Luo Ping, Zhang Kun, Chen You, Geng Xiuwen, Wu Tong, Li Li, Zhou Ping, Jiang Ping-Ping, Ma Liya
School of Public Health, Sun Yat-sen University, Guangzhou, China.
Department of Obstetrics, Bao'an Women and Children's Hospital, Jinan University, Shenzhen, China.
Front Pediatr. 2021 Dec 22;9:750058. doi: 10.3389/fped.2021.750058. eCollection 2021.
Antibiotics are widely prescribed by obstetricians, which exposes a large number of infants to antenatal antibiotics (AAB). The effect of AAB on various aspects of neonatal development of preterm infants remains unclear. In this retrospective study, infants born with gestational age (GA) between 22 and 36 weeks at our unit from 2017 to 2019 were included. Multivariable analysis was adopted to examine the associations between AAB exposure and various outcomes related to enteral feeding process, body growth, and neonatal infection after adjusting for potential confounders. Further subanalysis on the exposure level of AAB and stratified analysis by GA (<34 vs. ≥34 weeks) were also conducted. In this cohort comprising 2,543 preterm infants, AAB was associated with decreased risks of feeding intolerance (odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.48-0.82) and neonatal infection (OR: 0.63, 95% CI: 0.41-0.94). Higher AAB exposure level was associated with higher Z scores of birth weight (β = 0.37, 95% CI: 0.27-0.47), but lower Δbodyweight Z-scores (β = -0.20, 95% CI: -0.27 to -0.13). AAB was positively associated with the parameters related to body growth in infants with GA <34 weeks but negatively associated in those with GA ≥34 weeks. AAB exposure affects the enteral feeding process and neonatal infection. The effects on body growth vary by the exposure level of AAB and GA of infants. A well-designed prospective and preferably multi-centre study with predefined parameters is required to confirm our findings.
产科医生广泛使用抗生素，这使得大量婴儿在产前接触抗生素（AAB）。AAB对早产儿新生儿发育各个方面的影响尚不清楚。在这项回顾性研究中，纳入了2017年至2019年在我们单位出生、胎龄（GA）在22至36周之间的婴儿。采用多变量分析来检验在调整潜在混杂因素后，AAB暴露与肠内喂养过程、身体生长和新生儿感染等各种结局之间的关联。还对AAB的暴露水平进行了进一步的亚组分析，并按GA（<34周与≥34周）进行了分层分析。在这个包含2543名早产儿的队列中，AAB与喂养不耐受风险降低（优势比[OR]：0.63，95%置信区间[CI]：0.48 - 0.82）和新生儿感染风险降低（OR：0.63，95%CI：0.41 - 0.94）相关。较高的AAB暴露水平与出生体重的Z评分较高（β = 0.37，95%CI：0.27 - 0.47）相关，但体重增加的Z评分较低（β = -0.20，95%CI：-0.27至-0.13）。AAB与GA<34周婴儿的身体生长参数呈正相关，但与GA≥34周的婴儿呈负相关。AAB暴露会影响肠内喂养过程和新生儿感染。对身体生长的影响因AAB的暴露水平和婴儿的GA而异。需要一项设计良好的前瞻性研究，最好是多中心研究，并设定预定义参数来证实我们的发现。
