Endocrine Abstracts

JOINT556

Background: Antibiotics exposure in early life may have association with central precocious puberty (CPP), but evidence is limited. This study explored the association of antibiotics exposure with CPP using nationwide population-based cohort in South Korea.

Methods: Children who had regular health check-up at 4–6 months and 66–71 months of age were included and followed up until 10 years in boys and 9 years in girls. The diagnosis of CPP was based on the ICD-10 code and the prescription of gonadotropin-releasing hormone agonists. Multivariable Cox proportional hazards model was used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (Cis) for CPP according to age at first prescription of antibiotics and the number of antibiotic classes, respectively.

Results: Among 322,731 children (135,232 boys and 187,499 girls), 291,703 (90.4%) were prescribed antibiotics before 1 year of age. Compared with those prescribed antibiotics after first year of life, girls who received antibiotics before 3 months of age had an increased risk of CPP (aHR 1.231 [95% CI 1.119–1.355], P <0.001), followed by those prescribed antibiotics at 6–9 months (aHR 1.205 [95% CI 1.098–1.322], P <0.001), 3–6 months (aHR 1.169 [95% CI 1064–1.284], P = 0.001), and 9–12 months (aHR 1.146 [95% CI 1.042–1.261], P = 0.005) after adjusting for covariates. Furthermore, girls who used 5 or more classes or antibiotics had a higher risk of CPP compared to those who used 2 or less classes. However, in boys, no significant association was observed between age at first prescription or the number of antibiotic classes and CPP.

Conclusions: Exposure to antibiotics in early life and many numbers of antibiotics may be associated with a higher risk of CPP in girls. The effects of long-term antibiotics exposure on pubertal development and underlying should be further investigated.