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Timing of Intrapartum Antibiotics at Caesarean Section and Risk of Asthma, Eczema and Allergic Rhinitis: Results From

Lucy Pembrey1, Gillian Santorelli2, Sergio Souza da Cunha2

  • 1Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|November 14, 2025
PubMed

Insights

Maternal antibiotic timing for caesarean section (CS) does not affect childhood allergies. Pre-incision antibiotics showed no increased risk of asthma, eczema, or allergic rhinitis by age five.

Area of Science:

  • Obstetrics and Gynecology
  • Pediatric Allergy and Immunology
  • Epidemiology

Background:

  • Antibiotic prophylaxis is standard during caesarean section (CS).
  • The optimal timing of antibiotic administration (pre-incision vs. post-cord clamping) is debated.
  • Potential impacts on infant health, particularly allergic conditions, warrant investigation.

Purpose of the Study:

  • To determine if antibiotic timing during CS influences the risk of asthma, eczema, and allergic rhinitis in children at age five.
  • To compare allergy risks between infants exposed to maternal antibiotics before incision versus after cord clamping.

Main Methods:

  • A natural experiment utilizing UK birth cohort data from the Born in Bradford (BiB) and BiBBS cohorts.
  • Included 3013 children born via CS between 2007-2019.
  • Assessed the risk of asthma, atopic eczema, and allergic rhinitis at age five based on maternal antibiotic exposure timing.

Main Results:

  • No significant difference in the risk of asthma, eczema, or allergic rhinitis at age five was observed.
  • Children exposed to pre-incision antibiotics (n=579) did not show an increased risk compared to those receiving antibiotics post-cord clamping.
  • Adjusted risk ratios and differences indicated no statistically significant associations for any of the allergic outcomes.

Conclusions:

  • This study found no evidence linking pre-incision antibiotics during CS to an increased risk of childhood allergic diseases by age five.
  • Findings support current practices by suggesting that the timing of antibiotic prophylaxis does not adversely affect infant allergy development.
  • These results aid in balancing maternal and infant risks when determining optimal antibiotic administration protocols for CS.
Abstract

Keywords:
allergic rhinitisasthmacaesarean sectioneczemaprophylactic antibiotics

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