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Updated: Aug 30, 2025

Generating a Reproducible Model of Mid-Gestational Maternal Immune Activation using PolyI:C to Study Susceptibility and Resilience in Offspring
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Autism Risk and Perinatal Antibiotic Use

Amanda S Nitschke1, Jalisa L Karim2,3, Bruce A Vallance2

  • 1School of Population and Public Health.

Pediatrics
|August 26, 2022
PubMed

Insights

Antibiotic exposure during labor and delivery did not increase the risk of autism spectrum disorder (ASD) in offspring. This large study found no association, suggesting clinical decisions should not be influenced by ASD concerns.

Area of Science:

  • Perinatal medicine
  • Neurodevelopmental disorders
  • Pharmacology

Background:

  • Antibiotic administration during labor is common.
  • Previous research suggested a potential link between fetal antibiotic exposure and increased autism spectrum disorder (ASD) risk.
  • The clinical implications of this potential association warrant investigation.

Purpose of the Study:

  • To assess the association between antibiotic exposure during labor and delivery and the risk of ASD in offspring.
  • To investigate potential dose-response relationships using the length of the first stage of labor.

Main Methods:

  • Retrospective cohort study of 569,953 deliveries in British Columbia, Canada (2000-2014).
  • Inclusion of a subcohort of individuals testing positive for group B Streptococcus to control for indication.
  • Utilized Cox proportional hazards models and a sensitivity analysis based on labor duration.

Main Results:

  • Antibiotic use during labor and delivery was not associated with an increased risk of ASD in offspring.
  • Adjusted hazard ratios for ASD were 0.99 (overall cohort) and 0.88 (group B Streptococcus-positive cohort).
  • No significant dose-response relationship was observed based on the length of the first stage of labor.

Conclusions:

  • Findings suggest that concerns about ASD risk should not influence the clinical decision to administer antibiotics during labor and delivery.
  • Further research is recommended to explore the effects of longer durations of prenatal antibiotic exposure.
Abstract

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