Prevalence and predictors of antibiotic administration during pregnancy and birth

PLoS One. 2013 Dec 10;8(12):e82932. doi: 10.1371/journal.pone.0082932. eCollection 2013.

Abstract

Background: Antibiotic treatment during pregnancy and birth is very common. In this study, we describe the estimated 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 prescriptions during pregnancy filled at the pharmacy was obtained and verified longitudinally. Information on intrapartum antibiotics, 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 at birth; 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. Maternal educational 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 of antibiotics 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Cohort Studies
  • Denmark
  • Drug Therapy / statistics & numerical data*
  • Female
  • Humans
  • Life Style
  • Maternal Age
  • Odds Ratio
  • Parturition*
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / epidemiology
  • Prevalence
  • Risk Factors

Substances

  • Anti-Bacterial Agents

Grant support

COPSAC is funded by private and public research funds all listed on www.copsac.com. The Lundbeck Foundation; The Strategic Research Foundation; the Pharmacy Foundation of 1991; Augustinus Foundation; the Danish Medical Research Council and The Danish Pediatric Asthma Centre provided core support for COPSAC. No pharmaceutical companies were involved in the study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.