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Original Article

Perinatal antibiotic exposure of neonates in Canada and associated risk factors: a population-based study

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Pages 1190-1195 | Received 04 Jun 2014, Accepted 20 Jul 2014, Published online: 14 Aug 2014
 

Abstract

Objective: To describe neonatal antibiotic exposures occurring immediately before and after birth and their associated risk factors.

Methods: A retrospective review of the hospital charts of 449 mother–neonate pairs enrolled in the Canadian Healthy Infant Longitudinal Development national birth-cohort study was conducted at two tertiary hospitals and one rural hospital in Manitoba, Canada. The main outcome measures included the following: maternal and neonatal antibiotic use during the perinatal period; indications for antibiotic use, including suspected neonatal sepsis, maternal group B Streptococcus (GBS), premature rupture of membranes and caesarean-section; maternal health status, focusing on gestational hypertension, gestational diabetes, obesity and primigravida pregnancies.

Results: During the perinatal period, 45.0% of neonates were exposed to antibiotics. Intravenous penicillin G (17%) and cefazolin (16%) were the most commonly administered intrapartum antibiotics. Colonization with GBS was confirmed in 21.2% of women and treated with antibiotics in 86% of cases. Overweight women and women with hypertension were significantly more likely to receive intrapartum antibiotics for caesarean section or GBS prophylaxis. Antibiotic treatment of the neonate was highest following emergency caesarean section (12%) or unknown maternal GBS status (20%).

Conclusions: Neonates in Canada are routinely exposed to antibiotics during the perinatal period.

Acknowledgements

The authors extend sincere appreciation to the CHILD study investigators, staff and participants.

This study was approved on 5 February 2008 by the University of Manitoba Health Research Ethics Board (protocol reference number H2007:255). Participants provided written informed consent upon enrolment in the CHILD study.

Declaration of interest

The authors declare no conflicts of interest.

The CHILD study is funded by the Canadian Institutes of Health Research (CIHR) and AllerGen NCE. R. R. P. is the recipient of summer studentship awards from AllerGen NCE, the Manitoba Institute of Child Health and the University of Manitoba. At the time of this research, M. B. A. was a CIHR Banting Postdoctoral Fellow and supported by the Parker B. Francis Foundation and Alberta Innovates Health Solutions. A. L. K. held a Research Chair supported by the Women and Children's Health Research Institute/Stollery Children's Hospital Foundation.

Author contributions

M. R. S. is principal investigator for the CHILD study; A. B. B. is the Winnipeg site leader and oversaw recruitment of study participants. A. L. K. conceived of the study design and oversaw data collection and analyses. R. R. P. conducted hospital chart reviews and drafted the manuscript. M. B. A. conducted statistical analyses. R. S. C. provided expertise on obstetric practice guidelines. All authors critically reviewed and approved the manuscript.

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