Effect of Prenatal Antibiotic Exposure on Neonatal Outcomes of Preterm Infants
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Purpose: Antibiotic exposure during pregnancy may affect the fetus and newborn in many ways. This study investigated the impact of prenatal antibiotic exposure duration on neonatal outcomes in very preterm (VP) or very low birth weight (VLBW) infants. Methods: From September 2015 to December 2020, preterm infants with gestational age less than 32 weeks or with a BW less than 1,500 g who were admitted to the neonatal intensive care unit, and their mothers were enrolled. Prenatal antibiotic exposure was defined as antibiotics received by mothers before delivery, and the patients were categorized into the non-antibiotic group, short-duration (SD; ≤7 days) group, or long-duration (LD; >7 days) groups. Results: A total of 93 of 145 infants were exposed to prenatal antibiotics, among which 35 (37.6%) were in the SD group and 58 (62.4%) were in the LD group. Infants in the LD group had a significantly higher birth weight-for-gestational-age (BW/GA) Z-score than those in the non-antibiotic group, even after the adjustment for confounding factors (beta, 0.258; standard error, 0.149; P<0.001). Multivariate logistic regression analysis showed that prolonged prenatal antibiotic exposure was independently associated with death (adjusted odds ratio [aOR], 8.926; 95% confidence interval [CI], 1.482–53.775) and composite outcomes of death, necrotizing enterocolitis (NEC), and late-onset sepsis (LOS) (aOR, 2.375; 95% CI, 1.027–5.492). Conclusions: Prolonged prenatal antibiotic exposure could increase the BW/GA Z-score and the risk of death and composite outcomes of death, NEC, and LOS in VP or VLBW infants.
Abstract
Purpose: Antibiotic exposure during pregnancy may affect the fetus and newborn in many ways. This study investigated the impact of prenatal antibiotic exposure duration on neonatal outcomes in very preterm (VP) or very low birth weight (VLBW) infants. Methods: From September 2015 to December 2020, preterm infants with gestational age less than 32 weeks or with a BW less than 1,500 g who were admitted to the neonatal intensive care unit, and their mothers were enrolled. Prenatal antibiotic exposure was defined as antibiotics received by mothers before delivery, and the patients were categorized into the non-antibiotic group, short-duration (SD; ≤7 days) group, or long-duration (LD; >7 days) groups. Results: A total of 93 of 145 infants were exposed to prenatal antibiotics, among which 35 (37.6%) were in the SD group and 58 (62.4%) were in the LD group. Infants in the LD group had a significantly higher birth weight-for-gestational-age (BW/GA) Z-score than those in the non-antibiotic group, even after the adjustment for confounding factors (beta, 0.258; standard error, 0.149; P<0.001). Multivariate logistic regression analysis showed that prolonged prenatal antibiotic exposure was independently associated with death (adjusted odds ratio [aOR], 8.926; 95% confidence interval [CI], 1.482–53.775) and composite outcomes of death, necrotizing enterocolitis (NEC), and late-onset sepsis (LOS) (aOR, 2.375; 95% CI, 1.027–5.492). Conclusions: Prolonged prenatal antibiotic exposure could increase the BW/GA Z-score and the risk of death and composite outcomes of death, NEC, and LOS in VP or VLBW infants.
참고문헌 (40)
- Bookstaver PB, "A review of antibiotic use in pregnancy", Pharmacotherapy, 35, pp.1052~1062 (2015)
- Broe A, "Increasing use of antibiotics in pregnancy during the period 2000-2010: prevalence, timing, category, and demographics", BJOG, 121, pp.988~996 (2014)
- Committee on Practice Bulletins-Obstetrics, "ACOG practice bulletin No. 199: use of prophylactic antibiotics in labor and delivery", Obstet Gynecol, 132, pp.e103~e119 (2018)
- World Health Organization, "WHO recommendations for prevention and treatment of maternal peripartum infections", World Health Organization, ~ (2015)
- "Prelabor rupture of membranes: ACOG practice bulletin, number 217", Obstet Gynecol, 135, pp.e80~e97 (2020)
- Bizzarro MJ, "Changing patterns in neonatal Escherichia coli sepsis and ampicillin resistance in the era of intrapartum antibiotic prophylaxis", Pediatrics, 121, pp.689~696 (2008)
- Didier C, "Late-onset neonatal infections: incidences and pathogens in the era of antenatal antibiotics", Eur J Pediatr, 171, pp.681~687 (2012)
- Weintraub AS, "Antenatal antibiotic exposure in preterm infants with necrotizing enterocolitis", J Perinatol, 32, pp.705~709 (2012)
- Mercer BM, "Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes. A randomized controlled trial", JAMA, 278, pp.989~995 (1997)
