Does Maternal Antibiotic Use Up the Risk for Neonatal Seizures?

Researchers assessed the relationship between maternal antibiotic use and neonatal seizures in infants (>32 weeks gestation).

At the AES Annual Meeting 2017, researchers from University of Colorado reported on whether maternal antibiotic use during labor and delivery increased the risk of seizure in the neonate.

The use of antibiotics has been associated with seizures in adults but the link in pediatric patients has not been fully elucidated. Antibiotic administration is common during labor and delivery and “due to the permeability of the neonatal blood brain barrier, the association between antibiotic use and seizures may be enhanced”, the authors stated. 

To get a better understanding of this association, Kelly G. Knupp and coauthors performed a retrospective chart review using Colorado Birth certificate data from 2007 to 2015 to evaluate the relationship between maternal antibiotic use and neonatal seizures in infants >32 weeks gestation. 

The data showed antibiotics given during labor and delivery were significantly associated with neonatal seizures (odds ratio [OR] 1.96, 95% CI: 1.4, 2.7). However, after infant risk factors were accounted for, the association was no longer significant (OR 1.2, 95% CI: 0.8, 1.6). Significant risk factors associated with neonatal seizures were hypoxic ischemic encephalopathy (HIE), antibiotics administered to the infant for suspected sepsis, and the presence of congenital abnormalities. Premature birth, in contrast, was associated with a reduced risk of neonatal seizures. 

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Although an initial association was seen with antibiotics given during labor and the risk of neonatal seizures, there was no longer a significant association once the maternal and infant risk factors were taken into account. “Ultimately, infant risk factors had a greater influence on the risk for neonatal seizures than maternal risk factors,” concluded Knupp.

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Knupp KG, Phillipus A, Stendel P. Maternal Antibiotic Use During Labor and its Effect on Seizures in the Neonate. Presented at AES annual meeting in Washington, DC. Abstract 3.282.