Reviewer's report
Title:Antibiotic exposure in pregnancy and risk of coeliac disease in offspring: a
cohort study
Version:1Date:18 December 2013
Reviewer: Umberto Volta
Reviewer's report:
The present study “Antibiotic exposure in pregnancy and risk of celiac disease in
offspring” is a cohort study, aiming to investigate the association between
antibiotic exposure during pregnancy and CD in offspring. Of the 1836 children
exposed to antibiotics during pregnancy, 12 (0.7%) children developed celiac
disease in comparison with 34 (0.5%) of the 6893 unexposed children. The
Authors conclude that no statistically significant association between antibiotic
exposure during pregnancy and CD in offspring was observed.
This is a clear and very simple study with a negative result since the data
produced did not show any causal effect of antibiotic treatment during pregnancy
on the possible development of CD in offspring.
It has been demonstrated that the infant microbiota may play a role in celiac
disease development and it has been also proved that protracted antibiotic
treatment in the first 18 months of life can cause changes of intestinal microbiota
leading to an increased risk for celiac disease. Based on the results of the
present paper, antibiotic treatment during the pregnancy does not cause an
increased risk of CD in offspring.
The Authors underline in the text the limitations of their study. One of the most
important is the lack of information about the duration of antibiotic treatment and
its dosage, which obviously could have a relevant impact on microbiota changes,
so increasing the risk for celiac disease in cases with protracted and high dose
treatment.
I address a couple of questions to the Authors:
1) Did the antibiotic treatment favor an earlier appearance of celiac disease? It
could be of interest for the reader to know if the 12 children exposed to antibiotics
had an earlier onset of celiac disease compared to the 34 unexposed children.
2) Moreover, the Authors should specify if the two groups of subjects developing
celiac disease (those exposed to antibiotics and those unexposed) displayed a
different clinical presentation (classical, non classical, subclinical). It is difficult to
have this information in the cohort studies, but, if available, it should be provided
to the reader.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interest
Reviewer's report
Title:Antibiotic exposure in pregnancy and risk of coeliac disease in offspring: a
cohort study
Version:1Date:18 December 2013
Reviewer: Umberto Volta
Reviewer's report:
The present study “Antibiotic exposure in pregnancy and risk of celiac disease in
offspring” is a cohort study, aiming to investigate the association between
antibiotic exposure during pregnancy and CD in offspring. Of the 1836 children
exposed to antibiotics during pregnancy, 12 (0.7%) children developed celiac
disease in comparison with 34 (0.5%) of the 6893 unexposed children. The
Authors conclude that no statistically significant association between antibiotic
exposure during pregnancy and CD in offspring was observed.
This is a clear and very simple study with a negative result since the data
produced did not show any causal effect of antibiotic treatment during pregnancy
on the possible development of CD in offspring.
It has been demonstrated that the infant microbiota may play a role in celiac
disease development and it has been also proved that protracted antibiotic
treatment in the first 18 months of life can cause changes of intestinal microbiota
leading to an increased risk for celiac disease. Based on the results of the
present paper, antibiotic treatment during the pregnancy does not cause an
increased risk of CD in offspring.
The Authors underline in the text the limitations of their study. One of the most
important is the lack of information about the duration of antibiotic treatment and
its dosage, which obviously could have a relevant impact on microbiota changes,
so increasing the risk for celiac disease in cases with protracted and high dose
treatment.
I address a couple of questions to the Authors:
1) Did the antibiotic treatment favor an earlier appearance of celiac disease? It
could be of interest for the reader to know if the 12 children exposed to antibiotics
had an earlier onset of celiac disease compared to the 34 unexposed children.
2) Moreover, the Authors should specify if the two groups of subjects developing
celiac disease (those exposed to antibiotics and those unexposed) displayed a
different clinical presentation (classical, non classical, subclinical). It is difficult to
have this information in the cohort studies, but, if available, it should be provided
to the reader.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interest
Please review this paper.
user
Reviewer's report
Title:Antibiotic exposure in pregnancy and risk of coeliac disease in offspring: a
cohort study
Version:1Date:18 December 2013
Reviewer: Umberto Volta
Reviewer's report:
The present study “Antibiotic exposure in pregnancy and risk of celiac disease in
offspring” is a cohort study, aiming to investigate the association between
antibiotic exposure during pregnancy and CD in offspring. Of the 1836 children
exposed to antibiotics during pregnancy, 12 (0.7%) children developed celiac
disease in comparison with 34 (0.5%) of the 6893 unexposed children. The
Authors conclude that no statistically significant association between antibiotic
exposure during pregnancy and CD in offspring was observed.
This is a clear and very simple study with a negative result since the data
produced did not show any causal effect of antibiotic treatment during pregnancy
on the possible development of CD in offspring.
It has been demonstrated that the infant microbiota may play a role in celiac
disease development and it has been also proved that protracted antibiotic
treatment in the first 18 months of life can cause changes of intestinal microbiota
leading to an increased risk for celiac disease. Based on the results of the
present paper, antibiotic treatment during the pregnancy does not cause an
increased risk of CD in offspring.
The Authors underline in the text the limitations of their study. One of the most
important is the lack of information about the duration of antibiotic treatment and
its dosage, which obviously could have a relevant impact on microbiota changes,
so increasing the risk for celiac disease in cases with protracted and high dose
treatment.
I address a couple of questions to the Authors:
1) Did the antibiotic treatment favor an earlier appearance of celiac disease? It
could be of interest for the reader to know if the 12 children exposed to antibiotics
had an earlier onset of celiac disease compared to the 34 unexposed children.
2) Moreover, the Authors should specify if the two groups of subjects developing
celiac disease (those exposed to antibiotics and those unexposed) displayed a
different clinical presentation (classical, non classical, subclinical). It is difficult to
have this information in the cohort studies, but, if available, it should be provided
to the reader.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interest
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