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Use of Antibiotic Treatment in Pregnancy and the Risk of Several Neonatal Outcomes: A Population-Based Study

Author

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  • Anna Cantarutti

    (National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
    Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
    Contributed equally as co-first authors.)

  • Federico Rea

    (National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
    Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
    Contributed equally as co-first authors.)

  • Matteo Franchi

    (National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
    Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy)

  • Benedetta Beccalli

    (Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy)

  • Anna Locatelli

    (Department of Mother and Child, ASST Vimercate, 20871 Vimercate, Italy
    School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy)

  • Giovanni Corrao

    (National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
    Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy)

Abstract

Background: Limited evidence is available on the safety and efficacy of antimicrobials during pregnancy, with even less according to the trimester of their use. Objective: This study aimed to evaluate the association between exposure to antibiotics therapy (AT) during pregnancy and short-term neonatal outcomes. Methods: We considered 773,237 deliveries that occurred between 2007–2017 in the Lombardy region of Italy. We evaluated the risk of neonatal outcomes among infants that were born to mothers who underwent AT during pregnancy. The odds ratios and the hazard ratios, with the 95% confidence intervals, were estimated respectively for early (first/second trimester) and late (third trimester) exposure. The propensity score was used to account for potential confounders. We also performed subgroup analysis for the class of AT. Results: We identified 132,024 and 76,921 singletons that were exposed to AT during early and late pregnancy, respectively. Infants born to mothers with early exposure had 17, 11, and 16% increased risk of preterm birth, low birth weight, and low Apgar score, respectively. Infants that were exposed in late pregnancy had 25, 11, and 13% increased risk of preterm birth, low birth weight, and low Apgar score, respectively. The results were consistent in the subgroup analysis. Conclusion: Our results suggested an increased risk of several neonatal outcomes in women exposed to ATs during pregnancy, albeit we were not able to assess to what extent the observed effects were due to the infection itself. To reduce the risk of neonatal outcomes, women that are prescribed AT during pregnancy should be closely monitored.

Suggested Citation

  • Anna Cantarutti & Federico Rea & Matteo Franchi & Benedetta Beccalli & Anna Locatelli & Giovanni Corrao, 2021. "Use of Antibiotic Treatment in Pregnancy and the Risk of Several Neonatal Outcomes: A Population-Based Study," IJERPH, MDPI, vol. 18(23), pages 1-11, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12621-:d:691630
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    References listed on IDEAS

    as
    1. Begoña Martinez De Tejada, 2014. "Antibiotic Use and Misuse during Pregnancy and Delivery: Benefits and Risks," IJERPH, MDPI, vol. 11(8), pages 1-17, August.
    2. Giovanni Corrao & Federico Rea & Matteo Franchi & Benedetta Beccalli & Anna Locatelli & Anna Cantarutti, 2020. "Warning of Immortal Time Bias When Studying Drug Safety in Pregnancy: Application to Late Use of Antibiotics and Preterm Delivery," IJERPH, MDPI, vol. 17(18), pages 1-11, September.
    3. Burt, R.D. & Vaughan, T.L. & Daling, J.R., 1988. "Evaluating the risks of cesarean section: Low Apgar score in repeat C-section and vaginal deliveries," American Journal of Public Health, American Public Health Association, vol. 78(10), pages 1312-1314.
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    Cited by:

    1. Chien-Lung Chan & Chi-Chang Chang, 2022. "Big Data, Decision Models, and Public Health," IJERPH, MDPI, vol. 19(14), pages 1-9, July.

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