Antibiotic Treatment and Length of Hospital Stay in Relation to Delivery Mode and Prematurity

PLoS One. 2016 Oct 7;11(10):e0164126. doi: 10.1371/journal.pone.0164126. eCollection 2016.

Abstract

Aim: To investigate how 1) maternal delivery mode and 2) prematurity in infants are associated to antibiotic treatment and length of hospital stay.

Methods: Women having given birth and infants 0-12 months discharged from hospital between July 2005 and November 2011 were identified from the Swedish National Patient Register. Medical records were reviewed for 203 women and 527 infants. The risk ratio (RR) between antibiotic treatment and 1) delivery mode in women; 2) prematurity in infants was calculated. Length of stay and days of antibiotic therapy were compared by Wilcoxon rank-sum test.

Results: Women: There was an association between emergency caesarean section (CS) and antibiotic treatment (RR 5.0 95% confidence interval (CI) 2.2-11.5), but not for elective CS. Length of stay was longer for CS (emergency and elective) compared to vaginal delivery (p<0.01). Infants: RR for antibiotic treatment in preterm compared to term infants was 1.4 (95% CI 1.0-1.9). Length of stay (p<0.01), but not days of therapy (p = 0.17), was higher in preterm compared to term infants.

Conclusion: We found that emergency CS increased the probability of maternal antibiotic treatment during hospitalisation, but no difference was found between term and preterm infants. The results are well aligned with current guidelines and may be considered in future studies on the effects of antibiotics.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / adverse effects*
  • Cesarean Section / statistics & numerical data
  • Cross-Sectional Studies
  • Delivery, Obstetric / statistics & numerical data
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Length of Stay / statistics & numerical data*
  • Parturition / drug effects*
  • Pregnancy

Substances

  • Anti-Bacterial Agents

Grants and funding

This work was supported by the grants from a) the Swedish Research Council (Vetenskapsrådet) Grant number 2011-3060 (http://www.vr.se/) to CA; b) the Swedish Initiative for Research on Microdata in the Social And Medical Sciences Grants no 80748301 and 340-2013-5867) (http://simsam.nu/) to CA and WY; c) Stockholm County Council (Stockholms Läns Landsting) ALF-projects award numbers 502262, 520344 and 530422 (http://www.sll.se/) to CA; d) the Strategic Research Program in Epidemiology at Karolinska Institutet (www.ki.se) to CA; e) the Swedish Heart-Lung Foundation (https://www.hjart-lungfonden.se/) to CA. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.