PDF herunterladen
Am J Perinatol 2019; 36(03): 243-251
DOI: 10.1055/s-0038-1669948
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Antibiotic Use in Pregnancy, Abnormal Fetal Growth, and Development of Gestational Diabetes Mellitus

John F. Mission
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, Pennsylvania
2   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Janet Catov
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, Pennsylvania
2   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Tiffany Deihl
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, Pennsylvania
2   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Maisa Feghali
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, Pennsylvania
2   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Christina Scifres
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, Pennsylvania
3   Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
4   Harold Hamm Diabetes Center, Oklahoma City, Oklahoma
› Institutsangaben Funding This study was funded in part by the Magee-Womens Research Institute Clinical Research Trainee Award.
Weitere Informationen

Publikationsverlauf

09. Juni 2017

07. August 2018

Publikationsdatum:
12. September 2018 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Abstract

Objective Antibiotics are commonly used in pregnancy. Prior studies have indicated that antibiotic use in pregnancy may affect birth weight, whereas data in nonpregnant individuals suggest that antibiotic exposure may increase diabetes risk. We evaluated the impact of antibiotic prescriptions during pregnancy on the prevalence of small for gestational age (SGA) and large for gestational age (LGA) birth weight and gestational diabetes mellitus (GDM).

Study Design This retrospective cohort study of 12,551 women who delivered at a large academic medical center between 2012 and 2014 assessed the number and type of antibiotic prescriptions prior to GDM testing using the electronic medical record. SGA and LGA birth weight and GDM rates were compared among women who were or were not prescribed antibiotics.

Results Overall, 3,991 (31.8%) of 12,551 patients received at least one antibiotic prescription. After covariate adjustment, no differences existed in risk of SGA (adjusted odds ratio [aOR]: 1; 95% confidence interval [CI]: 0.88–1.15; p = 0.94), LGA (aOR: 1; 95% CI: 0.86–1.17; p = 0.97), or GDM (aOR: 0.90; 95% CI: 0.72–1.13; p = 0.36) between women who were or were not prescribed antibiotics.

Conclusion Antibiotic use does not affect the risk of SGA or LGA birth weight or GDM in pregnant women. These results provide reassurance regarding the use of antibiotics when clinically indicated in pregnancy.

Keywords

antibiotics - gestational diabetes mellitus - fetal growth - large for gestational age - small for gestational age

Supplementary Material

 

