Exposure to group B Streptococcal antibiotic prophylaxis and early childhood body mass index in a vaginal birth cohort
Exposure to group B Streptococcal antibiotic prophylaxis and early childhood body mass index in a vaginal birth cohort
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DOI：
10.1080/14767058.2019.1571575
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发表时间：
2020-10-01
影响因子：
1.8
通讯作者：
Heyborne, Kent D.
中科院分区：
文献类型：
--
作者：
Metz, Torri D.;McKinney, Jennifer;Heyborne, Kent D.
目的：围产期抗生素暴露可能与婴儿早期肠道菌群和儿童肥胖的变化有关。我们的目的是评估B组链球菌（GBS）抗生素预防是否与儿童早期较高的体重指数（BMI）相关。材料和方法：这是一个回顾性队列研究的母亲/儿童二对在一个单一的医院系统超过6年的时间。所有足月、单胎、头位、阴道分娩的妇女，未接受抗生素或仅接受抗生素预防GBS，其子女在2-5岁时有BMI。将儿童分为三组进行比较：GBS阳性母亲所生的儿童仅接受抗生素用于GBS预防，GBS阴性妇女所生的儿童未接受抗生素（健康对照），以及GBS阳性母亲所生的儿童未接受抗生素。主要结局是2-5岁时最早可用的儿童BMIZ评分。多变量线性回归用于估计组间儿童BMIZ评分的差异，调整母亲BMI，年龄，种族，产次，烟草使用和儿童出生体重。结果：4825例患者中，786例（16.3%）GBS阳性，并接受预防性抗生素治疗，3916例（81.2%）GBS阴性，但未接受抗生素治疗，123例（2.5%）GBS阳性，但未接受抗生素治疗。在未校正（平均值（SE），0.04（0.04）vs-0.3（0.02），p = 0.11）和校正（0.01（0.05）vs-0.04（0.03），p = 0.3）模型中，暴露于分娩期GBS预防的儿童与未暴露的健康对照儿童的儿童BMIZ评分相似。结论：与健康对照组相比，分娩期预防性使用抗生素治疗GBS与儿童早期BMIZ评分升高无关。
Purpose:Perinatal antibiotic exposure may be associated with changes in both early infancy gut microbiota and later childhood obesity. Our objective was to evaluate if group B Streptococcus (GBS) antibiotic prophylaxis is associated with higher body mass index (BMI) in early childhood. Materials and methods:This is a retrospective cohort study of mother/child dyads in a single hospital system over a 6-year period. All women with term, singleton, vertex, vaginal deliveries who received no antibiotics or received antibiotics only for GBS prophylaxis and whose children had BMIs available at 2-5 years of age were included. Children were divided into three groups for comparison: children born to GBS positive mothers that received antibiotics solely for GBS prophylaxis, children born to GBS negative women that received no antibiotics (healthy controls), and children born to GBS positive mothers who received no antibiotics. The primary outcome was the earliest available child BMIZ-score at 2-5 years of age. Multivariable linear regression was used to estimate differences in child BMIZ-scores between groups, adjusted for maternal BMI, age, race, parity, tobacco use, and child birthweight. Results:Of 4825 women, 786 (16.3%) were GBS positive and received prophylactic antibiotics, 3916 (81.2%) were GBS negative and received no antibiotics, and 123 (2.5%) were GBS positive but received no antibiotics. Childhood BMIZ-scores were similar between children exposed to intrapartum GBS prophylaxis and healthy controls who were unexposed in both unadjusted (mean (SE), 0.04 (0.04) versus -0.3 (0.02),p = .11) and adjusted (0.01 (0.05) versus -0.04 (0.03),p = .3) models. Conclusions:Exposure to intrapartum antibiotic prophylaxis for GBS was not associated with higher early childhood BMIZ-scores compared to healthy controls.