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Study on the relationship between intrapartum group B streptococcus prophylaxis and food allergy in children
Hong Zhang1, Kang Xu1, Zhihui Liu2
1Department of Pediatrics,Taixing People's Hospital, Taizhou, Jiangsu, China.
Insights
Intrapartum antibiotic prophylaxis for group B streptococcus (GBS) in mothers may increase food allergy risk in infants under 18 months. This association was not significant in children up to three years old.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Immunology
Background:
- Group B Streptococcus (GBS) prophylaxis during labor is common.
- The long-term effects of GBS prophylaxis on infant health are under investigation.
- Emerging evidence suggests potential links between early-life antibiotic exposure and immune-related conditions.
Purpose of the Study:
- To examine the association between intrapartum antibiotic prophylaxis for GBS (GBS-IAP) and the risk of food allergy in Chinese children.
- To determine if GBS-IAP influences the incidence and timing of food allergy development.
- To assess these associations at different age points (18 months and 3 years).
Main Methods:
- A retrospective cohort study involving 2,909 mother-child pairs from Taixing People's Hospital.
- GBS-IAP defined as intravenous antibiotics (penicillin G, ampicillin, or cefazolin) administered ≥4 hours before delivery.
- Kaplan-Meier survival analysis, log-rank tests, and Cox proportional hazards models were used to analyze food allergy incidence and risk.
Main Results:
- Higher cumulative incidence of food allergy in children under 18 months exposed to GBS-IAP (8.1%) compared to controls (4.5%, P=0.005).
- GBS-IAP was associated with faster food allergy development in children under 18 months (univariate HR: 1.887, P=0.005; multivariate HR: 1.906, P=0.011).
- No significant differences in food allergy incidence or risk were found in children under three years old.
Conclusions:
- Intrapartum antibiotic prophylaxis for GBS may elevate the risk of food allergy in infants younger than 18 months.
- The observed association between GBS-IAP and food allergy diminishes by age three.
- Further research is warranted to understand the mechanisms and long-term implications of GBS-IAP on child immune development.
Objective:
To investigate the associations between intrapartum antibiotic prophylaxis of group B streptococcus (GBS) in pregnant women and the risk of food allergy in Chinese children.
Design:
Retrospective cohort study of 2,909 mother-child pairs.
Setting:
Taixing People's Hospital in Eastern China.
Participants:
Term infants born 2018-2019, followed longitudinally from birth to 3 years.
Exposures:
The GBS-IAP was defined as therapy with intravenous penicillin G or ampicillin or cefazolin ≥4 h prior to delivery to the mother. Reference infants were defined as born without or with other intrapartum antibiotic exposure.
Methods:
To investigate the incidence information of food allergy in children aged 18 months and three years old. Kaplan-Meier survival analysis and log-rank tests were used to evaluate the cumulative incidence in the group with GBS-IAP and the group without GBS-IAP. Cox proportional hazards models were conducted to determine the univariate and multivariate association between maternal GBS-IAP and incident food allergy after various covariates were adjusted.
Results:
The cumulative incidence of food allergy in the group with GBS-IAP was higher than that in the group without GBS-IAP in children under 18 months old (8.1% vs. 4.5%, P = 0.005, log-rank test), but no significant differences were observed in children under three years old (9.2% vs. 7.0%, P = 0.146, log-rank test). The univariate cox proportional hazards model in children under 18 months old revealed that children in the GBS-IAP group had faster food allergy development when compared with children in the group without GBS-IAP (HR.: 1.887,95% CI: 1.207-2.950, P = 0.005), so was the multivariate model (HR.: 1.906,95% CI: 1.158-3.137, P = 0.011). However, both univariate (HR: 1.343, 95% CI: 0.891∼2.026, P = 0.159) and multivariate (HR: 1.253, 95%CI: 0.796∼1.972, P = 0.329) cox proportional hazards model in children under three years old showed no significant differences between children in the group with GBS-IAP and group without GBS-IAP.
Conclusion:
Intrapartum antibiotic prophylaxis of group B streptococcus may increase the cumulative incidence and risk of food allergy in children under 18 months old, but it had no significant effect on children under three years old.
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