{
  "abstract": "Background Women who undergo caesarean section (CS) are given intrapartum antibiotic prophylaxis to prevent post caesarean surgical site infection. Historically, these antibiotics were administered to the mother after the umbilical cord was clamped. However, since 2011, UK national guidelines recommend giving antibiotics to the mother before the incision for the CS, as evidence shows this reduces the risk of wound infections. Exposure to antibiotics early in life could affect the risk of asthma and allergic disease via an impact on the gut microbiome.This study aims to investigate whether the risk of asthma, eczema, and allergic rhinitis at 5 years in children born by CS differs by timing of antibiotic administration to the mother during delivery (pre-incision vs post-cord clamping).Methods Children born by CS between 2007 and 2011 in the Born in Bradford (BiB) birth cohort and those born between 2016 and 2019 in the BiB Better Start (BiBBS) birth cohort were included. Timing of antibiotic administration was determined by review of maternity notes for BiB participants. All BiBBS mothers delivering by CS received antibiotics pre-incision, confirmed through a review of maternity records in a random sample. Children with asthma, atopic eczema and allergic rhinitis were identified through linked primary care diagnosis and prescription data.Data on potential confounders (sex, maternal history of asthma/allergic disease, maternal educational attainment, smoking during pregnancy, ethnicity, breastfeeding, other antibiotics prescriptions to mothers and children) were available from study questionnaires, and linked primary and secondary care data. Adjusted generalised linear models were used to estimate the association between pre-incision antibiotic exposure and each outcome.Results Of a total of 3,013 children, 579 (19.2%) were exposed to pre-incision antibiotics. At 5 years, 272 (9.0%) children had asthma, 672 (22.3%) had eczema and 180 (6.0%) had hay fever.There was no evidence of an increased risk of asthma (adjusted risk ratio (aRR) 1.21, 95% CI 0.61, 2.44), eczema (aRR 1.00, 95% CI 0.61, 1.65) or allergic rhinitis (aRR 1.14, 95% CI 0.50, 2.62) at 5 years in children whose mothers received pre-incision antibiotics compared to those whose mothers received antibiotics after cord clamping.Conclusion Our findings do not indicate an increased risk of asthma, eczema or allergic rhinitis by age 5 in children exposed to pre-incision antibiotics during CS delivery. This contributes to the evidence base regarding the optimum time to administer prophylactic antibiotics to women for CS, balancing the risks and benefits to the mother and her child.",
  "authors": [
    {
      "affiliations": [
        "Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Lucy Pembrey"
    },
    {
      "affiliations": [
        "Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"
      ],
      "name": "Gillian Santorelli"
    },
    {
      "affiliations": [
        "Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"
      ],
      "name": "Sergio Souza da Cunha"
    },
    {
      "affiliations": [
        "Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"
      ],
      "name": "Sam Oddie"
    },
    {
      "affiliations": [
        "School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK",
        "National Institute for Health Research Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK"
      ],
      "name": "Emily Petherick"
    },
    {
      "affiliations": [
        "Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Neil Pearce"
    },
    {
      "affiliations": [
        "Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"
      ],
      "name": "John Wright"
    }
  ],
  "title": "OP50 Timing of intrapartum antibiotic prophylaxis administration for caesarean section and risk of asthma, eczema and allergic rhinitis in the born in bradford birth cohort",
  "uid": "7856d756-b74f-58fb-bb66-7b3c88d38d83"
}