  • References

  • 1 Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernández-Díaz S. ; National Birth Defects Prevention Study. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol 2011; 205 (01) 51.e1-51.e8
    CrossrefPubMedSuche in Google Scholar
  • 2 Olesen C, Steffensen FH, Nielsen GL, de Jong-van den Berg L, Olsen J, Sørensen HT. Drug use in first pregnancy and lactation: a population-based survey among Danish women. The EUROMAP group. Eur J Clin Pharmacol 1999; 55 (02) 139-144
    CrossrefPubMedSuche in Google Scholar
  • 3 Amann U, Egen-Lappe V, Strunz-Lehner C, Hasford J. Antibiotics in pregnancy: analysis of potential risks and determinants in a large German statutory sickness fund population. Pharmacoepidemiol Drug Saf 2006; 15 (05) 327-337
    CrossrefPubMedSuche in Google Scholar
  • 4 Santos F, Oraichi D, Bérard A. Prevalence and predictors of anti-infective use during pregnancy. Pharmacoepidemiol Drug Saf 2010; 19 (04) 418-427
    CrossrefPubMedSuche in Google Scholar
  • 5 Andrade SE, Gurwitz JH, Davis RL. , et al. Prescription drug use in pregnancy. Am J Obstet Gynecol 2004; 191 (02) 398-407
    CrossrefPubMedSuche in Google Scholar
  • 6 Daw JR, Mintzes B, Law MR, Hanley GE, Morgan SG. Prescription drug use in pregnancy: a retrospective, population-based study in British Columbia, Canada (2001-2006). Clin Ther 2012; 34 (01) 239-249
    CrossrefPubMedSuche in Google Scholar
  • 7 Stokholm J, Schjørring S, Pedersen L. , et al. Prevalence and predictors of antibiotic administration during pregnancy and birth. PLoS One 2013; 8 (12) e82932
    CrossrefPubMedSuche in Google Scholar
  • 8 Thuny F, Richet H, Casalta JP, Angelakis E, Habib G, Raoult D. Vancomycin treatment of infective endocarditis is linked with recently acquired obesity. PLoS One 2010; 5 (02) e9074
    CrossrefPubMedSuche in Google Scholar
  • 9 Trasande L, Blustein J, Liu M, Corwin E, Cox LM, Blaser MJ. Infant antibiotic exposures and early-life body mass. Int J Obes 2013; 37 (01) 16-23
    CrossrefPubMedSuche in Google Scholar
  • 10 Bailey LC, Forrest CB, Zhang P, Richards TM, Livshits A, DeRusso PA. Association of antibiotics in infancy with early childhood obesity. JAMA Pediatr 2014; 168 (11) 1063-1069
    CrossrefPubMedSuche in Google Scholar
  • 11 Mikkelsen KH, Knop FK, Frost M, Hallas J, Pottegård A. Use of antibiotics and risk of type 2 diabetes: a population-based case-control study. J Clin Endocrinol Metab 2015; 100 (10) 3633-3640
    CrossrefPubMedSuche in Google Scholar
  • 12 Jakobsson HE, Jernberg C, Andersson AF, Sjölund-Karlsson M, Jansson JK, Engstrand L. Short-term antibiotic treatment has differing long-term impacts on the human throat and gut microbiome. PLoS One 2010; 5 (03) e9836
    CrossrefPubMedSuche in Google Scholar
  • 13 Dethlefsen L, Relman DA. Incomplete recovery and individualized responses of the human distal gut microbiota to repeated antibiotic perturbation. Proc Natl Acad Sci USA 2011; 108 (Suppl. 01) 4554-4561
    CrossrefPubMedSuche in Google Scholar
  • 14 Ridaura VK, Faith JJ, Rey FE. , et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science 2013; 341 (6150): 1241214
    CrossrefPubMedSuche in Google Scholar
  • 15 Vrieze A, Van Nood E, Holleman F. , et al. Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome. Gastroenterology 2012; 143 (04) 913-916
    CrossrefPubMedSuche in Google Scholar
  • 16 Bäckhed F, Ding H, Wang T. , et al. The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci U S A 2004; 101 (44) 15718-15723
    CrossrefPubMedSuche in Google Scholar
  • 17 Qin J, Li Y, Cai Z. , et al. A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature 2012; 490 (7418): 55-60
    Suche in Google Scholar
  • 18 Karlsson FH, Tremaroli V, Nookaew I. , et al. Gut metagenome in European women with normal, impaired and diabetic glucose control. Nature 2013; 498 (7452): 99-103
    CrossrefPubMedSuche in Google Scholar
  • 19 Jepsen P, Skriver MV, Floyd A, Lipworth L, Schønheyder HC, Sørensen HT. A population-based study of maternal use of amoxicillin and pregnancy outcome in Denmark. Br J Clin Pharmacol 2003; 55 (02) 216-221
    CrossrefPubMedSuche in Google Scholar
  • 20 Czeizel AE, Rockenbauer M, Olsen J. Use of antibiotics during pregnancy. Eur J Obstet Gynecol Reprod Biol 1998; 81 (01) 1-8
    CrossrefPubMedSuche in Google Scholar
  • 21 Vidal AC, Murphy SK, Murtha AP. , et al. Associations between antibiotic exposure during pregnancy, birth weight and aberrant methylation at imprinted genes among offspring. Int J Obes 2013; 37 (07) 907-913
    CrossrefPubMedSuche in Google Scholar
  • 22 Mueller NT, Rifas-Shiman SL, Blaser MJ, Gillman MW, Hivert MF. Association of prenatal antibiotics with foetal size and cord blood leptin and adiponectin. Pediatr Obes 2017; 12 (02) 129-136
