Antibiotic use during pregnancy and the risk of preterm birth: a population-based Swedish cohort study.


Journal

The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617

Informations de publication

Date de publication:
27 04 2022
Historique:
received: 01 10 2021
accepted: 28 01 2022
pubmed: 3 3 2022
medline: 3 5 2022
entrez: 2 3 2022
Statut: ppublish

Résumé

To assess the impact of gestational antibiotics on the risk of preterm birth, since a healthy maternal microbiome may be protective. Population-based cohort study including all first pregnancies in Sweden (2006-16). The association between gestational and recent pre-conception systemic antibiotics and preterm birth was assessed by multivariable logistic regression presented as ORs and 95% CIs, adjusted for comorbidities (hypo- and hyperthyroidism, hypertension, or diabetes mellitus pre-gestation), trimester, antibiotic class and treatment duration. Compared with non-users, antibiotic exposure was associated with increased risks of preterm birth in mothers with comorbidities (OR = 1.32, 95% CI 1.18-1.48) and without (OR = 1.09, 95% CI 1.06-1.13). Pre-conception use showed no association, while risk was increased for first and second trimester use and decreased for third trimester use. The increased risks were seen for the following antibiotic groups in mothers without and with comorbidities, respectively: macrolides, lincosamides and streptogramins (OR = 1.63, 95% CI 1.45-1.83; OR = 2.48, 95% CI 1.72-3.56); quinolones (OR = 1.60, 95% CI 1.32-1.94; OR = 2.11, 95% CI 1.12-4.03); non-penicillin β-lactams (OR = 1.15, 95% CI 1.07-1.24; OR = 1.39, 95% CI 1.07-1.83); other antibacterials (OR = 1.09, 95% CI 1.03-1.14; 1.38, 95% CI 1.16-1.63); and penicillins (OR = 1.04, 95% CI 1.01-1.08; 1.23, 95% CI 1.09-1.40). Antibiotic indications were not available, which could also affect preterm birth. Antibiotic use during pregnancy was associated with an increased risk of preterm birth, especially in mothers with chronic diseases.

Identifiants

pubmed: 35233608
pii: 6540605
doi: 10.1093/jac/dkac053
pmc: PMC9047673
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1461-1467

Subventions

Organisme : Research Foundation-Flanders
ID : 12I6319N

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.

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Auteurs

M H Nguyen (MH)

I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium.
Centre for Translational Microbiome Research, Department of Microbiology Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.

R Fornes (R)

Centre for Translational Microbiome Research, Department of Microbiology Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.

N Kamau (N)

I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium.
Centre for Translational Microbiome Research, Department of Microbiology Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.

H Danielsson (H)

Centre for Translational Microbiome Research, Department of Microbiology Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
Sach's Children's and Youth Hospital, Södersjukhuset, Stockholm, Sweden.

S Callens (S)

Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.

E Fransson (E)

Centre for Translational Microbiome Research, Department of Microbiology Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.

L Engstrand (L)

Centre for Translational Microbiome Research, Department of Microbiology Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.

R Bruyndonckx (R)

I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium.
Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.

N Brusselaers (N)

Centre for Translational Microbiome Research, Department of Microbiology Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
Global Health Institute, Antwerp University, Antwerp, Belgium.
Department of Head and Skin, Ghent University, Ghent, Belgium.

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