Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study

Abstract Background Exposure to antibiotics during pregnancy is frequent, despite the limited evidence derived from clinical trials. Drug utilization studies could improve knowledge on utilization of these medications during this critical period. In this context, the present study aimed to describe...

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Main Authors: Michela Servadio, Valeria Belleudi, Francesca R. Poggi, Serena Perna, Antonio Addis, Marina Davoli, Francesco Trotta, Filomena Fortinguerra, MoM-Net Group
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07605-0
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author Michela Servadio
Valeria Belleudi
Francesca R. Poggi
Serena Perna
Antonio Addis
Marina Davoli
Francesco Trotta
Filomena Fortinguerra
MoM-Net Group
author_facet Michela Servadio
Valeria Belleudi
Francesca R. Poggi
Serena Perna
Antonio Addis
Marina Davoli
Francesco Trotta
Filomena Fortinguerra
MoM-Net Group
author_sort Michela Servadio
collection DOAJ
description Abstract Background Exposure to antibiotics during pregnancy is frequent, despite the limited evidence derived from clinical trials. Drug utilization studies could improve knowledge on utilization of these medications during this critical period. In this context, the present study aimed to describe antibiotic exposure during pregnancy in Italy at both national and regional levels. Methods This retrospective population-based study involved a cohort of women who gave birth from 2016 to 2018 and were residents of one of the following Italian regions: Lombardy, Veneto, Emilia-Romagna, Tuscany, Umbria, Lazio, Apulia or Sardinia. A series of sociodemographic and clinical characteristics were retrieved from regional healthcare databases. The prevalence of the use of antibiotics was estimated in nine trimesters, which were divided into three different periods: pre- pregnancy (-III, -II, -I) during pregnancy (I, II, III) and post-pregnancy (+ I, + II, + III). Analyses were stratified by region and by prenatal invasive diagnostic performed. Results A total of 449,012 women were included in the study, of whom more than 37% were aged ≥ 35 years at birth. The overall prevalence rates of antibiotic use in the study cohort were 33.9% pre-pregnancy (per trimester: -III = 14.3%, -II = 14.5%, -I = 14.5%), 31.8% during pregnancy (per trimester: I = 12.0%, II = 16.0%, III = 11.4%) and 29.3% post-pregnancy (per trimester: + I = 15.3%, + II = 9.7%; + III = 11.0%). The regions with the lowest usage pre-, during and post-pregnancy were Lombardy (29.7%, 26.1%, 28.0%) and Veneto (28.8%, 26.4%, 25.5%), whereas Apulia reached the highest values (45.6%, 41.6%, 38.3%). The highest peaks during pregnancy were reached by Umbria (25.8%), Latium (24.1%) and Apulia (21.4%). Women who underwent chorionic villus sampling and those who underwent amniocentesis registered a peak during trimester I (25%) and trimester II (41%), respectively. These peaks were in line with the timing of the invasive prenatal diagnostic procedures. Conclusions The use of antibiotics during pregnancy in Italy was in line with other European countries, reflecting national and international guidelines. However, a certain level of misuse of specific antibiotics and different utilization rates across the regions were observed. Continuous monitoring of long- and short-term outcomes associated with exposure to antibiotics during pregnancy may contribute to reducing excessive utilization and improving the diffusion of more appropriate procedures and practices.
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spelling doaj-art-6aa3379d0abc43a0aa8a822c1cc5d5992025-08-20T03:53:32ZengBMCBMC Pregnancy and Childbirth1471-23932025-04-0125111210.1186/s12884-025-07605-0Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based studyMichela Servadio0Valeria Belleudi1Francesca R. Poggi2Serena Perna3Antonio Addis4Marina Davoli5Francesco Trotta6Filomena Fortinguerra7MoM-Net GroupDepartment of Epidemiology, Lazio Regional Health ServiceDepartment of Epidemiology, Lazio Regional Health ServiceDepartment of Epidemiology, Lazio Regional Health ServiceItalian Medicines Agency (AIFA)Department of Epidemiology, Lazio Regional Health ServiceDepartment of Epidemiology, Lazio Regional Health ServiceItalian Medicines Agency (AIFA)Italian Medicines Agency (AIFA)Abstract Background Exposure to antibiotics during pregnancy is frequent, despite the limited evidence derived from clinical trials. Drug utilization studies could improve knowledge on utilization of these medications during this critical period. In this context, the present study aimed to describe antibiotic exposure during pregnancy in Italy at both national and regional levels. Methods This retrospective population-based study involved a cohort of women who gave birth from 2016 to 2018 and were residents of one of the following Italian regions: Lombardy, Veneto, Emilia-Romagna, Tuscany, Umbria, Lazio, Apulia or Sardinia. A series of sociodemographic and clinical characteristics were retrieved from regional healthcare databases. The prevalence of the use of antibiotics was estimated in nine trimesters, which were divided into three different periods: pre- pregnancy (-III, -II, -I) during pregnancy (I, II, III) and post-pregnancy (+ I, + II, + III). Analyses were stratified by region and by prenatal invasive diagnostic performed. Results A total of 449,012 women were included in the study, of whom more than 37% were aged ≥ 35 years at birth. The overall prevalence rates of antibiotic use in the study cohort were 33.9% pre-pregnancy (per trimester: -III = 14.3%, -II = 14.5%, -I = 14.5%), 31.8% during pregnancy (per trimester: I = 12.0%, II = 16.0%, III = 11.4%) and 29.3% post-pregnancy (per trimester: + I = 15.3%, + II = 9.7%; + III = 11.0%). The regions with the lowest usage pre-, during and post-pregnancy were Lombardy (29.7%, 26.1%, 28.0%) and Veneto (28.8%, 26.4%, 25.5%), whereas Apulia reached the highest values (45.6%, 41.6%, 38.3%). The highest peaks during pregnancy were reached by Umbria (25.8%), Latium (24.1%) and Apulia (21.4%). Women who underwent chorionic villus sampling and those who underwent amniocentesis registered a peak during trimester I (25%) and trimester II (41%), respectively. These peaks were in line with the timing of the invasive prenatal diagnostic procedures. Conclusions The use of antibiotics during pregnancy in Italy was in line with other European countries, reflecting national and international guidelines. However, a certain level of misuse of specific antibiotics and different utilization rates across the regions were observed. Continuous monitoring of long- and short-term outcomes associated with exposure to antibiotics during pregnancy may contribute to reducing excessive utilization and improving the diffusion of more appropriate procedures and practices.https://doi.org/10.1186/s12884-025-07605-0AntibioticsPregnancyPrevalence of usePrenatal diagnostic proceduresMisuseMonitoring
spellingShingle Michela Servadio
Valeria Belleudi
Francesca R. Poggi
Serena Perna
Antonio Addis
Marina Davoli
Francesco Trotta
Filomena Fortinguerra
MoM-Net Group
Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study
BMC Pregnancy and Childbirth
Antibiotics
Pregnancy
Prevalence of use
Prenatal diagnostic procedures
Misuse
Monitoring
title Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study
title_full Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study
title_fullStr Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study
title_full_unstemmed Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study
title_short Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study
title_sort real world antibiotic utilization during pregnancy in italy a multiregional retrospective population based study
topic Antibiotics
Pregnancy
Prevalence of use
Prenatal diagnostic procedures
Misuse
Monitoring
url https://doi.org/10.1186/s12884-025-07605-0
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