- Reed BD, "The impact of maternal antibiotics on neonatal disease", J Pediatr, 197, pp.97~103.e3 (2018)
- Fenton TR, "A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants", BMC Pediatr, 13, pp.59~ (2013)
- Walsh MC, "Necrotizing enterocolitis: treatment based on staging criteria", Pediatr Clin North Am, 33, pp.179~201 (1986)
- Ehrenkranz RA, "Validation of the National Institutes of Health consensus definition of bronchopulmonary dysplasia", Pediatrics, 116, pp.1353~1360 (2005)
- Bizzarro MJ, "Seventy-five years of neonatal sepsis at Yale: 1928-2003", Pediatrics, 116, pp.595~602 (2005)
- Chiang MF, "International classification of retinopathy of prematurity, third edition", Ophthalmology, 128, pp.e51~e68 (2021)
- de Jonge L, "Antibiotics prescribed before, during and after pregnancy in the Netherlands: a drug utilization study", Pharmacoepidemiol Drug Saf, 23, pp.60~68 (2014)
- 김서연, "Questionnaire survey on the management of pregnant women with preterm premature rupture of membranes", Obstetrics & Gynecology Science, 63(3), pp.286~292 (2020), 대한산부인과학회[DOI]
- Kenyon SL, "Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial", Lancet, 357, pp.979~988 (2001)
- Lee J, "A new antibiotic regimen treats and prevents intra-amniotic inflammation", infection in patients with preterm PROM, 2016, pp.29, 2727~2737
- "Intraamniotic infection with genital mycoplasmas exhibits a more intense inflammatory response than intraamniotic infection with other microorganisms in patients with preterm premature rupture of membranes", Am J Obstet Gynecol, 203, pp.211.e1~211.e8 (2010)
- Redelinghuys MJ, "Antimicrobial susceptibility patterns of Ureaplasma species and Mycoplasma hominis in pregnant women", BMC Infect Dis, 14, pp.171~ (2014)
- Park HS, "Placental transfer of clarithromycin in human pregnancies with preterm premature rupture of membranes", J Perinat Med, 40, pp.641~646 (2012)
- Aghaali M, "Association between early antibiotic exposure and risk of childhood weight gain and obesity: a systematic review and meta-analysis", J Pediatr Endocrinol Metab, 32, pp.439~445 (2019)
- Mueller NT, "Association of prenatal antibiotics with foetal size and cord blood leptin and adiponectin", Pediatr Obes, 12, pp.129~136 (2017)
- Zhang M, "Association of prenatal antibiotics with measures of infant adiposity and the gut microbiome", Ann Clin Microbiol Antimicrob, 18, pp.18~ (2019)
- Collado MC, "Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid", Sci Rep, 6, pp.23129~ (2016)
- Nogacka AM, "Early microbiota, antibiotics and health", Cell Mol Life Sci, 75, pp.83~91 (2018)
- Pacifici GM, "Placental transfer of antibiotics administered to the mother: a review", Int J Clin Pharmacol Ther, 44, pp.57~63 (2006)
- Dai Z, "Amino acid metabolism in intestinal bacteria and its potential implications for mammalian reproduction", Mol Hum Reprod, 21, pp.389~409 (2015)
- Mikkelsen KH, "Effect of antibiotics on gut microbiota, glucose metabolism and body weight regulation: a review of the literature", Diabetes Obes Metab, 18, pp.444~453 (2016)
- Nogues P, "Maternal obesity influences expression and DNA methylation of the adiponectin and leptin systems in human third-trimester placenta", Clin Epigenetics, 11, pp.20~ (2019)
- Josefson JL, "Maternal leptin predicts adiposity of the neonate", Horm Res Paediatr, 81, pp.13~19 (2014)
- Khan I, "Metagenomic analysis of antibioticinduced changes in gut microbiota in a pregnant rat model", Front Pharmacol, 7, pp.104~ (2016)
- Andrews RE, "Clinical presentation and multifactorial pathogenesis of necrotizing enterocolitis in the preterm infant", Adv Neonatal Care, 21, pp.349~355 (2021)
- Zeissig S, "Life at the beginning: perturbation of the microbiota by antibiotics in early life and its role in health and disease", Nat Immunol, 15, pp.307~310 (2014)
- Deshmukh HS, "The microbiota regulates neutrophil homeostasis and host resistance to Escherichia coli K1 sepsis in neonatal mice", Nat Med, 20, pp.524~530 (2014)
- Romagano MP, "Maternal antepartum antibiotic administration and patterns of bacterial resistance in early preterm neonates", J Matern Fetal Neonatal Med, pp.1~5 (2020)
- Patangia DV, "Vertical transfer of antibiotics and antibiotic resistant strains across the mother", baby axis, 2022, pp.30, 47~56
- Hayes K, "A review of antibiotic resistance in group B streptococcus: the story so far", Crit Rev Microbiol, 46, pp.253~269 (2020)
- Doenhardt M, "Neonatal and young infant sepsis by group B streptococci and Escherichia coli: a single-center retrospective analysis in Germany-GBS screening implementation gaps and reduction in antibiotic resistance", Eur J Pediatr, 179, pp.1769~1777 (2020)