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Influência da disbiose intestinal materna, determinada por antibioterapia, no desenvolvimento de obesidade infantil : uma revisão sistemática
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Introdução
A alteração do equilíbrio da microbiota intestinal é reconhecida como fator de risco para obesidade, um importante problema de saúde pública. No entanto, durante a gravidez, permanece desconhecido o impacto da disbiose intestinal materna no desenvolvimento do feto e determinismo das suas características metabólicas futuras.
O conhecimento de moduladores da microbiota intestinal materna, como a antibioterapia, poderá contribuir para a formulação de estratégias preventivas precoces, com o objetivo de reduzir a prevalência de obesidade infantil.
Objetivo
O objetivo da presente revisão é estudar a disbiose intestinal materna, decorrente do uso de antibioterapia durante a gravidez, como fator de risco de obesidade infantil na descendência.
Metodologia
A questão PICO aplicada foi a seguinte: Estarão as crianças, filhas de mães com disbiose intestinal durante a gravidez decorrente do uso de antibióticos, em maior risco de obesidade infantil, comparando com as restantes crianças?
Foram identificados estudos através da fonte de pesquisa Pubmed, em Inglês ou Português, com uma população alvo entre o nascimento e os dez anos de idade e publicados nos últimos 5 anos. Foram selecionados os seguintes termos, incluindo termos alternativos: “Pediatric Obesity”, “Gastrointestinal Microbiome”, “Dysbiosis”, “Antibiotics”, “Pregnancy”.
Resultados
Foram incluídos quatro estudos de coorte prospetivos que estudaram a relação entre antibioterapia durante a gravidez e o risco associado de excesso de peso infantil na descendência.
Discussão e Conclusão Concluiu-se que a antibioterapia durante a gravidez, através da modulação da microbiota intestinal materna, influencia a constituição da microbiota intestinal da descendência e o seu risco para excesso de peso infantil.
A associação estabelecida é mais relevante de acordo com o trimestre em que é realizada a antibioterapia, destacando-se o segundo trimestre, o número de ciclos de antibioterapia efetuados, e o maior espetro de cobertura dos antibióticos.
Introduction The alteration of the health balance of the gut microbiota is recognized as a risk factor for obesity, an important public health problem. However, during pregnancy, the impact of maternal intestinal dysbiosis on fetal development and determinism of its future metabolic characteristics remains unknown. The knowledge of maternal intestinal microbiota modulators, such as antibiotic therapy, may contribute to the knowledge of early obesity modulators, with the aim of reducing the prevalence of childhood obesity. Objective The aim of the present review is to study maternal intestinal dysbiosis, resulting from the use of antibiotic therapy during pregnancy, as a risk factor for childhood obesity in offspring. Methodology The PICO question applied was the following: Are children, offspring of mothers with intestinal dysbiosis during pregnancy resulting from the use of antibiotics, at greater risk of childhood obesity, compared to the remaining children? Studies were identified through the search source Pubmed, in English or Portuguese, with a target population between birth and ten years of age and published in the last 5 years. The following terms were selected, including alternative terms: “Pediatric Obesity”, “Gastrointestinal Microbiome”, “Dysbiosis”, “Antibiotics”, “Pregnancy”. Results We included four prospective cohort studies that studied the relationship between antibiotic therapy during pregnancy and the associated risk of childhood obesity in offspring. Discussion and Conclusion It was concluded that antibiotic therapy during pregnancy, through the modulation of the maternal intestinal microbiota, influences the constitution of the intestinal microbiota of the offspring and their risk for child overweight. The association established is more relevant according to the trimester in which the antibiotic therapy is performed, with emphasis on the second trimester, the number of antibiotic cycles performed, and the widest spectrum of antibiotic coverage.
Introduction The alteration of the health balance of the gut microbiota is recognized as a risk factor for obesity, an important public health problem. However, during pregnancy, the impact of maternal intestinal dysbiosis on fetal development and determinism of its future metabolic characteristics remains unknown. The knowledge of maternal intestinal microbiota modulators, such as antibiotic therapy, may contribute to the knowledge of early obesity modulators, with the aim of reducing the prevalence of childhood obesity. Objective The aim of the present review is to study maternal intestinal dysbiosis, resulting from the use of antibiotic therapy during pregnancy, as a risk factor for childhood obesity in offspring. Methodology The PICO question applied was the following: Are children, offspring of mothers with intestinal dysbiosis during pregnancy resulting from the use of antibiotics, at greater risk of childhood obesity, compared to the remaining children? Studies were identified through the search source Pubmed, in English or Portuguese, with a target population between birth and ten years of age and published in the last 5 years. The following terms were selected, including alternative terms: “Pediatric Obesity”, “Gastrointestinal Microbiome”, “Dysbiosis”, “Antibiotics”, “Pregnancy”. Results We included four prospective cohort studies that studied the relationship between antibiotic therapy during pregnancy and the associated risk of childhood obesity in offspring. Discussion and Conclusion It was concluded that antibiotic therapy during pregnancy, through the modulation of the maternal intestinal microbiota, influences the constitution of the intestinal microbiota of the offspring and their risk for child overweight. The association established is more relevant according to the trimester in which the antibiotic therapy is performed, with emphasis on the second trimester, the number of antibiotic cycles performed, and the widest spectrum of antibiotic coverage.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Obesidade infantil Microbiota intestinal Disbiose Gravidez Antibioterapia