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Research ArticleOriginal Research

Intrapartum Antibiotics and Childhood Atopic Dermatitis

Debra L. Wohl, William J. Curry, Dave Mauger, Jennifer Miller and Kaitlyn Tyrie
The Journal of the American Board of Family Medicine January 2015, 28 (1) 82-89; DOI: https://doi.org/10.3122/jabfm.2015.01.140017
Debra L. Wohl
From the Department of Biology, Elizabethtown College, Elizabethtown, PA (DLW); the Department of Family and Community Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA (WJC); the Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey (WJC, DM); the Department of Pediatrics, Penn State Milton S. Hershey Medical Center and Pennsylvania State University College of Medicine, Hershey (JM); and the Pennsylvania State University College of Medicine, Hershey (KT).
PhD, MS
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William J. Curry
From the Department of Biology, Elizabethtown College, Elizabethtown, PA (DLW); the Department of Family and Community Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA (WJC); the Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey (WJC, DM); the Department of Pediatrics, Penn State Milton S. Hershey Medical Center and Pennsylvania State University College of Medicine, Hershey (JM); and the Pennsylvania State University College of Medicine, Hershey (KT).
MD, MS
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Dave Mauger
From the Department of Biology, Elizabethtown College, Elizabethtown, PA (DLW); the Department of Family and Community Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA (WJC); the Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey (WJC, DM); the Department of Pediatrics, Penn State Milton S. Hershey Medical Center and Pennsylvania State University College of Medicine, Hershey (JM); and the Pennsylvania State University College of Medicine, Hershey (KT).
PhD
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Jennifer Miller
From the Department of Biology, Elizabethtown College, Elizabethtown, PA (DLW); the Department of Family and Community Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA (WJC); the Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey (WJC, DM); the Department of Pediatrics, Penn State Milton S. Hershey Medical Center and Pennsylvania State University College of Medicine, Hershey (JM); and the Pennsylvania State University College of Medicine, Hershey (KT).
MD
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Kaitlyn Tyrie
From the Department of Biology, Elizabethtown College, Elizabethtown, PA (DLW); the Department of Family and Community Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA (WJC); the Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey (WJC, DM); the Department of Pediatrics, Penn State Milton S. Hershey Medical Center and Pennsylvania State University College of Medicine, Hershey (JM); and the Pennsylvania State University College of Medicine, Hershey (KT).
BS
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Article Figures & Data

Tables

    • View popup
    Table 1. Relative Risk of Atopic Dermatitis Associated With Infant Characteristics
    Eczema, % (n/N)RR (95% CI)P Value
    Sex
        Male30.3 (80/264)1.19 (0.9–1.56).229
        Female25.0 (57/228)——
    Intrapartum antibiotics
        Yes28.9 (37/128)1.03 (0.75–1.41).854
        No27.5 (100/364)——
    Birth order
        First born36.9 (80/217)1.78 (1.33–2.38).0001
        Second born or later20.7 (57/275)——
    Maternal eczema (ever)*
        Yes32.3 (21/65)1.16 (0.77–1.74).495
        No32.2 (98/350)——
    Paternal eczema (ever)*
        Yes41.4 (12/29)1.55 (0.96–2.51).146
        No27.7 (106/382)——
    Sibling eczema (ever)*
        Yes31.4 (28/80)1.26 (0.85–1.86).344
        No27.3 (81/311)——
    Maternal asthma (ever)*
        Yes27.9 (19/68)0.99 (0.65–1.49).958
        No28.6 (99/346)——
    Paternal asthma (ever)*
        Yes34.1 (14/41)1.20 (0.75–1.93).477
        No28.1 (104/370)——
    Pets (cats/dogs)*
        Yes29.0 (80/276)1.10 (0.73–1.66).652
        No27.4 (26/95)——
    GBS status
        Negative63 (63/229)1.32 (0.83–2.09).200
        Positive21.0 (17/81)——
    Smoking*
        No29.5 (120/407)1.65 (0.66–4.13).207
        Yes17.4 (4/23)——
    Infant feeding during first 3 months*
        Primarily breastfed29.7 (85/286)1.10 (0.79–1.53).579
        Primarily formula fed26.9 (39/145)——
    Gestational age (weeks)
         ≤4027.2 (94/346)
         >4030.1 (43/143)1.07 (0.78–1.46).678
    Birth weight (grams)
         <250057.1 (4/7)4.23 (0.9–19.92).068
        2500–450027.7 (132/477)1.92 (0.96–3.83).064
         >450012.5 (1/8)——
    Maternal education (years)*
        Did not attend college22.5 (32/142)0.70 (0.48–1.01).039
        College degree or more32.0 (97/303)——
    • ↵* Self-reported.

    • CI, confidence interval; RR, relative risk.

    • View popup
    Table 2. Intrapartum Antibiotic Exposure by Time and Atopic Dermatitis* (n = 118)
    Exposure Time (hours)Eczema, % (n/N)RR† (95% CI)P Value
    0–432.1 (9/28)1.17 (0.66–2.06).59
    4–1220.8 (11/53)0.76 (0.44–1.31).319
    12–2426.9 (7/26)0.98 (0.51–1.89).952
    >2454.5 (6/11)1.99 (1.13–3.49).017
    • ↵* Atopic dermatitis was diagnosed in 10 children who were not included in the analyses because intrapartum antibiotic exposure time could not be determined.

    • ↵† Relative risks (RRs) were calculated when compared with no intrapartum exposure (n = 364) and atopic dermatitis (n = 100).

    • CI, confidence interval.

    • View popup
    Table 3. Relative Risk of Atopic Dermatitis Associated With Infant Exposure to Antibiotics
    Age at Exposure to AntibioticsEczema, % (n/N)RR (95% CI)P Value
    <24 Hours
        Yes38.7 (12/32)1.43 (0.92–2.24).186
        No27.1 (125/461)——
    <7 Days
        Yes35.9 (14/39)1.32 (0.88–1.99).245
        No27.2 (123/453)——
    <30 Days
        Yes30.5 (18/59)1.11 (0.74–1.67).627
        No27.5 (119/433)——
    <1 Year
        Yes30.2 (80/265)1.19 (0.89–1.59).235
        No25.1 (57/227)——
    By 2 years
        Yes23.6 (103/348)1.26 (0.9–1.77).163
        No23.6 (34/144)——
    • CI, confidence interval; RR, relative risk.

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The Journal of the American Board of Family     Medicine: 28 (1)
The Journal of the American Board of Family Medicine
Vol. 28, Issue 1
January-February 2015
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Intrapartum Antibiotics and Childhood Atopic Dermatitis
Debra L. Wohl, William J. Curry, Dave Mauger, Jennifer Miller, Kaitlyn Tyrie
The Journal of the American Board of Family Medicine Jan 2015, 28 (1) 82-89; DOI: 10.3122/jabfm.2015.01.140017

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Intrapartum Antibiotics and Childhood Atopic Dermatitis
Debra L. Wohl, William J. Curry, Dave Mauger, Jennifer Miller, Kaitlyn Tyrie
The Journal of the American Board of Family Medicine Jan 2015, 28 (1) 82-89; DOI: 10.3122/jabfm.2015.01.140017
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