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Associations of intrapartum antibiotics and growth, atopy, gastrointestinal and sleep outcomes at one year of age.
Hutton, Eileen K; Simioni, Julia C; Thabane, Lehana; Morrison, Katherine M.
Afiliação
  • Hutton EK; Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
  • Simioni JC; McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada.
  • Thabane L; Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
  • Morrison KM; Department of Health Research Methods, Evidence and Impact, McMaster University, Canada; Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, ON, Canada.
Pediatr Res ; 94(3): 1026-1034, 2023 09.
Article em En | MEDLINE | ID: mdl-36807614
ABSTRACT

BACKGROUND:

Studies investigating neonatal outcomes following intrapartum antibiotic exposure show conflicting results.

METHODS:

Data were collected prospectively in pregnancy to 1-year-of-age, from 212 mother-infant pairs. Adjusted multivariable regression models estimated relationships following exposure to intrapartum antibiotics among vaginally-born, full-term infants and outcomes related to growth, atopic disease, gastrointestinal symptoms, and sleep at 1-year.

RESULTS:

Intrapartum antibiotic exposure (n = 40) was not associated with mass, ponderal index, BMI z-score (1- year), lean mass index (5-months) or height. Antibiotic exposure in labour ≥4-h was associated with increase in fat mass index at 5-months (ß 0.42 [95% CI 0.03, 0.80], p = 0.03). Intrapartum antibiotic was associated with atopy in the first year (OR 2.93 [95% CI 1.34, 6.43], p = 0.007). Antibiotic exposure during intrapartum or day 1-7 was associated with newborn fungal infection requiring antifungal therapy (OR 3.04 [95% CI 1.14, 8.10], p = 0.026), and number of fungal infections (IRR 2.90 [95% CI 1.02, 8.27], p = 0.046).

CONCLUSION:

Intrapartum and early life exposure to antibiotics were independently associated with measures of growth, atopy, and fungal infections suggesting that intrapartum and early neonatal antibiotics be used prudently following careful risk-benefit analysis. IMPACT This prospective study Shows a shift in fat mass index at 5 months associated with antibiotic administration ≥4 h in labour; an earlier age than previously reported; Shows atopy reported less frequently among those not exposed to intrapartum antibiotics; Supports earlier research of increased likelihood of fungal infection following exposure to intrapartum or early-life antibiotics; Adds to growing evidence that antibiotics used intrapartum and in early neonatal periods influence longer-term outcomes for infants. Suggests that use of intrapartum and early neonatal antibiotics should be used prudently after careful consideration of risk and benefit.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Antibacterianos / Mães Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Newborn / Pregnancy Idioma: En Revista: Pediatr Res Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Antibacterianos / Mães Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Newborn / Pregnancy Idioma: En Revista: Pediatr Res Ano de publicação: 2023 Tipo de documento: Article