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Demographic characteristics associated with a penicillin allergy label during pregnancy
Timothy M Buckey1, Patrick K Gleeson1, Cara M Curley2
1Section of Allergy and Immunology, Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Insights
Older age and atopic conditions increase penicillin allergy labels in pregnant women, while Black race is associated with a lower likelihood. This impacts penicillin allergy interventions during pregnancy.
Area of Science:
- Obstetrics and Gynecology
- Clinical Pharmacology
- Health Services Research
Background:
- Penicillin and beta-lactam antibiotics are frequently used in pregnant women for Group B Streptococcus and C-section prophylaxis.
- Penicillin allergy labels in pregnancy are linked to increased maternal morbidity.
- Evaluating penicillin allergy during pregnancy is safe and effective, but demographic factors are understudied.
Purpose of the Study:
- To investigate demographic factors associated with penicillin allergy labels in a diverse pregnant population.
- To identify characteristics that predict penicillin allergy labeling during pregnancy.
Main Methods:
- Retrospective observational study using electronic health records from 1/1/2020 to 6/30/2022.
- Inclusion of pregnant patients with outpatient Obstetrics and Gynecology visits and delivery encounters.
- Multivariable logistic regression analysis to determine factors associated with penicillin allergy labels.
Main Results:
- Out of 10,969 pregnant women, 8.6% had a penicillin allergy label.
- Penicillin allergy labels were positively associated with older maternal age (32-51 years) and atopic conditions (rhinitis, asthma, eczema).
- Black race was negatively associated with penicillin allergy labels compared to White race.
Conclusions:
- Older maternal age and atopic conditions are linked to a higher likelihood of penicillin allergy labels in pregnant women.
- Black race is associated with a lower likelihood of having a penicillin allergy label.
- These findings are crucial for understanding and addressing health outcomes and interventions related to penicillin allergy in pregnant populations.
Introduction:
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.
Methods:
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.
Results:
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, p = 0.02], 35-51 years (OR = 1.41 vs. 18-27 years, p = 0.002) and having rhinitis, asthma, or eczema (OR = 1.55 vs. none, p < 0.0005); and negatively associated with Black race (OR = 0.59 vs. White, p < 0.0005).
Discussion:
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.
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