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Intrapartum group B Streptococcal prophylaxis and childhood weight gain.
- Source :
-
Archives of disease in childhood. Fetal and neonatal edition [Arch Dis Child Fetal Neonatal Ed] 2021 Nov; Vol. 106 (6), pp. 649-656. Date of Electronic Publication: 2021 May 06. - Publication Year :
- 2021
-
Abstract
- Objective: To determine the difference in rate of weight gain from birth to 5 years based on exposure to maternal group B streptococcal (GBS) intrapartum antibiotic prophylaxis (IAP).<br />Design: Retrospective cohort study of 13 804 infants.<br />Setting: Two perinatal centres and a primary paediatric care network in Philadelphia.<br />Participants: Term infants born 2007-2012, followed longitudinally from birth to 5 years of age.<br />Exposures: GBS IAP defined as penicillin, ampicillin, cefazolin, clindamycin or vancomycin administered ≥4 hours prior to delivery to the mother. Reference infants were defined as born to mothers without (vaginal delivery) or with other (caesarean delivery) intrapartum antibiotic exposure.<br />Outcomes: Difference in rate of weight change from birth to 5 years was assessed using longitudinal rate regression. Analysis was a priori stratified by delivery mode and adjusted for relevant covariates.<br />Results: GBS IAP was administered to mothers of 2444/13 804 (17.7%) children. GBS IAP-exposed children had a significantly elevated rate of weight gain in the first 5 years among vaginally-born (adjusted rate difference 1.44% (95% CI 0.3% to 2.6%)) and caesarean-born (3.52% (95% CI 1.9% to 5.2%)) children. At 5 years, the rate differences equated to an additional 0.24 kg among vaginally-born children and 0.60 kg among caesarean-born children.<br />Conclusion: GBS-specific IAP was associated with a modest increase in rate of early childhood weight gain. GBS IAP is an effective intervention to prevent perinatal GBS disease-associated morbidity and mortality. However, these findings highlight the need to better understand effects of intrapartum antibiotic exposure on childhood growth and support efforts to develop alternate prevention strategies.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Antibiotic Prophylaxis adverse effects
Antibiotic Prophylaxis methods
Child, Preschool
Female
Humans
Infant, Newborn
Longitudinal Studies
Male
Maternal Exposure adverse effects
Pregnancy
Weight Gain drug effects
Anti-Bacterial Agents administration & dosage
Anti-Bacterial Agents adverse effects
Anti-Bacterial Agents classification
Child Development drug effects
Delivery, Obstetric adverse effects
Delivery, Obstetric methods
Delivery, Obstetric statistics & numerical data
Infectious Disease Transmission, Vertical prevention & control
Obstetric Labor Complications microbiology
Obstetric Labor Complications prevention & control
Pediatric Obesity diagnosis
Pediatric Obesity etiology
Pediatric Obesity prevention & control
Streptococcal Infections prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2052
- Volume :
- 106
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Archives of disease in childhood. Fetal and neonatal edition
- Publication Type :
- Academic Journal
- Accession number :
- 33958387
- Full Text :
- https://doi.org/10.1136/archdischild-2020-320638