ArticlePaediatric and perinatal epidemiology2009
Antibiotics potentially used in response to bioterrorism and the risk of major congenital malformations.
Article in Paediatric and perinatal epidemiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 8 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Safety of Antimicrobials During Pregnancy: A Systematic Review of Antimicrobials Considered for Treatment and Postexposure Prophylaxis of Plague.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Pooled it
- Prenatal Exposure to Macrolides and Risk of Congenital Malformations: A Meta-Analysis.Drug safety · 2020Pooled it
- Maternal Viral Infection and Risk of Fetal Congenital Heart Diseases: A Meta-Analysis of Observational Studies.Journal of the American Heart Association · 2019Pooled it
- Associations between use of macrolide antibiotics during pregnancy and adverse child outcomes: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Pregnancy Outcomes Following Exposure to Quinolone Antibiotics - a Systematic-Review and Meta-Analysis.Pharmaceutical research · 2018Pooled it
- Revisiting doxycycline in pregnancy and early childhood--time to rebuild its reputation?Expert opinion on drug safety · 2016Pooled it
- Chlamydia (uncomplicated, genital).BMJ clinical evidence · 2015Pooled it
- Chlamydia (uncomplicated, genital).BMJ clinical evidence · 2010Pooled it
- Influence of body weight, ethnicity, oral contraceptives, and pregnancy on the pharmacokinetics of azithromycin in women of childbearing age.Antimicrobial agents and chemotherapy · 2012Trial
- Prenatal Azithromycin Exposure and Risk of Neurodevelopmental Disorders in Children.JAMA network open · 2026Article
- Expanding treatment options for syphilis during pregnancy: a review of alternatives to penicillin.Frontiers in global women's health · 2026Review
- Doxycycline safety during pregnancy: a large population-based cohort of pregnancies.Infection · 2025Article
- The impact of prenatal amoxicillin exposure at different doses, stages, and courses on offspring ovarian development.Molecular medicine (Cambridge, Mass.) · 2025Article
- First Trimester Tetracycline Exposure and Risk of Major Congenital Malformations.JAMA network open · 2024Article
- Community pharmacist intervention in doxycycline self-medication for acne among pregnant women in Saudi Arabia.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2024Article
- Embryonic Amoxicillin Exposure Has Limited Impact on Liver Development but Increases Susceptibility to NAFLD in Zebrafish Larvae.International journal of molecular sciences · 2024Article
- Case Report: Fatal Rickettsiosis in Pregnancy.The American journal of tropical medicine and hygiene · 2024Article
- Article
- Doxycycline use and adverse pregnancy or neonatal outcomes: A descriptive study using the United States Food and Drug Administration Adverse Event Reporting System database.Health science reports · 2022Article
- A Case Study of ZoonoticOpen forum infectious diseases · 2022Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
This study was designed to assess the association between pregnancy-related exposures to antibiotics recommended for use in the event of a bioterrorism attack and major congenital malformations. A retrospective cohort study included 30 049 infants from Tennessee Medicaid born between 1985 and 2000 identified from computerised state databases. Infants with fetal exposures to ciprofloxacin, azithromycin, doxycycline and amoxicillin (antibiotics recommended for potential bioterrorism attacks) (n = 24 521) and erythromycin (included as a positive control) (n = 2128) were compared with infants with no fetal exposure to any antibiotics (n = 3400). Major congenital malformations identified from computerised records were confirmed through medical record review. Overall, 869 (2.9%) of infants in the cohort had a confirmed major congenital malformation, with major malformations ranging from 2.5% to 3.0% among the antibiotic-specific exposure groups. No increased risk was present in multivariable analyses for any malformations and for malformations of specific organ systems. In conclusion, these data suggest that ciprofloxacin, azithromycin, doxycycline or amoxicillin use by pregnant women should not result in a greater incidence of overall major congenital malformations in infants whose mothers take these medications, though a large increase in risk cannot be ruled out.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.