ENVIRONMENTAL ANTIBIOTIC EXPOSURE DURING PREGNANCY AND THE RISK OF CHILDHOOD ALLERGIC DISEASES: A SCOPING REVIEW
Abstract
Background: Environmental antibiotic contamination in food and water has emerged as a potential source of chronic low-dose exposure during pregnancy. However, evidence regarding its association with childhood allergic diseases remains limited. Purpose: To systematically map biomonitoring-based evidence concerning association between prenatal environmental antibiotic exposure and childhood allergic outcomes, while also delineating existing gaps in literature. Methods: The review was reported following the PRISMA-ScR guideline. Literature searches were performed in PubMed, Google Scholar, and ScienceDirect from database inception to 1 June 2026. Eligible studies assessed environmental antibiotic exposure using biomonitoring methods and evaluated allergic outcomes in children. The selection of studies, extraction of data, and assessment of study quality were independently completed by two reviewers. Narrative findings then were synthesized. Results: Of 905 records identified, two prospective birth cohort studies involving 2,704 mother-child pairs met the eligibility criteria. Both studies were conducted in China and reported antibiotic detection percentages exceeding 90% in maternal urine samples. Veterinary antibiotics and preferred-as-veterinary antibiotics were the predominant exposure categories. Prenatal environmental exposure to specific antibiotics was associated with increased risks of asthma, wheeze, eczema, atopic dermatitis, and food allergen sensitization in preschool-aged children. Microbiome disruption was proposed as a potential underlying mechanism. Conclusion: Current biomonitoring-based evidence suggests that prenatal environmental antibiotic exposure may elevate the likelihood of developing allergic conditions. Nonetheless, current findings remain constrained by a limited number of studies and narrow geographic representation. Further multinational prospective studies are needed to confirm these findings and clarify the underlying mechanisms.