OBJECTIVES Antibiotics are commonly administered during labor and delivery, and research has suggested that fetal exposure to antibiotics can increase risk for autism spectrum disorder (ASD). We assessed whether antibiotic exposure during labor and delivery increased the risk of ASD in the offspring. METHODS This retrospective cohort study included everyone who delivered a live singleton-term infant in British Columbia, Canada, between April 1, 2000, and December 31, 2014. This cohort included 569 953 deliveries. To examine the association among pregnant individuals being treated for the same indication, we studied a subcohort of those who tested positive for group B Streptococcus. Cox proportional hazards models were used to estimate unadjusted and adjusted hazard ratios in both cohorts. A sensitivity analysis was conducted using length of first stage of labor as a proxy measure for dose to assess for a dose-response relationship. RESULTS In this population-based study, antibiotic use during labor and delivery was not associated with an increased risk of ASD in offspring. The unadjusted and adjusted hazard ratios were 1.29 (95% confidence interval, 1.24-1.35) and 0.99 (0.94-1.04), respectively; and 1.07 (0.90-1.27) and 0.88 (0.74-1.05), respectively, in the group B Streptococcus-positive cohort. We observed no substantial difference in the association between antibiotic exposure and ASD depending on length of the first stage of labor. CONCLUSIONS Our findings suggest that concern for ASD should not factor into the clinical decision on whether to administer antibiotics during labor and delivery. Future research is needed to examine longer durations of prenatal antibiotic exposure.

中文翻译：

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自闭症风险和围产期抗生素使用。

目的 抗生素通常在分娩过程中使用，研究表明胎儿接触抗生素会增加患自闭症谱系障碍 (ASD) 的风险。我们评估了分娩期间抗生素暴露是否会增加后代患 ASD 的风险。方法 这项回顾性队列研究纳入了 2000 年 4 月 1 日至 2014 年 12 月 31 日期间在加拿大不列颠哥伦比亚省分娩活单胎足月婴儿的所有人。该队列包括 569 953 例分娩。为了检查接受相同适应症治疗的怀孕个体之间的关联，我们研究了 B 组链球菌检测呈阳性的一组亚群。Cox 比例风险模型用于估计两个队列中未调整和调整后的风险比。使用第一产程的长度作为剂量的代理措施进行敏感性分析，以评估剂量反应关系。结果 在这项基于人群的研究中，分娩期间抗生素的使用与后代 ASD 风险增加无关。未调整和调整后的风险比分别为 1.29（95% 置信区间，1.24-1.35）和 0.99（0.94-1.04）；在 B 组链球菌阳性队列中，分别为 1.07 (0.90-1.27) 和 0.88 (0.74-1.05)。我们观察到抗生素暴露与 ASD 之间的关联没有显着差异，具体取决于第一产程的长度。结论 我们的研究结果表明，对 ASD 的关注不应成为临床决定是否在分娩期间使用抗生素的因素。