Prevalence and Predictors of Antibiotic Administration during Pregnancy and Birth

Background: Antibiotic treatment during pregnancy and birth is very common. In this study, we describe theestimated prevalence of antibiotic administration during pregnancy and birth in the COPSAC2010 pregnancy cohort,and analyze dependence on social and lifestyle-related factors.
Methods: 706 pregnant women from the novel unselected Copenhagen Prospective Study on Asthma in Childhood(COPSAC2010) pregnancy cohort participated in this analysis. Detailed information on oral antibiotic prescriptionsduring pregnancy filled at the pharmacy was obtained and verified longitudinally. Information on intrapartumantibiotics, social, and lifestyle-factors was obtained by personal interviews.
Results: The prevalence of antibiotic use was 37% during pregnancy and 33% intrapartum. Lower maternal age atbirth; adjusted odds ratio (aOR) 0.94, 95% CI, [0.90-0.98], p = 0.003 and maternal smoking; aOR 1.97, 95% CI,[1.07-3.63], p = 0.030 were associated with use of antibiotics for urinary tract infection during pregnancy. Maternaleducational level (low vs. high), aOR 2.32, 95% CI, [1.24-4.35], p = 0.011, maternal asthma; aOR 1.99, 95% CI,[1.33-2.98], p < 0.001 and previous childbirth; aOR 1.80, 95% CI, [1.21-2.66], p = 0.004 were associated with use ofantibiotics for respiratory tract infection during pregnancy. Lower gestational age; aOR 0.72, 95% CI, [0.61-0.85], p <0.001, maternal smoking; aOR 2.84, 95% CI, [1.33-6.06], p = 0.007, and nulliparity; aOR 1.79, 95% CI, [1.06-3.02], p= 0.030 were associated with administration of intrapartum antibiotics in women giving birth vaginally.
Conclusion: Antibiotic administration during pregnancy and birth may be influenced by social and lifestyle-factors.Understanding such risk factors may guide preventive strategies in order to avoid unnecessary use of antibiotics