Intrapartum Antibiotic Exposure and Body Mass Index in Children. (25th January 2021)

• Record Type: Journal Article
• Authors: Koebnick, Corinna; Sidell, Margo A; Getahun, Darios; Tartof, Sara Y; Rozema, Emily; Taylor, Brianna; Xiang, Anny H; Spiller, Michael W; Sharma, Andrea J; Mukhopadhyay, Sagori; Puopolo, Karen M; Schrag, Stephanie J
• Is Part Of: Clinical infectious diseases. Volume 73:Number 4(2021)
• Page Start: e938
• Page End: e946
• Publication Date: 2021-01-25
• Subjects: childhood obesity -- body mass index -- intrapartum antibiotic prophylaxis -- delivery mode; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciab053
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Intrapartum antibiotic prophylaxis (IAP) reduces a newborn's risk of group B streptococcal infection (GBS) but may lead to an increased childhood body mass index (BMI). Methods: This was a retrospective cohort study of infants (n = 223 431) born 2007–2015 in an integrated healthcare system. For vaginal delivery, we compared children exposed to GBS-IAP and to any other type or duration of intrapartum antibiotics to no antibiotic exposure. For cesarean delivery, we compared children exposed to GBS-IAP to those exposed to all other intrapartum antibiotics, including surgical prophylaxis. BMI over 5 years was compared using nonlinear multivariate models with B-spline functions, stratified by delivery mode and adjusted for demographics, maternal factors, breastfeeding, and childhood antibiotic exposure. Results: In vaginal deliveries, GBS-IAP was associated with higher BMI from 0.5 to 5.0 years of age compared to no antibiotics ( P < .0001 for all time points, ΔBMI at age 5 years 0.12 kg/m 2, 95% confidence interval [CI]: .07–.16 kg/m 2 ). Other antibiotics were associated with higher BMI from 0.3 to 5.0 years of age. In cesarean deliveries, GBS-IAP was associated with increased BMI from 0.7 years to 5.0 years of age ( P < .05 for 0.7–0.8 years, P < .0001 for all other time points) compared to other antibiotics (ΔBMI at age 5 years 0.24 kg/m 2, 95% CI: .14–.34 kg/m 2 ). Breastfeeding did not modify these associations. Conclusions: GBS-IAP was associated with a small but sustained increase in BMI starting at very early age. This association highlights the need to better understand the effects of perinatal antibiotic exposure on childhood health. Abstract : Intrapartum antibiotic prophylaxis reduces a newborn's risk of group B streptococcal infection but is also associated with a small but sustained increase in body mass. Our results highlight the need to better understand effects of in utero exposure to antibiotics.