{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:47:23Z","timestamp":1785498443181,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002879","name":"Canadian HIV Trials Network, Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002879","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008252","name":"Health Sciences Centre Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008252","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>While 10% of pregnant individuals report a penicillin allergy, there is no established best practice for penicillin allergy delabeling in pregnancy. To better understand options for penicillin delabeling, we aimed to evaluate two penicillin allergy delabeling protocols in pregnancy regarding efficacy, adverse events, and patient satisfaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>From July 2019 to December 2022, we completed a two\u2010center prospective cohort study, where each site recruited pregnant patients over 24\u2009weeks gestational age with a reported penicillin allergy. One center offered antepartum amoxicillin oral challenges, either directly or after negative skin testing (i.e., antepartum oral challenge site). Our other centers completed a two\u2010step approach with antepartum penicillin skin testing only and deferred oral challenges to the postpartum period (i.e., postpartum oral challenge site). Our primary outcome was the rate of penicillin allergy delabeling, defined as tolerating an antibiotic challenge with penicillin or amoxicillin. Univariate analyses were completed using chi\u2010squared, Fisher's exact, and Wilcoxon rank tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 276 pregnant patients were assessed, with 207 in the antepartum oral challenge site and 69 in the postpartum oral challenge site. Among the 204 patients who completed antepartum oral challenges, 201 (98%) passed without reactions. Deferring oral challenges to the postpartum period led to a loss of follow\u2010up for 37\/53 (70%) of eligible individuals. Overall, 97% (201\/207) of patients at the antepartum oral challenge site were delabeled from their penicillin allergy\u2014compared to 38% (26\/69) of patients referred to the postpartum oral challenge site (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Three antepartum oral challenge reactions were noted, including two mild cutaneous reactions and a case of transient abdominal discomfort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Antepartum amoxicillin oral challenge is a more effective method to delabel pregnant patients from their penicillin allergy. Deferral of oral challenges to the postpartum period introduces a significant barrier for penicillin allergy delabeling.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14964","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T06:57:16Z","timestamp":1725951436000},"page":"2289-2295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Antepartum vs postpartum amoxicillin oral challenge in pregnant patients with a reported penicillin allergy: A two\u2010center prospective cohort study"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9164-3383","authenticated-orcid":false,"given":"Jeffrey Man Hay","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Mak","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Medicine University of British Columbia  Vancouver British Columbia Canada"},{"name":"Division of Allergy and Immunology, Department of Pediatrics University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie C.","family":"Erdle","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Pediatrics University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Barber","sequence":"additional","affiliation":[{"name":"Section of Allergy and Clinical Immunology, Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianne","family":"van Schalkwyk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Women's Health Research Institute, BC Women's Hospital and Health center  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Watt","sequence":"additional","affiliation":[{"name":"Section of Allergy and Clinical Immunology, Department of Internal Medicine University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudharsana Rao","family":"Ande","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dozie","family":"Ochulor","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"Elwood","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Women's Health Research Institute, BC Women's Hospital and Health center  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Poliquin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2019.11.067"},{"key":"e_1_2_12_3_1","first-page":"116","article-title":"Establishing obstetrics\u2010specific metrics and interventions for antimicrobial stewardship","volume":"8","author":"Wong JMH","year":"2023","journal-title":"J Assoc Med Microbiol Infect Dis Can"},{"key":"e_1_2_12_4_1","first-page":"e2051","article-title":"Pregnant patients with a documented history of penicillin allergy and associated maternal and neonatal outcomes at a tertiary care center","volume":"41","author":"Azmy V","year":"2023","journal-title":"Am J 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