Objective To understand the occurrence of atopic dermatitis (AD) in children aged 2 years on exposure to maternal group B streptococcus (GBS) antibiotic prophylaxis (IAP). Design Retrospective cohort study of 2909 mother–child pairs. Setting Taixing People’s Hospital in Eastern China. Participants Term infants born 2018–2019, followed longitudinally from birth to 2 years. Exposures The GBS-IAP was defined as therapy with intravenous penicillin G or ampicillin or cefazolin ≥ 4 h prior to delivery to the mother. Reference infants were defined as born without or with other intrapartum antibiotic exposure. Outcomes The logistic regression models were employed to analyze the effect of intrapartum GBS prophylaxis on AD in 2-year-old children during delivery. Analysis was a priori stratified according to the mode of delivery and adjusted for relevant covariates. Results The cohorts showed that preventive GBS-IAP was potentially associated with increased incidence of AD in children delivered vaginally according to logistic regression models before and after covariate-adjusted treatment (OR: 6.719,95% CI: 4.730–9.544,P < 0.001;aOR: 6.562,95% CI: 4.302–10.008, P < 0.001). Conclusion Prophylactic treatment of intrapartum GBS may raise the risk of AD in vaginally delivered children. These findings highlight the need to better understand the risk between childhood AD and current GBS-IAP intervention strategies.

The increasing trend in the incidence of adverse perinatal outcomes is a public health concern globally as well as in China. However, the causes of the increasing trend are not well understood. The present tertiary-hospital-based retrospective study (2011–2019) aims to determine the secular trends and age-period-cohort effect on adverse perinatal outcomes in Hubei, China. The age-standardized incidence rates of adverse perinatal outcomes significantly decreased such as preterm births by 22% [AAPC − 3.4% (95% CI − 7.8, − 1.2)], low birth weight (LBW) by 28.5% [AAPC − 4.7% (95% CI − 6.0, − 3.3)], and fetal distress by 64.2% [AAPC − 14.0% (95% CI − 17.8, − 10.0)] during 2011–2019. Both extremes of maternal age groups (18–20 years and 42–44 years) had a higher risk ratio for adverse perinatal outcomes including preterm birth, perinatal mortality, LBW, low ponderal index (LPI), low Apgar score, and congenital defect compared to the reference age group (30–32 years). A higher risk ratio for perinatal mortality, intrauterine growth restriction (IUGR), and fetal distress and a lower risk ratio for preterm births and LBW were observed in the period 2017–2019. Both the young cohort (1997–1999) and the old cohort (1976–1969) had a higher risk ratio for preterm birth, perinatal mortality, macrosomia, and congenital defect compared to the reference cohort (1982–1984). In conclusion, some of the adverse perinatal outcomes incidence significantly decreased in the last 9 years in Hubei. However, extremes of maternal age groups and both young and old cohorts were associated with a higher risk of preterm birth, perinatal mortality, and congenital defect.

Objective To understand the occurrence of atopic dermatitis (AD) in children aged 2 years on exposure to maternal group B streptococcus (GBS) antibiotic prophylaxis (IAP). Design Retrospective cohort study of 2909 mother-child pairs. Setting Taixing People's Hospital in Eastern China. Participants Term infants born 2018–2019, followed longitudinally from birth to 2 years. Exposures The GBS-IAP was defined as therapy with intravenous penicillin G or ampicillin or cefazolin ≥ 4 hours from delivery. Reference infants were defined as born with intrapartum antibiotic exposure via cesarean sections. Outcomes The logistic regression models were employed to analyze the effect of intrapartum GBS prophylaxis on AD in 2-year-old children during delivery. Analysis was a priori stratified according to the mode of delivery and adjusted for relevant covariates. Results Univariate and multivariate logistic regression models before and after covariate-adjusted treatment simultaneously showed that preventive GBS-IAP was associated with increased incidence of AD in children delivered vaginally (OR: 6.719,95% CI: 4.730–9.544,P < 0.001;aOR: 6.562,95% CI: 4.302–10.008, P < 0.001), whereas cesarean delivery in 2-year-old children (OR: 0.555,95% CI: 0.276–1.117, P = 0.099;aOR: 0.560,95% CI: 0.271–1.155, P = 0.116) was not related to AD. Conclusion Prophylactic treatment of intrapartum GBS may raise the risk of AD in vaginally delivered children. Children delivered through cesarean section, on the other hand, did not have an elevated risk of AD. These findings highlight the need to better understand the risk between childhood AD and current GBS-IAP intervention strategies.

