Table 1:
Demographic, maternal, birth-related, and childhood characteristics by delivery mode and intrapartum antibiotic exposure*
| Total Cohort | Vaginal delivery | Cesarean delivery | ||||||
|---|---|---|---|---|---|---|---|---|
|
|
||||||||
| Antibiotic exposure: | None | GBS | Other | P value | GBS | Other | P value | |
| N | 223431 | 113693 | 31263 | 11425 | 8366 | 58684 | ||
|
| ||||||||
| Children within delivery mode (%) | 72.7 | 20.0 | 7.3 | 12.5 | 87.5 | |||
| Total follow-up, y | <0.001 | <0.001 | ||||||
| Mean | 4.9 (2.71) | 5.1 (2.80) | 4.5 (2.43) | 4.7 (2.47) | 4.6 (2.44) | 5.0 (2.74) | ||
| Median (IQR) | 4.4 (2.7, 7.0) | 4.6 (2.7, 7.2) | 4.0 (2.6, 6.4) | 4.2 (2.7, 6.5) | 4.1 (2.6, 6.4) | 4.5 (2.7, 7.1) | ||
| Demographics | ||||||||
| Sex, | <0.001 | <0.001 | ||||||
| Male | 108967 (48.8) | 56801 (50.0) | 15198 (48.6) | 5551 (48.6) | 3682 (44.0) | 27735 (47.3) | ||
| Female | 114464 (51.2) | 56892 (50.0) | 16065 (51.4) | 5874 (51.4) | 4684 (56.0) | 30949 (52.7) | ||
| Race/Ethnicity | <0.001 | <0.001 | ||||||
| White | 63085 (28.2) | 32554 (28.6) | 8494 (27.2) | 2946 (25.8) | 2112 (25.2) | 16979 (28.9) | ||
| Hispanic | 105699 (47.3) | 55662 (49.0) | 14200 (45.4) | 5475 (47.9) | 3701 (44.2) | 26661 (45.4) | ||
| Black | 18934 (8.5) | 8157 (7.2) | 3277 (10.5) | 989 (8.7) | 1080 (12.9) | 5431 (9.3) | ||
| Asian/Pacific Islander | 27937 (12.5) | 13394 (11.8) | 4123 (13.2) | 1632 (14.3) | 1187 (14.2) | 7601 (13) | ||
| Other, unknown | 7776 (3.5) | 3926 (3.5) | 1169 (3.7) | 383 (3.4) | 286 (3.4) | 2012 (3.4) | ||
| State-subsidized health plan | 20071 (9.0) | 10273 (9.0) | 3275 (10.5) | 1082 (9.5) | <0.001 | 688 (8.2) | 4753 (8.1) | 0.697 |
| Maternal and pregnancy-related factors | ||||||||
| Maternal education | <0.001 | 0.002 | ||||||
| Less than HS | 10969 (4.9) | 6275 (5.5) | 1263 (4.0) | 547 (4.8) | 295 (3.5) | 2589 (4.4) | ||
| High School | 55668 (25.0) | 29347 (25.9) | 7857 (25.2) | 2874 (25.2) | 1921 (23.0) | 13669 (23.3) | ||
| Some college | 67772 (30.4) | 33994 (30.0) | 9783 (31.3) | 3426 (30.0) | 2608 (31.2) | 17961 (30.6) | ||
| Bachelor degree or higher | 86037 (38.5) | 42565 (37.5) | 11950 (38.2) | 4418 (38.7) | 3423 (41.0) | 23681 (40.4) | ||
| Unknown | 2985 (1.2) | 1512 (1.1) | 410 (1.3) | 160 (1.3) | 119 (1.3) | 784 (1.3) | ||
| Parity | <0.001 | <0.001 | ||||||
| 1 | 168219 (75.3) | 83883 (73.8) | 24256 (77.6) | 8440 (73.9) | 7468 (89.3) | 44172 (75.3) | ||
| 2 | 36208 (16.2) | 19336 (17.0) | 4353 (13.9) | 1938 (17.0) | 578 (6.9) | 10003 (17.0) | ||
| 3+ | 19004 (8.5) | 10474 (9.2) | 2654 (8.5) | 1047 (9.2) | 320 (3.8) | 4509 (7.7) | ||
| Diabetes | 13542 (6.1) | 4962 (4.4) | 2104 (6.7) | 671 (5.9) | <0.001 | 791 (9.5) | 5014 (8.5) | 0.010 |
| Pre-pregnancy BMI (kg/m2) | ||||||||
| Mean (SD) | 26.9 (6.15) | 26.2 (5.64) | 26.9 (6.23) | 26.3 (5.79) | <0.001 | 28.6 (7.12) | 28.2 (6.70) | <0.001 |
| Pregnancy weight gain (lbs) | ||||||||
| Mean (SD) | 27.5 (13.53) | 27.6 (12.86) | 26.8 (14.11) | 27.2 (13.25) | <0.001 | 28.0 (15.41) | 27.6 (14.22) | <0.001 |
| Chorioamnionitis | 10869 (4.9) | 1203 (1.1) | 2213 (7.1) | 2604 (22.8) | <0.001 | 1806 (21.6) | 3043 (5.2) | <0.001 |
