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.
J Antimicrob Chemother. 2022 Apr 27;77(5):1461-1467. doi: 10.1093/jac/dkac053.
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.
评估妊娠期使用抗生素对早产风险的影响，因为健康的母体微生物群可能具有保护作用。
这是一项基于人群的队列研究，纳入了瑞典所有的初次妊娠（2006-16 年）。通过多变量逻辑回归评估了妊娠期和近期孕前全身使用抗生素与早产之间的关联，结果以比值比（OR）和 95%置信区间（CI）表示，并调整了合并症（孕前亚临床甲状腺功能减退或甲状腺功能亢进、高血压或糖尿病）、孕期、抗生素类别和治疗持续时间的影响。
与未使用者相比，有合并症的母亲（OR=1.32，95%CI 1.18-1.48）和无合并症的母亲（OR=1.09，95%CI 1.06-1.13）使用抗生素与早产风险增加相关。孕前使用无相关性，而第一和第二孕期使用风险增加，第三孕期使用风险降低。在无合并症和有合并症的母亲中，以下抗生素组的风险增加：大环内酯类、林可酰胺类和链阳性菌素类（OR=1.63，95%CI 1.45-1.83；OR=2.48，95%CI 1.72-3.56）；喹诺酮类（OR=1.60，95%CI 1.32-1.94；OR=2.11，95%CI 1.12-4.03）；非青霉素类β-内酰胺类（OR=1.15，95%CI 1.07-1.24；OR=1.39，95%CI 1.07-1.83）；其他抗菌药物（OR=1.09，95%CI 1.03-1.14；OR=1.38，95%CI 1.16-1.63）；青霉素类（OR=1.04，95%CI 1.01-1.08；OR=1.23，95%CI 1.09-1.40）。抗生素的适应证不详，这也可能影响早产。
妊娠期间使用抗生素与早产风险增加相关，尤其是在患有慢性疾病的母亲中。
