Appendix

World Health Organization International Classification of Diseases, 8th Edition (ICD-8) and 10th Edition (ICD-10) codes used in this study.

Conditions / ICD-8 codes / ICD-10 codes
Gastrointestinal infection / 000-009 (except 009.99) / A00-A09
Tuberculosis / 010-018 / A15-A19
Misc. bacterial infections / 020-35, 039, 073,076,
100-104 / A20-A38, A42-A44, A48-A49, A65-A79
Meningococcal disease / 036 / A39
Septicaemia / 038 / A40-41
Sexually transmitted diseases / 090-099 / A50-A64
Herpes simplex or zoster / 053, 054 / B00-B02
Viral Hepatitis / 070 / B15-b19
HIV / B20-B24
Misc. viral infections / 050-052, 055-057,
060-065, 067-068, 072,
074-075, 079 / A90-A99, B01, B03-B09, B25-B34
Candidiasis and other fungal infections / 110-117 / B35-B49
Parasitic infections / 080-089, 120-131 / B50-B89
CNS infections (÷meningococcal disease) / 040-046, 071 / A80-A89, G00-G07
Heart infections (acute rheumatic fever, infectious pericarditis or myocarditis, endocarditis) / 390-392, 420-422 / I00-I02, I30.1, I32.0, I33, I38, I39.8, I40.0
Upper respiratory tract infections / 460-465, 501 / J00-J06, J36, J39.0, J39.1
Influenza / 470-474 / J10-J11
Pneumonia / 480-486 / J12-J18
Other lower respiratory tract infections / 466, 510, 511.19, 513 / J20-J22, J44.0, J85.1, J86
Intra-abdominal infections / 540-541, 566-567, 572,
574.01, 574.04, 575.00,
575.02-575.04 / K35, K37, K57.0, K57.2, K57.4, K57.8, K61, K63.0, K65.0, K65.9, K67, K75.0, K75.1, K80.0, K80.3, K80.4, K81.0, K81.9, K83.0, K85.9
Skin and subcutaneous infections, including cellulitis/erysipelas and lymphadenitis / 680-686 / A46, J34.0, L00-L08
Septic arthritis, osteomylitis, myositis / 710, 720, 732 / M00, M01, M86, M63.0, M63.2
Urinary tract infections / 590, 595, 597.00, 599.00,
599.06 / N10, N12, N15.1, N30, N33.0, N34.1, N39.0
Female pelvic infections (salpingo-oophritis, uterine infections, vulvovaginitis, etc.) / 612-614, 616, 620, 622,
629.49 / N70-N77
Obstetrical infections / 630, 635, 670, 680.00,
678.01,678.09 / O23, O26.4, O41.1, O74.0, O75.3, O85, O86, 088.3, O91, O98
Infectious complications of procedures, catheters, etc. / T80.2, T81.4, T82.6, T82.7, T83.5, T83.6, T84.5, T84.6, T84.7, T85.7, T88.0, T89.9
Other infections or sequelae of infections / B90-B99, E06.0, E32.1, H00, H01.0, H03.0, H03.1, H05.0, H06.1, H10, H13.1, H19.1-H19.2, H22.0, H32.0, H44.0, H60.0, H60.1, H60.3, H62.0-H62.3, H65.0, H66.0-H66.4, H67, H70.0, J85.3, K04.0, K04.6, K04.7, K05.2, K11.3, K12.2, N61.9
Type 2 diabetes / 249.x, 250.x / E10.x, E11.x, E14.x, G63.2.x, H36.0, N08.3, O24.3
Gestational diabetes / - / O24.4, O24.9

Anatomical Therapeutic Chemical classification system (ATC) codes used in this study

ATC codes for systemic antibacterials:

ATC-codes: J01xx (antibacterials for systemic use)

ATC codes for glucose-lowering drugs used to identify pre-existing diabetes and gestational diabetes:

ATC-codes: A10Ax, A10BAx, A10BBx, A10BFx, A10BGx, A10BHx, A10BXx, A10BDx

Supplementary table 1. Exposure to antibiotics or hospital diagnosis of infections used to identify prenatalexposure.

