title: Intrapartum antibiotics and childhood atopic dermatitis.
abstract: BACKGROUND
  Atopic dermatitis (AD) in children significantly impacts families because of medical costs, "lost" hours, and secondary characteristics such as asthma and ancillary infections. We investigate whether children delivered vaginally to women receiving intrapartum antibiotics have a greater risk of AD when younger than the age of 2 years than their counterparts.
  
  
  METHODS
  We conducted a retrospective analysis of women who delivered child(ren) vaginally between 1996 and 2008. Women were identified as those who received intrapartum antibiotics and those who did not. Pediatric records were used to determine the incidence of AD.
  
  
  RESULTS
  We collected data for 492 mother-child pairs. Intrapartum antibiotics were administered during 128 births; 28.9% of those children were diagnosed with AD by age 2 years (relative risk [RR], 1.03; 95% confidence interval [CI], 0.75-1.41). Factors with the greatest risk of diagnosis of AD by 2 years of age were intrapartum antibiotic exposure for >24 hours (RR, 1.99; 95% CI, 1.13-3.49), first born (RR, 1.78; 95% CI, 1.33-2.38), and higher maternal education (RR, 1.43; 95% CI, 0.99-2.06). No statistical differences in the prevalence of AD related to parental eczema, maternal group B Streptococcus status, or gestational age existed.
  
  
  CONCLUSIONS
  Exposure to antibiotics for <24 hours during a vaginal delivery does not increase the risk of AD. Studies are needed to understand whether exposure for >24 hours during the intrapartum period increases the risk of AD.
authors.affiliation: 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). wohld@etown.edu.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Wohl
authors.affiliation: 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).
authors.forename: William J
authors.initials: WJ
authors.lastname: Curry
authors.affiliation: 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).
authors.forename: Dave
authors.initials: D
authors.lastname: Mauger
authors.affiliation: 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).
authors.forename: Jennifer
authors.initials: J
authors.lastname: Miller
authors.affiliation: 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).
authors.forename: Kaitlyn
authors.initials: K
authors.lastname: Tyrie
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000139:chemically induced*; D005260:Female; D006801:Humans; D064307:Microbiota / Q000187:drug effects; D058725:Peripartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Atopic; Birth; Dermatitis; Obstetrics; Pediatrics