婴幼儿3岁前使用抗生素增加情绪行为问题风险：β -内酰胺类长期使用及与大环内酯类联用的行为影响

Effects of early-life antibiotic use on emotional and behavioral development trajectories in preschool children
早期抗生素使用对学龄前儿童情绪和行为发展轨迹的影响

Authors：Lu Chen, Penggui Wu, Juan Tong, Shuangqin Yan, Guopeng Gao, Fangbiao Tao, Kun Huang
Source：Journal of Psychiatric Research
DOI: 10.1016/j.jpsychires.2025.04.031

Abstract
Background: Limited research exists on the link between antibiotic use and emotion and behavior, particularly the lack of continuous emotional and behavioral assessment. Emotions and behaviors reflect key modifiable dimensions of brain function and evolve during childhood growth and development. This paper aimed to examine the antibiotic use (yes/no), categories and duration in association with preschool children's emotional and behavioral development trajectory.
Methods: Based on Ma'anshan-Anhui Birth Cohort, 1147 mother-child pairs were included in the study. Parents or guardians reported the children's antibiotic use before age 3, including whether antibiotics were used and the types and duration of antibiotics use. The trajectories of children's emotional and behavioral development were fitted using scores from the Strengths and Difficulties Questionnaire (SDQ) at 48, 60, and 72 months.

Results: A total of 23.3 % (268/1147) of children had used antibiotics in the past three months. Children's antibiotic use significantly related with high level of hyperactivity. The use of β-lactam antibiotics, especially non-penicillin, was associated with the risk of high level hyperactivity at a dose-response pattern in duration. Children's combined use of β-lactam and macrolides was related with increased risk of high level hyperactivity, total difficulties and emotional symptoms.
Conclusions: Children's antibiotic use before age 3 is observed to be associated with hyperactivity development, especially using β-lactam antibiotics with a relatively long duration. The combined use of β-lactam and macrolides may increase the development of hyperactivity, total difficulties and emotional symptoms.
Keywords: Antibiotics; Emotional and behavioral development; Microbiota; Neurodevelopmental disorders; Preschool children.

摘要

背景：关于抗生素使用与情绪和行为之间联系的研究有限，特别是缺乏持续的情绪和行为评估。情绪和行为反映了大脑功能的关键可改变维度，并在儿童成长和发育过程中不断发展。本文旨在检查抗生素使用（是/否）、类别和持续时间与学龄前儿童的情绪和行为发展轨迹相关。

方法：基于马鞍山-安徽出生队列，研究纳入 1147 对母子。父母或监护人报告了儿童在 3 岁之前使用抗生素的情况，包括是否使用抗生素以及抗生素使用的类型和持续时间。使用 48 、 60 和 72 个月时的优势和困难问卷的分数拟合儿童情绪和行为发展的轨迹。

结果：共有 23.3% （268/1147） 的儿童在过去 3 个月内使用过抗生素。儿童抗生素的使用与高度多动症显著相关。使用 β-内酰胺类抗生素，尤其是非青霉素，与持续时间剂量反应模式的高水平多动风险相关。儿童联合使用 β-内酰胺类药物和大环内酯类药物与高度多动、完全困难和情绪症状的风险增加有关。

结论：据观察，儿童在 3 岁之前使用抗生素与多动发展有关，尤其是使用持续时间相对较长的 β-内酰胺类抗生素。β-内酰胺类和大环内酯类药物的联合使用可能会增加多动症、完全困难和情绪症状的发展。

关键词：抗生素；情绪和行为发育；微生物群；神经发育障碍；学龄前儿童