Antibiotic Use in Early Pregnancy May Raise Birth Defect Risk

A new study shows the danger of certain antibiotics prescribed to women in early pregnancy due to the risk of birth defects. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) analyzed antibiotic prescriptions filled by pregnant women who had urinary tract infections in their first trimester of pregnancy. They found that despite recommendations against their use, trimethoprim-sulfamethoxazole (Bactrim) and nitrofurantoin (Macrobid) antibiotics were commonly prescribed medications for pregnant women with UTIs. The American College of Obstetricians and Gynecologists (ACOG) does not recommend prescribing sulfonamides and nitrofurantoin during the first trimester of pregnancy unless other antibiotics would not be clinically appropriate.

The challenge is that urinary tract infections can cause complications for pregnant women and their unborn children, but the antibiotics that could treat those infections also carry small but significant risks.  Elizabeth Ailes, a CDC health scientist and lead researcher of the study said that there is a three percent risk of birth defects in all pregnancies, and, “Birth defects associated with these drugs include heart, brain and facial defects. The increased risks associated with these antibiotics is relatively small, but significant — about two-times.”

If a UTI remains untreated, it can cause low birthweight, babies born prematurely and the development of systemic infections which can lead to death. In a CBS News story, Dr. Jill Rabin, chief of ambulatory care, obstetrics and gynecology and urogynecology at Northwell Health said that if a UTI can only be cured with Bactrim or Macrobid, they need to be prescribed at the lowest effective dose regardless of the small risk.

Doctors must balance the risk of managing the infection with prescribing a drug that could potentially double the risk of birth defects.

The importance of antibiotic stewardship

While antibiotics are responsible for saving countless lives from once deadly infections, and making so many of the advances in medicine possible, the CDC reports that anywhere from 20 to 50% of all antibiotics prescribed in the U.S. are either unnecessary or inappropriate. Misusing antibiotics contributes to the problem of antibiotic resistance, which has become a major threat to public health. The principle of antimicrobial stewardship is critical to improving public safety.

The Association for Professionals in Infection Control and Epidemiology (APIC) defines antimicrobial stewardship as a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics) improves patient outcomes, reduces microbial resistance and decreases the spread of infections caused by multidrug-resistant organisms.

How to protect yourself and your baby from potentially dangerous antibiotics

Women who develop a urinary tract infection in the first trimester of pregnancy, should discuss the safety of the antibiotic that their doctor prescribes and whether it is safe for early pregnancy or for a woman who might be pregnant.

Women who have had a child born with cleft palate, heart defects, or anencepolopathy who were also prescribed antibiotics in the first trimester of pregnancy may wish to consult with an experienced dangerous drugs lawyer immediately.

McGowan, Hood, Felder & Phillips, LLC, fights on behalf of injury victims. Discover what we can do for you when you have suffered from the adverse effects of dangerous drugs. Call 803-327-7800 or fill out our contact form and schedule an appointment. We are based in South Carolina, but have helped people throughout the country seek justice. We maintain offices in Columbia, Anderson, Rock Hill, Sumter, Charleston, and Georgetown, SC, as well as Charlotte, NC, for your convenience.