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Objective: Animal studies and epidemiological studies have shown that there is potential sex-specific sensitivity to the intrauterine environment in relation to the developmental programming of obesity. The objective of this study was to assess the sex-specific association between prenatal antibiotics exposure and body mass index (BMI) in offspring from 1 to 4 years., Methods: A total of 10,163 mother-child pairs from the Medical Birth Registry in Xiamen, China, were included in this prospective cohort study. Data on prenatal antibiotics exposure were collected from the prescription database., Results: A total of 4909 (48.3%) offspring had prenatal antibiotics exposure. The associations between prenatal antibiotics exposure and offspring's BMI were significantly different among female offspring and male offspring (P for interaction: 0.034 at 1 year of age; 0.033 at 2 years of age; 0.020 at 3 years of age; and 0.021 at 4 years of age). In female offspring, prenatal antibiotic use was significantly associated with a higher BMI Z-score from 1 to 4 years old (difference in BMI Z-score: 0.11 [95% CI: 0.05-0.17] at 1 years of age; 0.10 [95% CI: 0.05-0.16] at 2 years of age; 0.14 [95% CI: 0.09-0.21] at 3 years of age; and 0.13 [95% CI: 0.07-0.19] at 4 years of age) after adjustment for confounder. Prenatal antibiotics use was not associated with offspring BMI Z-score from 1 to 4 years in male offspring., Conclusions: The association of prenatal antibiotics exposure and BMI Z-score from 1 to 4 years old may differ by sex of offspring.

Our aim was to assess effects of breast-feeding (BF) in the association between large-for-gestational age (LGA) and body mass index (BMI) trajectories on childhood overweight from 1 to 4 years old. A total of 1649 healthcare records of mother–child pairs had detailed records of feeding practices and were included in this retrospective cohort study. Data were available in Medical Birth Registry of Xiamen between January 2011 and March 2018. Linear and logistic regression models were used to access the difference between BF and no-BF group. For offspring were LGA and BF was significantly associated with a lower BMI Z-score from 1 to 4 years old after adjustment confounders in Model 1 to 3 [difference in BMI Z-score in Model 1: estimated β: −0.07 [95%CI: −0.13 to −0.01]; Model 2: estimated β: −0.07 (−0.13 to −0.004); Model 3: estimated β: −0.06 (−0.12 to −0.001); P = 0.0221, 0.0371, 0.0471]. A significantly lower risk of childhood overweight was observed in Model 1 [odd ratio (OR): 0.85 (95%CI, 0.73 to 1.00)], P = 0.0475) with adjustment for maternal pre-pregnancy BMI. Furthermore, Model 2 and Model 3 showed LGA-BF infants had a lower risk for childhood overweight then LGA-no-BF infants [OR: 0.87 and 0.87 (95%CI, 0.73 to 1.03; 0.74 to 1.03)], however, there was no statistical significance (P = 0.1099, and 0.1125)]. BF is inversely related to BMI Z-score and risk for overweight in children were LGA from 1 to 4 years old. Adjustment for maternal pre-pregnancy BMI, the protective association between BF and childhood overweight was more significant. [ABSTRACT FROM AUTHOR]