Autism Risk and Perinatal Antibiotic Use.

This large Canadian study followed nearly 570,000 births to see if antibiotics given during labor increased autism risk in children. While there appeared to be a connection at first, when researchers accounted for other factors that could influence the results, they found no increased autism risk from antibiotics during delivery. The study suggests parents shouldn't worry about autism risk when doctors recommend antibiotics during childbirth.

This large retrospective cohort study examined 569,953 deliveries in British Columbia, Canada (2000-2014) to investigate whether antibiotic exposure during labor and delivery increases autism spectrum disorder (ASD) risk in offspring. Initial unadjusted analysis showed a 29% increased risk, but after controlling for confounding factors, no significant association remained (adjusted HR 0.99, 95% CI 0.94-1.04). A focused analysis of mothers with group B Streptococcus infection similarly found no increased risk after adjustment (HR 0.88, 95% CI 0.74-1.05). Sensitivity analysis using labor duration as a proxy for antibiotic dose found no dose-response relationship.

The findings suggest clinical decisions about peripartum antibiotic use should not be influenced by ASD concerns.

These findings provide reassurance that ASD risk should not influence clinical decisions regarding antibiotic administration during labor and delivery. Healthcare providers can continue following evidence-based guidelines for peripartum antibiotic use without concerns about increasing autism risk in offspring.

The study was retrospective and observational in design. The authors noted that longer durations of prenatal antibiotic exposure still require investigation. Labor duration was used as a proxy measure for antibiotic dose rather than actual dosage data.

Antibiotics are commonly administered during labor and delivery, and research has suggested that fetal exposure to antibiotics can increase risk for autism spectrum disorder (ASD). We assessed whether antibiotic exposure during labor and delivery increased the risk of ASD in the offspring. This retrospective cohort study included everyone who delivered a live singleton-term infant in British Columbia, Canada, between April 1, 2000, and December 31, 2014. This cohort included 569 953 deliveries.

To examine the association among pregnant individuals being treated for the same indication, we studied a subcohort of those who tested positive for group B Streptococcus. Cox proportional hazards models were used to estimate unadjusted and adjusted hazard ratios in both cohorts. A sensitivity analysis was conducted using length of first stage of labor as a proxy measure for dose to assess for a dose-response relationship. In this population-based study, antibiotic use during labor and delivery was not associated with an increased risk of ASD in offspring.

The unadjusted and adjusted hazard ratios were 1.29 (95% confidence interval, 1.24-1.35) and 0.99 (0.94-1.04), respectively; and 1.07 (0.90-1.27) and 0.88 (0.74-1.05), respectively, in the group B Streptococcus-positive cohort. We observed no substantial difference in the association between antibiotic exposure and ASD depending on length of the first stage of labor. Our findings suggest that concern for ASD should not factor into the clinical decision on whether to administer antibiotics during labor and delivery. Future research is needed to examine longer durations of prenatal antibiotic exposure.