结直肠癌（CRC）的发病率在年轻成年人和中年人中不断增加，暗示早期生活中的暴露是危险因素。我们研究了胎儿期接受抗生素暴露与成年后子代患CRC的风险之间的关联。Child Health and Development Studies是1959年至1966年期间在加利福尼亚州奥克兰接受产前护理的孕妇的前瞻性队列研究，交付日期截至1967年6月。从怀孕前6个月到分娩期间，从母亲的病历记录中提取诊断条件和所有开处方药物。我们确定了在妊娠期接受抗生素（包括青霉素、四环素、短效磺胺和长效磺胺）的母亲。通过与加利福尼亚癌症登记处的联系，识别出18,751名成年（年龄≥18岁）后代的CRC诊断情况。使用Cox比例模型估计调整的风险比（aHR），从出生到癌症诊断、死亡或最后联系累积了随访。在18,751名活产后代中，约有15％（n=2,635）在胎儿期接受了抗生素：5.4％（n=1,016）接受了四环素，4.9％（n=918）接受了青霉素，4.2％（n=785）接受了短效磺胺和1.5％（n=273）接受了长效磺胺。与未暴露的子代相比，胎儿期接受抗生素和成年后子代患CRC之间的关联为：四环素aHR 1.03（95％ CI 0.32，3.31）；青霉素aHR 1.12（95％ CI 0.35，3.58）；短效磺胺aHR 0.83（95％ CI 0.20，3.42）；长效磺胺aHR 4.40（95％ CI 1.63，11.88）。我们的发现支持胎儿期接受长效磺胺与成人期CRC之间的关联。©作者等2023年；版权所有。由牛津大学出版社代表国际流行病学协会出版。

Incidence rates of colorectal cancer (CRC) are increasing among younger adults and in mid-life, implicating exposures in early life as risk factors. We examined the association between in-utero exposure to antibiotics and risk of CRC in adult offspring.The Child Health and Development Studies is a prospective cohort of women receiving prenatal care between 1959 and 1966 in Oakland, California, with deliveries through June 1967. Diagnosed conditions and all prescribed medications were abstracted from mothers' medical records beginning 6 months prior to pregnancy through delivery. We identified mothers who received antibiotics in pregnancy, including penicillins, tetracyclines, short-acting sulfonamides and long-acting sulfonamides. Diagnoses of CRC in adult (age ≥18 years) offspring were ascertained through 2021 by linkage with the California Cancer Registry. Cox proportional models were used to estimate adjusted hazard ratios (aHR), with follow-up accrued from birth through cancer diagnosis, death or last contact.Of 18 751 liveborn offspring, about 15% (n = 2635) were exposed in utero to antibiotics: 5.4% (n = 1016) to tetracyclines, 4.9% (n = 918) to penicillins, 4.2% (n = 785) to short-acting sulfonamides and 1.5% (n = 273) to long-acting sulfonamides. Compared with offspring not exposed, associations between in-utero exposure and CRC in adult offspring were: aHR 1.03 (95% CI 0.32, 3.31) for tetracyclines; aHR 1.12 (95% CI 0.35, 3.58) for penicillins; aHR 0.83 (95% CI 0.20, 3.42) for short-acting sulfonamides; and aHR 4.40 (95% CI 1.63, 11.88) for long-acting sulfonamides.Our findings support an association between in-utero exposure to long-acting sulfonamides and CRC in adulthood.© The Author(s) 2023; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.