A cohort study of intrapartum group B streptococcus prophylaxis on atopic dermatitis in 2-year-old children

Abstract

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.