670 - Perinatal antibiotics and risk of childhood infectious diseases
Saturday, April 29, 2023
3:30 PM – 6:00 PM ET
Poster Number: 670 Publication Number: 670.241
Sagori Mukhopadhyay, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; William O.. Quarshie, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Robert W. Grundmeier, Children's Hospital of Philadelphia, PHILADELPHIA, PA, United States; Di Shu, University of Pennsylvania & Children’s Hospital of Philadelphia, Philadelphia, PA, United States; Scott A. Lorch, The Children's Hospital of Philadelphia/University of Pennsylvnaia, Philadelphia, PA, United States; Jeffrey S. Gerber, Children's Hospital of Philadelphia, PHILADELPHIA, PA, United States; Miren B. Dhudasia, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Karen M. Puopolo, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
Assistant Professor Childrens Hospital of Philadelphia Philadelphia, Pennsylvania, United States
Background: In epidemiological studies and in experimental models, early-life antibiotics are associated with increased risk for subsequent infections. A potential mechanism includes disruption of the defense provided by a diverse microbiome, which may be enduring when it occurs in the foundational early period of microbiome development. As one of the earliest forms of antibiotic exposure, the role of perinatal antibiotics in this association has not been investigated Objective: Determine the association of perinatal antibiotics with risk of childhood infectious diseases requiring inpatient admission in the first 6 years’ after birth Design/Methods: Retrospective cohort study of infants born at 2 centers between 2007-2012 at ≥37 weeks gestation, without major anomalies or culture-confirmed infection ≤3 days after birth. Follow-up information was collected from linked electronic medical records till 6 years of age. Perinatal antibiotics was defined as any intravenous antibiotic administered to the mother during birth admission (excluding surgical skin prophylaxis during cesarean section) or administered to the infant ≤3 days after birth. The primary outcome was defined as frequency of infection related inpatient encounters identified by pre-specified diagnostic codes associated with the encounter.In a secondary model we investigated the association of early antibiotics defined as perinatal antibiotics and pediatric antibiotics prescribed in ≤3 months after birth with the outcome after that time-period. We used a recurrent event model for analysis and adjusted appropriate covariates. Results: Of 13,919 infants in the study cohort, 3936 (28%) infants had exposure to perinatal antibiotics (Table 1). Over the 6 years’ follow-up, 1294 (9.3%) infants had 1619 inpatient encounters. Of these 996 (62%) encounters were infection related, and 44% occurred in the first year (Figure). The most frequently identified codes included those for acute respiratory infection (ICD-9 code 465 to 488), viral infections (ICD-9 code 079.x) and urinary tract infection (ICD-9 code 599.x). In the adjusted multivariate model, perinatal antibiotics was not associated with increased hazard for infection-related inpatient encounters [(aHR) 1.22, 95% confidence interval (CI) 0.97, 1.51] (Table 2). Similarly, early antibiotic exposure in the first 3 months was not associated with the outcome
Conclusion(s): Perinatal antibiotics alone or with pediatric antibiotics exposure in the first 3 months after birth was not associated with subsequent frequency of childhood infectious diseases requiring inpatient admission in the first 6 years’ after birth.
