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 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.

Maternal exposure to antibiotics and risk of atopic dermatitis in childhood: a systematic review and meta-analysis

“…Thirteen studies failed to meet the eligibility criteria. Finally, 18 studies were included in the review (12)(13)(14)(15)(16)(17)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) (Figure 1). The inter-reviewer reliability for the selection of studies was high (κ = 0.9).…”

“…These results must be considered in light of changed guidelines that recommend the use of antibiotics before skin incision in caesarean sections ( 15 ). However, studies also suggest that the mode of delivery is an important confounder and the correlation between intrapartum antibiotic treatment and AD is increased for vaginally delivered infants but not for infancts, delivered by cesarean sections ( 12 ). Similarly, while Mubanga et al ( 24 ) have shown a modest increase in the risk of AD that was associated with maternal antibiotics in all three trimesters, Geng et al ( 23 ) have shown that the timing of antibiotic exposure is confounded by the type of antibiotic.…”

“…Corresponding clinical studies have also produced mixed results. While some studies showed that risk of AD increased after maternal exposure to antibiotics (12)(13)(14), others found no significant association (15-17).…”

“…The relationship between maternal exposure to antibiotics and the risk of AD has been a subject of research in multiple studies (6)(7)(8) but with conflicting results. While few studies have reported a positive association (12)(13)(14), others have not detected the correlation between maternal exposure to antibiotics and AD (15)(16)(17). Several meta-analyses (6)(7)(8) have attempted to summarize the evidence.…”