Related Experiment Video

Updated: May 23, 2026

A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
08:50

A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development

Published on: June 24, 2020

Penicillin allergy testing in pregnancy improves maternal and neonatal clinical outcomes

Jamie L Waldron1,2, Nerlyne Desravines3, Carolina Alvarez4,5

  • 1Department of Medicine, Division of Allergy and Immunology, Massachusetts General Hospital, Boston, Mass.

The Journal of Allergy and Clinical Immunology. Global
|May 22, 2026
PubMed

Insights

Penicillin allergy evaluation during pregnancy improves maternal and infant outcomes. This proactive approach reduces cesarean delivery rates and neonatal complications, ensuring better health for both mother and baby.

Area of Science:

  • Obstetrics and Gynecology
  • Allergy and Immunology
  • Neonatology

Background:

  • Penicillin allergy is frequently reported during pregnancy, a period of high antibiotic use.
  • Unverified penicillin allergy can lead to alternative antibiotic prescriptions, increasing risks for mothers and newborns.
  • These risks include higher rates of cesarean delivery, prolonged hospital stays, and increased infectious complications.

Purpose of the Study:

  • To assess the impact of penicillin allergy evaluation on antibiotic use up to 30 days postpartum.
  • To compare maternal and neonatal clinical outcomes between patients undergoing evaluation and a usual care group.

Main Methods:

  • A prospective cohort study involving pregnant patients undergoing penicillin allergy evaluation.
  • Evaluation included skin testing and supervised drug challenge with amoxicillin during the second or third trimester.
  • Outcomes were compared to a control group receiving usual care using linear regression models.

Main Results:

  • Patients undergoing penicillin allergy evaluation showed significantly increased perinatal beta-lactam receipt (96% vs 38%).
  • These patients had reduced odds of cesarean delivery (OR=0.31) and shorter infant hospital stays (OR=0.31).
  • Infants born to evaluated mothers had lower odds of high neonatal sepsis scores (OR=0.41).

Conclusions:

  • Proactive penicillin allergy evaluation during pregnancy is safe and beneficial.
  • This evaluation positively impacts maternal and neonatal clinical outcomes.
  • It leads to improved antibiotic utilization and reduced adverse events.
Abstract

Keywords:
Penicillinantibioticcesarean sectiondrug challengegroup B Streptococcushypersensitivityneonatal sepsis scorepregnancyskin testβ-lactam

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