Exposure / ATC codes/ ICD codes / No. of participants exposed
Exposure to single antibiotic
Tetracyclines / J01A / 19
Penicillins / J01C / 2102
Sulfonamides and trimethoprim / J01E / 330
Macrolides / J01F / 200
Quinolones / J01M / 6
Exposure to multiple antibiotics / ATC: J01A, J01C, J01E, J01F, J01M / 371
Upper respiratory tract infections
Influenza
Pneumonia / ICD-8: 460-465, 501, 470-474,480-486
ICD-10:J20-J22, J44.0, J85.1, J86, J00-J06, J36, J39.0, J39.1, J10-J11, J12-J18, J34.0 / 27
Gastrointestinal infection
Tuberculosis
Misc. bacterial infections
Meningococcal disease
Septicemia
Sexually transmitted diseases / ICD-8:000-009 (except 009.99), 010-018, 020-35, 039, 073,076, 100-104, 036, 038, 090-099
ICD-10:A00-A09, A15-A19, A20-A38, A42-A44, A48-A49, A65-A79, A39, A40-41, A50-A64, A46, A80-A89, A90-A99 / 65
Herpes simplex or zoster
Viral Hepatitis
HIV
Misc. viral infections
Candidiasis and other fungal infections
Parasitic infections / ICD-8:053, 054, 070, 050-052, 055-057, 060-065, 067-068, 072, 074-075, 079, 110-117, 080-089, 120-131
ICD-10: B00-B02, B15-b19, B20-B24, B01, B03-B09, B25-B34, B35-B49, B50-B89 / 21
Heart infections (acute rheumatic fever, infectious pericarditis or myocarditis, endocarditis) / ICD-8: 390-392, 420-422
ICD-10: I00-I02, I30.1, I32.0, I33, I38, I39.8, I40.0 / 0
Intra-abdominal infections / ICD-8: 540-541, 566-567, 572, 574.01, 574.04, 575.00, 575.02-575.04
ICD-10: K35, K37, K57.0, K57.2, K57.4, K57.8, K61, K63.0, K65.0, K65.9, K67, K75.0, K75.1, K80.0, K80.3, K80.4, K81.0, K81.9, K83.0, K85.9 / 24
Skin and subcutaneous infections, including cellulitis/erysipelas and lymphadenitis / ICD-8: 680-686
ICD-10: L00-L08 / 13
Septic arthritis, osteomyelitis, myositis / ICD-8: 710, 720, 732
ICD-10: M00, M01, M86, M63.0, M63.2 / 0
Female pelvic infections (salpingo-oophritis, uterine infections, vulvovaginitis, etc.) / ICD-8: 590, 595, 597.00, 599.00, 599.06, 612-614, 616, 620, 622, 629.49
ICD-10: N10, N12, N15.1, N30, N33.0, N34.1, N39.0, N70-N77 / 39
Obstetrical infections / ICD-8: 630, 635, 670, 680.00, 678.01,678.09
ICD-10: O23, O26.4, O41.1, O74.0, O75.3, O85, O86, 088.3, O91, O98 / 357
Infectious complications of procedures, catheters, etc. / ICD-10: T80.2, T81.4, T82.6, T82.7, T83.5, T83.6, T84.5, T84.6, T84.7, T85.7, T88.0, T89.9 / 3
Other infections / ICD-10: B90-B99, E06.0, E32.1, H00, H01.0, H03.0, H03.1, H05.0, H06.1, H10, H13.1, H19.1-H19.2, H22.0, H32.0, H44.0, H60.0, H60.1, H60.3, H62.0-H62.3, H65.0, H66.0-H66.4, H67, H70.0, J85.3, K04.0, K04.6, K04.7, K05.2, K11.3, K12.2, N61.9, G00-G07 / 7

Supplementary table 2.Prevalence ratios (PR) of overweight* and obesity* according to prenatal exposure to specific antibacterials.

Overweight / Obesity
Exposure / Cases / Crude PR (95% CI) / Adjusted† PR(95% CI) / Cases / Crude PR(95% CI) / Adjusted† PR(95% CI)
No antibacterials / 494 / 193
Tetracyclines / 1 / 0.75 (0.11 – 5.04) / 0.72 (0.11 – 4.86) / 1 / 1.87 (0.28 – 12.66) / 1.80 (0.27 – 12.00)
Penicillins / 177 / 1.18 (1.00 – 1.39) / 1.13 (0.96 – 1.34) / 79 / 1.34 (1.03 – 1.73) / 1.25 (0.96 – 1.62)
Sulfonamides and trimethoprim / 35 / 1.50 (1.08 – 2.07) / 1.47 (1.06 – 2.03) / 15 / 1.62 (0.97 – 2.70) / 1.59 (0.95 – 2.65)
Macrolides / 18 / 1.25 (0.80 – 1.96) / 1.18 (0.75 – 1.84) / 6 / 1.06 (0.48 – 2.37) / 1.02 (0.46 – 2.26)
Mixed‡ / 43 / 1.63 (1.22 – 2.18) / 1.51 (1.12 – 2.02) / 15 / 1.44 (0.86 – 2.40) / 1.31 (0.78 – 2.19)

Abbreviations: CI, confidence interval

*Age- and sex-specific cut-offs were taken from the International Obesity Task Force. The overweight category does not include obese schoolchildren.

†Adjusted for sex, maternal age group, smoking during pregnancy, Apgar score at five minutes, marital status, and multiple pregnancy. In addition, for 2nd and 3rd trimester exposure, we also adjusted for previous exposure to antibiotics during the same pregnancy.

‡Mixed= exposure to multiple antibiotic groups during the pregnancy.

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