The relationship between intrapartum group B streptococcus prophylaxis and allergic rhinitis in children at the age of 3 : a retrospective cohort study of 3010 children

Abstract

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.