Prenatal and intrapartum antibiotic exposure and childhood infections: considerations and complexities

Coggins et al.1 reported a lack of association between intravenous perinatal and early postnatal antibiotics and subsequent childhood infections. They contrast their findings with those from other studies of pregnancy and intrapartum antibiotic use, which show dose–response associations with later infection, and in which increased risk is thought to result from immunological consequences of antibiotic-associated dysbiosis.2–4 They conclude that their findings differ from these previous studies. However, their adjusted estimate of 1.16 (95% CI 0.95–1.51) is a similar magnitude to previous studies (quoted estimates ranging between 1.10 and 1.34); the difference is that their confidence interval includes the null.