Associations between antibiotics and birth defects

CUIDADO los ginecólogos y todos los demás colegas... Ya que supuestamente la nitrofurantoina está como clase B !!!!

This population-based, multisite, case-control study by US authors included women who had pregnancies affected by 1 of more than 30 eligible major birth defects identified via birth defect surveillance programs in 10 states (n = 13 155) and control women randomly selected from the same geographical regions (n = 4941). They compare maternal use of antibacterials 1 month before pregnancy through the end of the first trimester, adjusting for potential confounders.

They found: “The reported use of antibacterials increased during pregnancy, peaking during the third month. Sulfonamides were associated with anencephaly (adjusted OR = 3.4), hypoplastic left heart syndrome (AOR = 3.2), coarctation of the aorta (AOR = 2.7), choanal atresia (AOR = 8.0), transverse limb deficiency (AOR = 2.5), and diaphragmatic hernia (AOR = 2.4). Nitrofurantoins were associated with anophthalmia or microphthalmos (AOR = 3.7), hypoplastic left heart syndrome (AOR = 4.2), atrial septal defects (AOR = 1.9), and cleft lip with cleft palate (AOR = 2.1). Other antibacterial agents that showed associations included erythromycins (2 defects), penicillins (1 defect), cephalosporins (1 defect), and quinolones (1 defect).”

The authors concluded: "Reassuringly, penicillins, erythromycins, and cephalosporins, although used commonly by pregnant women, were not associated with many birth defects. Sulfonamides and nitrofurantoins were associated with several birth defects, indicating a need for additional scrutiny.”

Arch Pediatr Adolesc Med163(11):978-985, November 2009 © 2009 to the American Medical AssociationAntibacterial Medication Use During Pregnancy and Risk of Birth Defects-National Birth Defects Prevention Study. Krista S. Crider, Mario A. Cleves, Jennita Reefhuis, Robert J. Berry, Charlotte A. Hobbs, Dale J. Hu. Correspondence to: Dr. Crider: kcrider@cdc.gov