Early Life Factors and Disease Development in Childhood

Sammanfattning

Background and Aim The aim was to investigate the effects of four early life factors – delivery mode, feeding method, probiotics, and antibiotics – on disease development in childhood. This was done by conducting a structured literature review. Methods A literature search was performed in PubMed, Google Scholar and ReadCube Papers for studies published between January 2000 and October 2022. For each selected study, data was extracted, and the risk of bias was assessed using guides from The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU). Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the reliability of the results. Results 46 out of 2381 identified studies met the inclusion criteria and were included in the review. The results demonstrate that cesarean section significantly increases the risk of asthma, allergies, inflammatory bowel disease (IBD), and potentially juvenile idiopathic arthritis (JIA) in childhood. Children who have been exclusively or predominantly breastfed have a decreased the risk of developing asthma, allergic rhinitis, IBD and potentially type 1 diabetes and JIA. Probiotics administrated during pregnancy or infancy do not decrease the risk of asthma or allergies in childhood overall but may reduce the risk for cesarean delivered children. Lastly, antibiotics administered during pregnancy or infancy significantly increase the risk of asthma, IBD, and potentially allergies and celiac disease in childhood. Conclusion The findings in this review suggest that delivery mode, feeding method, and antibiotics have long term health impacts on the child. These effects are speculated to be a result of perturbations of the gut microbiota during a critical time period of an infant’s life. It should be further evaluated if probiotics can reduce these impacts.