Combined effects of prenatal medication use and delivery type are associated with eczema at age 2 years.
BACKGROUND
Separately, prenatal antibiotics and Caesarian delivery have been found to be associated with increased risk of allergic diseases. It is not clear whether these factors may modify the effect of each other.


OBJECTIVE
To assess whether the associations between delivery types and eczema, sensitization and total IgE at age 2 years were modified by maternal use of prenatal medications.


METHODS
Prenatal charts of women enrolled in the WHEALS birth cohort were reviewed for delivery mode and medications prescribed and administered throughout their entire pregnancy, including systemic antibiotics and vaginally applied antifungal medications. The associations between the delivery mode and select medications and, eczema, sensitization (≥ 1 of 10 allergen-specific IgE ≥ 0.35 IU/mL) and total IgE at age 2 years were assessed.


RESULTS
There was a lower risk of eczema among vaginally vs. c-section born children (relative risk adjusted for race = aRR = 0.77, 95% CI 0.56, 1.05). Although not statistically significantly different, this association was stronger among the subset of children born vaginally to a mother who did not use systemic antibiotics or vaginal antifungal medications (aRR = 0.69, 95% CI 0.44, 1.08) compared to those born vaginally to mothers who used systemic antibiotics or vaginal antifungals (aRR = 0.81, 95% CI 0.57, 1.14). A protective association between vaginal birth and sensitization (aRR = 0.86, 95% CI 0.72, 1.03) was similar for those children born vaginally to a mother who did not (aRR = 0.87, 95% CI 0.69, 1.10) and who did (RR = 0.85, 95% CI 0.70, 1.04) use systemic antibiotics or vaginal antifungal medications. There were no associations with total IgE.


CONCLUSIONS
Children born vaginally had lower risk of eczema and sensitization compared with those born via c-section; however, the protective association with eczema may be slightly weakened when mothers took systemic antibiotics or vaginally applied medications during pregnancy.
['Wegienka|G|G|', 'Havstad|S|S|', 'Zoratti|E M|EM|', 'Kim|H|H|', 'Ownby|D R|DR|', 'Johnson|C C|CC|']
D000328:Adult D000367:Age Factors D000890:Anti-Infective Agents D002585:Cesarean Section D002675:Child, Preschool D036861:Delivery, Obstetric D004485:Eczema D005260:Female D006801:Humans D007073:Immunoglobulin E D008297:Male D018811:Maternal Exposure D008824:Michigan D016017:Odds Ratio D011247:Pregnancy D011297:Prenatal Exposure Delayed Effects D012306:Risk D013292:Streptococcus agalactiae
prenatal eczema antibiotics IgE antifungal c-section microbiome