Intrapartum Group B Streptococcal Prophylaxis and Childhood Allergic Disorders.

Objectives: To determine if maternal intrapartum group B Streptococcus (GBS) antibiotic prophylaxis is associated with increased risk of childhood asthma, eczema, food allergy, or allergic rhinitis.
Methods: Retrospective cohort study of 14 046 children. GBS prophylaxis was defined as administration of intravenous penicillin, ampicillin, cefazolin, clindamycin, or vancomycin to the mother, ≥4 hours before delivery. Composite primary outcome was asthma, eczema, or food allergy diagnosis within 5 years of age, identified by diagnosis codes and appropriate medication prescription. Allergic rhinitis was defined by using diagnostic codes only and analyzed as a separate outcome. Analysis was a priori stratified by delivery mode and conducted by using Cox proportional hazards model adjusted for multiple confounders and covariates. Secondary analyses, restricted to children retained in cohort at 5 years' age, were conducted by using multivariate logistic regression.
Results: GBS prophylaxis was not associated with increased incidence of composite outcome among infants delivered vaginally (hazard ratio: 1.13, 95% confidence interval [CI]: 0.95-1.33) or by cesarean delivery (hazard ratio: 1.08, 95% CI: 0.88-1.32). At 5 years of age, among 10 404 children retained in the study, GBS prophylaxis was not associated with the composite outcome in vaginal (odds ratio: 1.21, 95% CI: 0.96-1.52) or cesarean delivery (odds ratio: 1.17, 95% CI: 0.88-1.56) cohorts. Outcomes of asthma, eczema, food allergy, separately, and allergic rhinitis were also not associated with GBS prophylaxis.
Conclusions: Intrapartum GBS prophylaxis was not associated with subsequent diagnosis of asthma, eczema, food allergy, or allergic rhinitis in the first 5 years of age.
Competing Interests: POTENTIAL CONFLICT OF INTEREST: Dr Bryan is a Canadian Agency for Drugs and Technologies in Health (Ottawa, ON, Canada) employee. The current work was unrelated to his employment and Canadian Agency for Drugs and Technologies in Health had no role in the funding, design, or oversight of the work reported; the other authors have indicated they have no potential conflicts of interest to disclose. ACKNOWLEDGEMENT: We thank Dr Joseph Chou, MD, PhD (Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA) for generating the birth anthropometric percentiles for the study population. Dr Chou did not receive any compensation for their assistance.
(Copyright © 2021 by the American Academy of Pediatrics.)