    CrossrefPubMedSuche in Google Scholar
  • 23 Catalano PM, Hauguel-De Mouzon S. Is it time to revisit the Pedersen hypothesis in the face of the obesity epidemic?. Am J Obstet Gynecol 2011; 204 (06) 479-487
    CrossrefPubMedSuche in Google Scholar
  • 24 Ibáñez L, Lopez-Bermejo A, Suárez L, Marcos MV, Díaz M, de Zegher F. Visceral adiposity without overweight in children born small for gestational age. J Clin Endocrinol Metab 2008; 93 (06) 2079-2083
    CrossrefPubMedSuche in Google Scholar
  • 25 Verkauskiene R, Jaquet D, Deghmoun S, Chevenne D, Czernichow P, Lévy-Marchal C. Smallness for gestational age is associated with persistent change in insulin-like growth factor I (IGF-I) and the ratio of IGF-I/IGF-binding protein-3 in adulthood. J Clin Endocrinol Metab 2005; 90 (10) 5672-5676
    CrossrefPubMedSuche in Google Scholar
  • 26 Rasmussen KM, Catalano PM, Yaktine AL. New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know. Curr Opin Obstet Gynecol 2009; 21 (06) 521-526
    CrossrefPubMedSuche in Google Scholar
  • 27 Scifres CM, Feghali MN, Althouse AD, Caritis SN, Catov JM. Effect of excess gestational weight gain on pregnancy outcomes in women with type 1 diabetes. Obstet Gynecol 2014; 123 (06) 1295-1302
    CrossrefPubMedSuche in Google Scholar
  • 28 Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol 1996; 87 (02) 163-168
    CrossrefPubMedSuche in Google Scholar
  • 29 Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982; 144 (07) 768-773
    CrossrefPubMedSuche in Google Scholar
  • 30 Hutcheon JA, Bodnar LM. Good practices for observational studies of maternal weight and weight gain in pregnancy. Paediatr Perinat Epidemiol 2018; 32 (02) 152-160
    CrossrefPubMedSuche in Google Scholar
  • 31 Curhan GC, Chertow GM, Willett WC. , et al. Birth weight and adult hypertension and obesity in women. Circulation 1996; 94 (06) 1310-1315
    CrossrefPubMedSuche in Google Scholar
  • 32 Curhan GC, Willett WC, Rimm EB, Spiegelman D, Ascherio AL, Stampfer MJ. Birth weight and adult hypertension, diabetes mellitus, and obesity in US men. Circulation 1996; 94 (12) 3246-3250
    CrossrefPubMedSuche in Google Scholar
  • 33 Mueller NT, Bakacs E, Combellick J, Grigoryan Z, Dominguez-Bello MG. The infant microbiome development: mom matters. Trends Mol Med 2015; 21 (02) 109-117
    CrossrefPubMedSuche in Google Scholar
  • 34 Aagaard K, Ma J, Antony KM, Ganu R, Petrosino J, Versalovic J. The placenta harbors a unique microbiome. Sci Transl Med 2014; 6 (237) 237ra65
    CrossrefPubMedSuche in Google Scholar
  • 35 Jiménez E, Fernández L, Marín ML. , et al. Isolation of commensal bacteria from umbilical cord blood of healthy neonates born by cesarean section. Curr Microbiol 2005; 51 (04) 270-274
    CrossrefPubMedSuche in Google Scholar
  • 36 Temmerman M, Njagi E, Nagelkerke N, Ndinya-Achola J, Plummer FA, Meheus A. Mass antimicrobial treatment in pregnancy. A randomized, placebo-controlled trial in a population with high rates of sexually transmitted diseases. J Reprod Med 1995; 40 (03) 176-180
    PubMedSuche in Google Scholar
  • 37 Gichangi PB, Ndinya-Achola JO, Ombete J, Nagelkerke NJ, Temmerman M. Antimicrobial prophylaxis in pregnancy: a randomized, placebo-controlled trial with cefetamet-pivoxil in pregnant women with a poor obstetric history. Am J Obstet Gynecol 1997; 177 (03) 680-684
    CrossrefPubMedSuche in Google Scholar
  • 38 McCormack WM, Rosner B, Lee YH, Munoz A, Charles D, Kass EH. Effect on birth weight of erythromycin treatment of pregnant women. Obstet Gynecol 1987; 69 (02) 202-207
    PubMedSuche in Google Scholar
  • 39 Elder HA, Santamarina BA, Smith S, Kass EH. The natural history of asymptomatic bacteriuria during pregnancy: the effect of tetracycline on the clinical course and the outcome of pregnancy. Am J Obstet Gynecol 1971; 111 (03) 441-462
    CrossrefPubMedSuche in Google Scholar
  • 40 McGregor JA, French JI, Reller LB, Todd JK, Makowski EL. Adjunctive erythromycin treatment for idiopathic preterm labor: results of a randomized, double-blinded, placebo-controlled trial. Am J Obstet Gynecol 1986; 154 (01) 98-103
    CrossrefPubMedSuche in Google Scholar
  • 41 Bendix J, Hegaard HK, Langhoff-Roos J, Bergholt T. Changing prevalence and the risk factors for antenatal obstetric hospitalizations in Denmark 2003-2012. Clin Epidemiol 2016; 8: 165-175
    PubMedSuche in Google Scholar
  • 42 Stokholm J, Schjørring S, Eskildsen CE. , et al. Antibiotic use during pregnancy alters the commensal vaginal microbiota. Clin Microbiol Infect 2014; 20 (07) 629-635
    CrossrefPubMedSuche in Google Scholar
  • 43 Mueller NT, Whyatt R, Hoepner L. , et al. Prenatal exposure to antibiotics, cesarean section and risk of childhood obesity. Int J Obes 2015; 39 (04) 665-670
    CrossrefPubMedSuche in Google Scholar