The Effect of Intrapartum Antibiotic Prophylaxis at Caesarean Section on Childhood Obesity: A…

Cohort studyPaediatric and perinatal epidemiology· Aug 2026

The Effect of Intrapartum Antibiotic Prophylaxis at Caesarean Section on Childhood Obesity: A Quasi-Experimental Study in Two Bi-Ethnic UK Cohorts.

Gillian Santorelli, Lucy Pembrey, Sergio Souza da Cunha … John Wright

Pediatric Gastroenterology & NutritionCohort studyClinical practiceQ1IF 1.8

Antibiotic timing at caesarean section not clearly linked to childhood obesity

The Effect of Intrapartum Antibiotic Prophylaxis at Caesarean Section on Childhood Obesity: A Quasi-Experimental Study in Two Bi-Ethnic UK Cohorts.

Gillian Santorelli … John Wright

Paediatric and perinatal epidemiology · Aug 2026 · Q1 in Pediatrics

Background

Clinical guidelines now recommend administering intrapartum antibiotic prophylaxis (intrapartum antibiotic prophylaxis) before skin incision at caesarean section to prevent maternal infection.

Purpose

To assess whether the timing of intrapartum antibiotic prophylaxis at caesarean section-before skin incision versus after umbilical cord clamping-is associated with childhood obesity at age 4-5 years.

Methods

We conducted a quasi-experimental study of a hospital-wide policy change in clinical practice using data from two birth cohorts (Born in Bradford [BiB] and Born in Bradford's Better Start [BiBBS]).

n = 1985 children

Results

no clear rise in childhood obesity with earlier antibiotic timing

aRR 1.25 (95% CI 0.53 to 2.98)

CI excludes the null - significant

More results

The prevalence of obesity was 11.9%.

Similarly, estimates for BMI z-score had wide confidence intervals indicating, limited precision.

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Conclusion · 1 of 2

We did not observe a clear difference in childhood obesity at 4-5 years between pre-incision and post-cord clamping prophylactic antibiotics at caesarean section.

Conclusion · 2 of 2

Confidence intervals were wide, and modest clinically relevant effects cannot be excluded. Findings are compatible with no large adverse effect and may provide reassurance regarding the metabolic safety of current clinical practice.

The Effect of Intrapartum Antibiotic Prophylaxis at Caesarean Section on Childhood Obesity: A Quasi-Experimental Study in Two Bi-Ethnic UK Cohorts.

The Effect of Intrapartum Antibiotic Prophylaxis at Caesarean Section on Childhood Obesity: A Quasi-Experimental Study in Two Bi-Ethnic UK Cohorts.

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