title: The ORACLE Children Study: educational outcomes at 11 years of age following antenatal prescription of erythromycin or co-amoxiclav.
abstract: BACKGROUND
  Antibiotics used for women in spontaneous preterm labour without overt infection, in contrast to those with preterm rupture of membranes, are associated with altered functional outcomes in their children.
  
  
  METHODS
  From the National Pupil Database, we used Key Stage 2 scores, national test scores in school year 6 at 11 years of age, to explore the hypothesis that erythromycin and co-amoxiclav were associated with poorer educational outcomes within the ORACLE Children Study.
  
  
  RESULTS
  Anonymised scores for 97% of surviving children born to mothers recruited to ORACLE and resident in England were analysed against treatment group adjusting for key available socio-demographic potential confounders. No association with crude or with adjusted scores for English, mathematics or science was observed by maternal antibiotic group in either women with preterm rupture of membranes or spontaneous preterm labour with intact membranes. While the proportion receiving special educational needs was similar in each group (range 31.6-34.4%), it was higher than the national rate of 19%.
  
  
  CONCLUSIONS
  Despite evidence that antibiotics are associated with increased functional impairment at 7 years, educational test scores and special needs at 11 years of age show no differences between trial groups.
  
  
  BACKGROUND
  ISCRT Number 52995660 (original ORACLE trial number).
authors: Institute for Women's Health, University College London, London, UK.
authors: Neil
authors: N
authors: Marlow
authors: Health Sciences Department, University of Leicester, Leicester, UK.
authors: Hannah
authors: H
authors: Bower
authors: Health Sciences Department, University of Leicester, Leicester, UK.
authors: David
authors: D
authors: Jones
authors: Institute for Women's Health, University College London, London, UK.
authors: Peter
authors: P
authors: Brocklehurst
authors: Institute of Applied Health Research, University of Birmingham, Edgbaston, UK.
authors: Sara
authors: S
authors: Kenyon
authors: Clinical Trials and Evaluation Unit, School of Clinical Sciences, University of Bristol, Bristol, UK.
authors: Katie
authors: K
authors: Pike
authors: Maternal and Newborn Health Initiative, International Federation of Gynaecology and Obstetrics, London, UK.
authors: David
authors: D
authors: Taylor
authors: Great Ormond Street Hospital for Children and Institute of Child Health, University College London, London, UK.
authors: Alison
authors: A
authors: Salt
mesh_terms: D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002657:Child Development / Q000187:drug effects*; D016208:Databases, Factual; D004521:Educational Measurement; D004739:England; D004917:Erythromycin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects
chemical_list: D000900:Anti-Bacterial Agents; D004917:Erythromycin; D019980:Amoxicillin-Potassium Clavulanate Combination
keywords: Fetal Medicine; Neurodevelopment; Outcomes research; School Health