Maternal antibiotic use during pregnancy increases the risk of offspring airway infections: a systematic review and meta-analysis.

This study synthesises all available data and evaluates the association between maternal antibiotic use during pregnancy and the risk of infections in offspring during childhood.

本研究综合了所有可获得的数据，并评估了孕期母亲使用抗生素与儿童期后代感染风险之间的关联。

Methods

We conducted a systematic reviewand meta-analysisfollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, registered with PROSPERO.

我们遵循系统评价和荟萃分析的首选报告项目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses）指南，并在PROSPERO进行了注册。

We searched PubMed, Embase, Ovid, ISRCTN registry, ClinicalTrials.gov and Cochrane Library for English language studies without publication date restrictions.

我们在没有出版日期限制的情况下，对PubMed、Embase、Ovid、ISRCTN注册库、ClinicalTrials.gov和Cochrane图书馆进行了英文研究的检索。

Studies reporting quantitative data on prenatal antibiotic exposure and childhood infections after the neonatal period were included.

纳入了报告孕期抗生素暴露与新生儿期后儿童感染定量数据的研究。

Two authors screened and extracted data from published reports.

两位作者筛选并从已发表的报告中提取数据。

Risk of bias was evaluated using the Newcastle-Ottawa Scale.

使用纽卡斯尔-渥太华量表评估偏倚风险。

The primary outcome was any childhood infection risk, analysed using random-effects meta-analyses with sensitivity analyses by infection type and study quality.

主要结果是任何儿童感染风险，使用随机效应的荟萃分析进行分析，并根据感染类型和研究质量进行敏感性分析。

Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).

证据的确定性是使用推荐、评估、发展和评估等级（GRADE）进行评估的。

Results

From 7317 records, 14 cohort studies (n=5 011 183 children) were included, of which 12 (n=4 995 449) provided data for meta-analysis.

从7317条记录中，纳入了14项队列研究（n=5,011,183名儿童），其中12项（n=4,995,449）提供了可用于荟萃分析的数据。

Prenatal antibiotic exposure was associated with an increased risk of any offspring infection (OR 1.33, 95% CI 1.01 to 1.76, p=0.04).

产前抗生素暴露与后代任何感染风险增加有关（OR 1.33，95% 置信区间 1.01 至 1.76，p=0.04）。

A sensitivity analysis (n=3 647 296) of six high-quality studies showed a stronger association (OR 1.48, 95% CI 1.13 to 1.95, p<0.01).

对六项高质量研究进行的敏感性分析（n=3,647,296）显示了更强的关联性（OR 1.48，95% 置信区间 1.13 至 1.95，p<0.01）。

Specifically, ear, nose and throat infections were significantly increased (n=2 841 644 children) (OR 1.40, 95% CI 1.18 to 1.65, p<0.0001).

具体来说，耳鼻喉感染显著增加（n=2 841 644名儿童）（OR 1.40，95% 置信区间1.18至1.65，p<0.0001）。

The risk of bias was low in the majority of the included studies and the certainty of evidence was high for any offspring infection from the GRADE assessment.

在纳入的研究中，大多数研究的偏倚风险较低，从GRADE评估来看，任何后代感染的证据确定性很高。

Conclusions

Prenatal antibiotic exposure was associated with increased offspring infection risk and in particular upper airway infections.

产前抗生素暴露与后代感染风险增加有关，特别是上呼吸道感染。

These findings indicate a need for cautious antibiotic prescribing during pregnancy, although potential confounding cannot be excluded.

这些发现表明，在怀孕期间需要谨慎开具抗生素处方，尽管不能排除潜在的混杂因素。

prospero_registration_number

CRD42024599699.

CRD42024599699.