See my Twitter
A new study published in the medical journal BMJ suggests women who were advised macrolides during the first three months of pregnancy had an increased risk of birth defects compared to those who were prescribed penicillin. The study analyzed data from more than 104,600 children born in the UK between 1990 and 2016. Their mothers were either prescribed penicillin or macrolides. The study found that prescribing macrolides which included erythromycin and clarithromycin and azithromycin to pregnant women during the first trimester increased the risk of major malformations to 28 of 1,000 births compared 18 per 1,000 births with penicillin.
University College London Professor Ruth Gilbert, one of the authors of the study, said this is a small but still noteworthy increase and, based on these outcomes, pregnant women and their doctors should find an alternate source depending on the type of infection. Gilbert also warned about the risks of not taking antibiotics at all. “If you’ve got a bacterial infection, it’s really important to take antibiotics because infection itself can be really damaging to the unborn baby,” Gilbert said.
In 2005, Sweden warned against the use of the macrolide erythromycin during the first trimester of pregnancy after a report found a link between the medicine and heart defects, the study said. For the time being, regulatory authorities in the United States and the UK only warn against the use of azithromycin and clarithromycin for adults with a high risk of cardiovascular complications, according to study authors. A prior study published in the Canadian Medical Association Journal found common antibiotics, including macrolides, are tied to an uptick in miscarriages when used in early pregnancy.
Considering other influencing factors, the researchers found macrolide prescribing during the first three months (the first trimester) of pregnancy was associated with an uptick of any major malformation compared with penicillin (28 versus 18 per 1,000 births ) and specifically cardiovascular malformations (11 v seven per 1,000 births).Macrolide prescribing in any trimester was also associated with a slightly increased risk of genital malformations (five v three per 1,000 births). No statistically significant associations were found for other system specific malformations or for any of the four neurodevelopmental disorders, according to sciencedaily.com.
Dr. Sarah Stock says that the findings from the study are convincing because the relationship between congenital malformation and macrolides antibiotics is steady. She said that pregnant women could use other alternatives to these antibiotics; however, if it is necessary to use them, they can do so because the risk of getting complications is not that huge.