Figure 2:
Comparison of adjusted excess BMI at 5 years of age associated with exposure to antibiotics during antepartum, intrapartum and postpartum periods
*Δ BMI attributable to neonatal antibiotics is no longer significant when excluding children with low or high birth weight and/or complex care conditions (Vaginal delivery: −0.05 kg/m2, 95% CI −0.11 kg/m2 to 0.01 kg/m2, P =0.090; Cesarean delivery: 0.02 kg/m2, 95% CI −0.04 kg/m2 to 0.09 kg/m2, P =0.499; see eFigure 3).
#Indirect antibiotic exposure through breastfeeding by a mother using antibiotics during the first 3 months after birth. The estimate for childhood exposure is per 14-day episode of antibiotic use.
Covariates adjusted for included demographics, maternal and birth-related factors included infant sex, gestational age at birth, birth weight, infant’s race/ethnicity (White, Black, Hispanic, Asian or Pacific Islander, other or unknown), year of birth, medical center of birth, maternal education, parity, maternal diabetes, maternal pre-pregnancy BMI, maternal gestational weight gain, maternal smoking during pregnancy, antepartum antibiotic exposure, neonatal antibiotic exposure, any breastfeeding, indirect antibiotic exposure during breastfeeding, and childhood antibiotic exposure.
The reference point reflects a population mean BMI at age 5 of 15.97 (SD 0.018) kg/m2 for vaginally delivered children unexposed to intrapartum antibiotics (None) and 16.09 (SD 0.028) kg/m2 for children delivered by Cesarean section and exposed to other intrapartum antibiotics (Other).