Buckey Timothy M, Gleeson Patrick K, Curley Cara M, Feldman Scott F, Apter Andrea J, Fadugba Olajumoke O
Section of Allergy and Immunology, Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Division of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, United States.
Front Allergy. 2024 Dec 9;5:1511392. doi: 10.3389/falgy.2024.1511392. eCollection 2024.
Penicillins and other beta-lactam antibiotics are used in greater than one-third of pregnant women as treatment for Group B Streptococcus colonization and prophylaxis for Caesarean sections. Penicillin allergy labels have been associated with increased morbidity in the pregnant population, and penicillin allergy evaluation during pregnancy is now recognized as safe and effective. Yet, demographic characteristics associated with having a penicillin allergy label during pregnancy have not been studied. We aimed to evaluate factors associated with having a penicillin allergy label in a diverse population of pregnant patients.
We performed a retrospective observational study of pregnant patients who had an outpatient visit with Obstetrics and Gynecology and a delivery encounter from 1/1/2020 through 6/30/2022 using electronic health record data in a large health system. We used a multivariable logistic regression model to evaluate factors associated with having a penicillin allergy label.
We identified 10,969 pregnant women of whom 940 (8.6%) had a penicillin allergy label. In the multivariable analysis, having a penicillin allergy label was positively associated with age 32-34 years [odds ratio (OR) = 1.31 vs. 18-27 years, = 0.02], 35-51 years (OR = 1.41 vs. 18-27 years, = 0.002) and having rhinitis, asthma, or eczema (OR = 1.55 vs. none, < 0.0005); and negatively associated with Black race (OR = 0.59 vs. White, < 0.0005).
This study found that Black race was associated with lower likelihood of penicillin allergy label, while older age and atopic conditions were associated with a higher likelihood. This finding may impact health outcomes and interventions related to penicillin allergy in pregnant women.
青霉素和其他β-内酰胺类抗生素在超过三分之一的孕妇中用于治疗B族链球菌定植和剖宫产预防。青霉素过敏标签与孕妇发病率增加有关，现在孕期青霉素过敏评估被认为是安全有效的。然而，与孕期有青霉素过敏标签相关的人口统计学特征尚未得到研究。我们旨在评估不同孕妇群体中与有青霉素过敏标签相关的因素。
我们使用大型医疗系统中的电子健康记录数据，对2020年1月1日至2022年6月30日期间进行过妇产科门诊就诊和分娩的孕妇进行了一项回顾性观察研究。我们使用多变量逻辑回归模型来评估与有青霉素过敏标签相关的因素。
我们确定了10969名孕妇，其中940名（8.6%）有青霉素过敏标签。在多变量分析中，有青霉素过敏标签与32 - 34岁年龄组呈正相关[比值比（OR）= 1.31，与18 - 27岁相比，P = 0.02]，35 - 51岁年龄组（OR = 1.41，与18 - 27岁相比，P = 0.002）以及患有鼻炎、哮喘或湿疹（OR = 1.55，与无此类疾病相比，P < 0.0005）；与黑人种族呈负相关（OR = 0.59，与白人相比，P < 0.0005）。
本研究发现黑人种族与青霉素过敏标签的可能性较低相关，而年龄较大和特应性疾病与较高可能性相关。这一发现可能会影响与孕妇青霉素过敏相关的健康结果和干预措施。
