Intrapartum group B Streptococcal prophylaxis and childhood weight gain.
Intrapartum group B Streptococcal prophylaxis and childhood weight gain.
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DOI：
10.1136/archdischild-2020-320638
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Puopolo KM
中科院分区：
文献类型：
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作者：
Mukhopadhyay S;Bryan M;Dhudasia MB;Quarshie W;Gerber JS;Grundmeier RW;Koebnick C;Sidell MA;Getahun D;Sharma AJ;Spiller MW;Schrag SJ;Puopolo KM
确定新生儿出生至5岁时暴露于母体B群链球菌（GBS）产时抗生素预防（IAP）的体重增长率差异。13804名婴儿的回顾性队列研究。在费城的两个围产期中心和一个初级儿科护理网络中，2007-2012年出生的足月婴儿，从出生到5岁纵向跟踪。GBS IAP定义为在分娩前≥4小时给予青霉素、氨苄西林、头孢唑林、克林霉素或万古霉素。参考婴儿被定义为没有（阴道分娩）或有其他（剖宫产）产时抗生素暴露的母亲所生。从出生到5岁体重变化率的差异使用纵向速率回归进行评估。分析按分娩方式进行先验分层，并根据相关协变量进行调整。对2444 / 13804名（17.7%）儿童的母亲进行GBS IAP。GBS iap暴露儿童在前5年的体重增加率明显高于阴道出生的儿童（调整后的比率差异为1.44% [95% CI, 0.3%-2.6%]）和剖腹产出生的儿童（调整后的比率差异为3.52% [95% CI, 1.9%-5.2%]）。5岁时，阴道出生的孩子体重增加了0.24公斤，剖腹产出生的孩子体重增加了0.60公斤。gbs特异性IAP与儿童早期体重增加率的适度增加有关。GBS IAP是预防围产期GBS疾病相关发病率和死亡率的有效干预措施。然而，这些发现强调需要更好地了解产时抗生素暴露对儿童生长的影响，并支持制定替代预防策略的努力。
To determine the difference in rate of weight gain from birth to five years based on exposure to maternal group B Streptococcal (GBS) intrapartum antibiotic prophylaxis (IAP). Retrospective cohort study of 13,804 infants. Two perinatal centers and a primary pediatric care network in Philadelphia Term infants born 2007–2012, followed longitudinally from birth to 5 years of age. GBS IAP defined as penicillin, ampicillin, cefazolin, clindamycin or vancomycin administered ≥4 hours prior to delivery to the mother. Reference infants were defined as born to mothers without (vaginal delivery) or with other (cesarean delivery) intrapartum antibiotic exposure. Difference in rate of weight change from birth to 5 years was assessed using longitudinal rate regression. Analysis was a priori stratified by delivery mode and adjusted for relevant covariates. GBS IAP was administered to mothers of 2,444/13,804 (17.7%) children. GBS IAP-exposed children had a significantly elevated rate of weight gain in the first 5 years among vaginally-born (adjusted rate difference 1.44% [95% CI, 0.3%–2.6%]) and cesarean-born (3.52% [95% CI, 1.9%–5.2%]) children. At 5 years, the rate differences equated to an additional 0.24 kilograms among vaginally-born children and 0.60 kilograms among cesarean-born children. GBS-specific IAP was associated with a modest increase in rate of early childhood weight gain. GBS IAP is an effective intervention to prevent perinatal GBS disease-associated morbidity and mortality. However, these findings highlight the need to better understand effects of intrapartum antibiotic exposure on childhood growth and support efforts to develop alternate prevention strategies.
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