ObjectiveTo investigate the associations between intrapartum antibiotic prophylaxis of group B streptococcus (GBS) in pregnant women and the risk of food allergy in Chinese childrenDesignRetrospective cohort study of 2,909 mother-child pairs.SettingTaixing People's Hospital in Eastern China.ParticipantsTerm infants born 2018–2019, followed longitudinally from birth to 3 years.ExposuresThe GBS-IAP was defined as therapy with intravenous penicillin G or ampicillin or cefazolin ≥4 h prior to delivery to the mother. Reference infants were defined as born without or with other intrapartum antibiotic exposure.MethodsTo investigate the incidence information of food allergy in children aged 18 months and three years old. Kaplan-Meier survival analysis and log-rank tests were used to evaluate the cumulative incidence in the group with GBS-IAP and the group without GBS-IAP. Cox proportional hazards models were conducted to determine the univariate and multivariate association between maternal GBS-IAP and incident food allergy after various covariates were adjusted.ResultsThe cumulative incidence of food allergy in the group with GBS-IAP was higher than that in the group without GBS-IAP in children under 18 months old (8.1% vs. 4.5%, P = 0.005, log-rank test), but no significant differences were observed in children under three years old (9.2% vs. 7.0%, P = 0.146, log-rank test). The univariate cox proportional hazards model in children under 18 months old revealed that children in the GBS-IAP group had faster food allergy development when compared with children in the group without GBS-IAP (HR.: 1.887,95% CI: 1.207–2.950, P = 0.005), so was the multivariate model (HR.: 1.906,95% CI: 1.158–3.137, P = 0.011). However, both univariate (HR: 1.343, 95% CI: 0.891∼2.026, P = 0.159) and multivariate (HR: 1.253, 95%CI: 0.796∼1.972, P = 0.329) cox proportional hazards model in children under three years old showed no significant differences between children in the group with GBS-IAP and group without GBS-IAP.ConclusionIntrapartum antibiotic prophylaxis of group B streptococcus may increase the cumulative incidence and risk of food allergy in children under 18 months old, but it had no significant effect on children under three years old.

Objective The study was aimed to explore the impact of intrapartum group B streptococcus prophylaxis on allergic rhinitis in children at the age of 3 and provide potential theory evidence to formulate GBS intervention strategies in line with China's national conditions. Methods A population-based retrospective cohort study was used to select 3010 pairs of pregnant women hospitalized in Taixing People's Hospital from June 2018 to December 2019. Hospital information system and face-to-face questionnaires were employed to gather information about allergic rhinitis and related covariates. 1:1 propensity score matching method with a caliper value of 0.02 was used. The comparison of baseline information was conducted using chi-square test for enumeration data, and analysis of variance for measurement data before and after 1:1 propensity score matching, while the modified Poisson regression models were utilized to explore the effect of IAP on AR in children. Results A total of 3010 mother-child pairs were included in the final sample and 381 pairs were obtained in each group with after 1:1 propensity score matching. Among 3010 mother-child pairs, the incidence of allergic rhinitis was higher in the IAP group compared to the non IAP group (9.3% vs 6.1%), with the difference being statistically significant (P = 0.017). After 1:1 propensity score matching, 36 children in the IAP group and 25 children in the non IAP group had AR, and no statistically significant difference was found (9.4% vs 6.6%, P = 0.142). Modified Poisson regression models revealed that children in the IAP group had higher RA risk than children in the non-IAP group (RR: 1.807,95% CI: 1.184–2.757, P = 0.006) before 1:1 propensity score matching. After 1:1 propensity score matching, such significant higher RA risk in children in the IAP group also existed (RR: 1.948,95% CI: 1.158–3.277, P = 0.012). Subgroup analyses revealed that children delivered vaginally (RR: 2.365, 95%CI: 1.327–4.217, P = 0.004), male children (RR: 2.211, 95%CI: 1.036–4.716, P = 0.040) and non-breastfeeding children (RR: 3.585, 95%CI: 1.197–10.742, P = 0.023) in the IAP group had higher RA incidence than that in the non IAP group. Conclusion Intrapartum antibiotic prophylaxis of group B streptococcus increases the cumulative incidence and risk of AR in children at the age of 3 especially children delivered vaginally, male children and non-breastfeeding children, and further studies are urgently required to explore the effect in more specific populations.