This large retrospective population-based cohort study used data from over 1.8 million children in Israel to examine the link between antibiotic use during the first year of life and the development of celiac disease autoimmunity (CDA). Exposure to antibiotics in infancy was associated with a higher risk of CDA, with stronger associations seen in girls and in children with more antibiotic prescriptions. A clear dose–response relationship was observed: more antibiotic prescriptions correlated with greater risk of developing CDA. The findings suggest early antibiotic exposure may influence immune development and increase later risk of celiac autoimmunity.

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