A longitudinal study published in JAMA Network Open shows that frequent infections in early life are linked to higher risks of severe infections and antibiotic use later in childhood.
Researchers from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) followed 614 children from birth to age 10 or 13 years, documenting common infections, such as colds, pneumonia, gastroenteritis, and fever episodes from birth to age 3 years, using daily infection diaries and medical records. Children with a high infection burden (over 16 episodes) during early life showed significantly increased risks for moderate to severe infections (adjusted incidence rate ratio [AIRR], 2.39) and systemic antibiotic treatments (AIRR, 1.34) later in childhood.
Specifically, each additional infection episode was linked to a 5 percent increased risk of moderate to severe infections (AIRR, 1.05) and a 2 percent increased likelihood of antibiotic treatment (AIRR, 1.02). Specific early-life infections, including pneumonia, colds, and fever, were independently associated with increased risks for later health complications, particularly pneumonia episodes.
Though the study’s strengths include detailed longitudinal data and a high follow-up rate (92 percent), limitations include its geographic focus on a Danish population and potential attrition bias. Additionally, subgroup analyses for specific pathogens, such as RSV, may have been underpowered.
Nevertheless, the findings point to the importance of early-life infection tracking in predicting long-term health risks. By identifying children with high infection burdens, clinicians could implement targeted interventions and monitoring to mitigate future health complications. Moreover, diagnostic models that incorporate early infection data may improve accuracy in identifying at-risk pediatric populations.
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