| Smoking during pregnancy | 24231 (10.8) | 11610 (10.2) | 3644 (11.7) | 1177 (10.3) | <0.001 | 1075 (12.8) | 6725 (11.5) | <0.001 |
| GBS culture status | <0.001 | <0.001 | ||||||
| Negative | 163026 (73.0) | 106423 (93.6) | 4662 (14.9) | 5384 (47.1) | 2173 (26) | 44384 (75.6) | ||
| Positive | 38258 (17.1) | 3204 (2.8) | 19535 (62.5) | 4305 (37.7) | 4469 (53.4) | 6745 (11.5) | ||
| Unknown | 22147 (9.9) | 4066 (3.6) | 7066 (22.6) | 1736 (15.2) | 1724 (20.6) | 7555 (12.9) | ||
| Antibiotic exposure | ||||||||
| Antepartum, trimester 1/2 | 65276 (29.2) | 30040 (26.4) | 11055 (35.4) | 3567 (31.2) | <0.001 | 2976 (35.6) | 17638 (30.1) | <0.001 |
| Antepartum, trimester 3 | 26710 (11.9) | 12053 (10.6) | 4589 (14.7) | 1502 (13.1) | <0.001 | 1319 (15.8) | 7247 (12.3) | <0.001 |
| Birth | ||||||||
| Birth weight (g) | ||||||||
| Mean (SD) | 3346 (546) | 3374 (458) | 3252 (577) | 3281 (543) | <0.001 | 3261 (760) | 3364 (634) | <0.001 |
| Gestational age (weeks) | ||||||||
| Mean (SD) | 38.7 (1.81) | 39.0 (1.33) | 38.4 (2.21) | 38.6 (2.02) | <0.001 | 38.2 (2.95) | 38.5 (2.04) | <0.001 |
| Preterm birth (<37th week) | 17191 (7.7) | 3638 (3.2) | 4880 (15.6) | 1173 (10.3) | <0.001 | 1546 (18.5) | 5954 (10.1) | <0.001 |
| Childhood | ||||||||
| Any Breastfeeding | ||||||||
| at 3 months of age | 147716 (66.1) | 75710 (70.3) | 21236 (70.1) | 7817 (70.6) | 0.717 | 5481 (68.0) | 37472 (67.8) | 0.634 |
| at 6 months of age | 125523 (56.2) | 64469 (59.8) | 18182 (60.1) | 6720 (60.6) | 0.232 | 4644 (57.6) | 31508 (57) | 0.262 |
| Antibiotic exposure | ||||||||
| Neonatal | ||||||||
| first 4 days (72 h) | 12953 (5.8) | 2528 (2.2) | 2851 (9.1) | 1360 (11.9) | <0.001 | 1534 (18.3) | 4680 (8.0) | <0.001 |
| 4–28 days | 7438 (3.3) | 2415 (2.1) | 1358 (4.3) | 548 (4.8) | <0.001 | 691 (8.3) | 2426 (4.1) | <0.001 |
| Indirect during lactation | ||||||||
| 0–3 mo | 30232 (13.5) | 13392 (11.8) | 4389 (14.0) | 1716 (15) | <0.001 | 1742 (20.8) | 8993 (15.3) | <0.001 |
| 3–6 mo | 13473 (6.0) | 6417 (5.6) | 2072 (6.6) | 706 (6.2) | 0.736 | 528 (6.3) | 3750 (6.4) | 0.782 |
| Cumulative childhood episodes | ||||||||
| Mean (SD) | 2.7 (3.11) | 2.7 (3.04) | 2.6 (2.99) | 2.6 (2.95) | 0.153 | 2.9 (3.26) | 2.9 (3.32) | 0.159 |
| BMI class at age 5# | <0.001 | 0.014 | ||||||
| N | 104394 | 55005 | 12714 | 4945 | 3556 | 28174 | ||
| Underweight | 4011 (3.8) | 2171 (3.9) | 509 (4.0) | 215 (4.3) | 147 (4.1) | 969 (3.4) | ||
| Normal weight | 73214 (70.1) | 39439 (71.7) | 8863 (69.7) | 3477 (70.3) | 2326 (65.4) | 19109 (67.8) | ||
| Overweight | 14164 (13.6) | 7185 (13.1) | 1781 (14.0) | 678 (13.7) | 524 (14.7) | 3996 (14.2) | ||
| Obesity | 13005 (12.5) | 6210 (11.3) | 1561 (12.3) | 675 (11.6) | 559 (15.7) | 4100 (14.6) | ||
*
Antibiotic exposure: none, no intrapartum exposure to antibiotics; GBS, GBS intrapartum antibiotic prophylaxis as recommended for the prevention of perinatal group B streptococcal disease; other, any other type or duration of intrapartum antibiotic administration
#
Extrapolated based on the nearest 2 weight measures within 6 months of a child’s 5th birthday (N=104394).