Use of certain antibiotics early in pregnancy is associated with an
increased risk for spontaneous abortion, the authors of a new study
report.
Macrolides (except erythromycin), quinolones, tetracyclines, sulfonamides, and metronidazole all were associated with a greater risk, compared with penicillins, cephalosporins, or no antibiotic exposure at all, Flory T. Muanda, MD, and colleagues write in an article published in the May 1 issue of CMAJ.
The findings should be considered when guidelines are updated regarding treatment of infection during pregnancy, according to the authors.
This study was "well-conducted and highlights some of the potential negative consequences of using antibiotics in this population, especially if they're being prescribed inappropriately," Jason G. Newland, MD, MEd, associate professor of pediatrics, Washington University School of Medicine, St. Louis, and a spokesperson for the Infectious Diseases Society of America, told Medscape Medical News. He was not involved in the research.
Large Cohort Study
To assess the potential effect of antibiotics on miscarriage risk, Dr Muanda, from the Faculty of Pharmacy, Université de Montréal, Quebec, Canada, and colleagues analyzed data from the Quebec Pregnancy Cohort on pregnancies that occurred between January 1998 and December 2009. The cohort is ongoing and includes information on all pregnancies among women covered by the Quebec Public Prescription Drug Insurance Plan.
Eligible patients were aged 15 to 45 years on the first day of gestation and continuously insured for at least 1 year before and during their pregnancy. Women who experienced a clinically detected spontaneous abortion before gestational week 20 were considered cases, with the calendar date of the spontaneous abortion designated the index date. For each case, the authors identified 10 control patients matched by age, year of pregnancy, and gestational date within 3 days.
Antibiotic exposure was defined as "having filled at least 1 prescription for any type of antibiotic either between the first day of gestation and the index date, or before pregnancy but with a duration that overlapped the first day of gestation," the authors explain.
Macrolides (except erythromycin), quinolones, tetracyclines, sulfonamides, and metronidazole all were associated with a greater risk, compared with penicillins, cephalosporins, or no antibiotic exposure at all, Flory T. Muanda, MD, and colleagues write in an article published in the May 1 issue of CMAJ.
The findings should be considered when guidelines are updated regarding treatment of infection during pregnancy, according to the authors.
This study was "well-conducted and highlights some of the potential negative consequences of using antibiotics in this population, especially if they're being prescribed inappropriately," Jason G. Newland, MD, MEd, associate professor of pediatrics, Washington University School of Medicine, St. Louis, and a spokesperson for the Infectious Diseases Society of America, told Medscape Medical News. He was not involved in the research.
To assess the potential effect of antibiotics on miscarriage risk, Dr Muanda, from the Faculty of Pharmacy, Université de Montréal, Quebec, Canada, and colleagues analyzed data from the Quebec Pregnancy Cohort on pregnancies that occurred between January 1998 and December 2009. The cohort is ongoing and includes information on all pregnancies among women covered by the Quebec Public Prescription Drug Insurance Plan.
Eligible patients were aged 15 to 45 years on the first day of gestation and continuously insured for at least 1 year before and during their pregnancy. Women who experienced a clinically detected spontaneous abortion before gestational week 20 were considered cases, with the calendar date of the spontaneous abortion designated the index date. For each case, the authors identified 10 control patients matched by age, year of pregnancy, and gestational date within 3 days.
Antibiotic exposure was defined as "having filled at least 1 prescription for any type of antibiotic either between the first day of gestation and the index date, or before pregnancy but with a duration that overlapped the first day of gestation," the authors explain.
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