Antibiotic use in the first 1000 days and maternal-infant outcomes: results from the MAMI-MED cohort

Abstract Introduction Antibiotic use within the initial thousand days of life could potentially lead to a range of negative health outcomes for both mothers and infants. This study seeks to identify the primary factors influencing antibiotic use and examine the associations with adverse neonatal outcomes, specifically focusing on neonatal intensive care unit (NICU) admissions. Methods Data were gathered from pregnant women and their offspring enrolled in the ‘MAMI-MED’ study at ARNAS Garibaldi Nesima in Catania (Italy), from December 2020 to January 2024. Information regarding antibiotic exposure and maternal-infant health outcomes was collected through follow-up questionnaires administered at birth, one year, and two years postpartum. Results Among 1492 women (average age: 31 years) included in the study, 20.4% reported using antibiotics during pregnancy. The mean age of antibiotic users during pregnancy was significantly higher compared to non-users (p = 0.008). Among the 304 women who used antibiotics during pregnancy, 45.5% did so during the third trimester, 41.4% during the second trimester, and 13.1% during the first trimester. Furthermore, 47.1% of women reported antibiotic use at delivery or postpartum. Of the 904 children studied, 63% were administered at least one antibiotic between birth and the first year of age. A greater proportion of newborns admitted to the NICU were born to mothers who used antibiotics during the second trimester of pregnancy compared to those who used antibiotics during other trimesters (p = 0.013). Conclusions Comprehensive research is needed to delve deeper into the intricate factors influencing maternal antibiotic use. This should thoroughly explore socio-demographic variables, such as income level, education, and access to healthcare. Understanding these multifaceted influences can provide valuable insights into designing tailored public health interventions aimed at promoting prudent antibiotic use during pregnancy. Key messages • Different factors influence maternal antibiotic use. • Tailored public health interventions aimed at promoting prudent antibiotic use during pregnancy are needed.