQ score at 6 months (β = -4.49, 95% CI: -7.14 to -1.86) and lower scores across all five developmental domains (βs ranging from -0.53 to -1.11; all P < 0.05). Each IQR increment of antibiotic burden was also associated with greater odds of belonging to the lower-score group of total ASQ trajectory (OR = 1.20, 95% CI: 1.04, 1.42) and the lower-score group of personal-social trajectory (OR = 1.13, 95% CI: 1.01, 1.28). Exploratory high-dimensional mediation analyses identified Lactobacillus and 2-(14,15-epoxyeicosatrienoyl) glycerol (2-14,15-EG) as candidate intermediates in the association between meconium-measured antibiotic burden and neurodevelopment. Our study suggested that higher meconium-based biomarkers of intrauterine antibiotic burden were significantly associated with lower neurodevelopmental outcomes in early childhood, with the strongest inverse associations observed at 6 months. Lactobacillus and 2-14,15-EG were identified as potential mediator biomarkers. These hypothesis-generating findings require independent replication, longitudinal temporal validation, and experimental studies before causal mechanisms or microbiota-targeted interventions can be inferred.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Measurement of antibiotic biomarkers in meconium with integrated analysis of infant gut microbiome and metabolome to identify mediating pathways
- Population
- 300 mother-infant pairs from the Shanghai Maternal-Child Pairs Cohort, China
Key finding
Each IQR increase in meconium antibiotic burden associated with 4.49-point lower total ASQ score at 6 months (95% CI: -7.14 to -1.86)
Zhou et al. · PubMed (US National Library of Medicine) · 11 Aug 2026