ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2017
Use of antibiotics during pregnancy and risk of spontaneous abortion.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 6 of them syntheses that pooled it.
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Who cites it
57 citing papers in PubMed, 6 syntheses or guidelines pooled it, 131 citations in OpenAlex.
- Tularemia Antimicrobial Treatment and Prophylaxis: CDC Recommendations for Naturally Acquired Infections and Bioterrorism Response - United States, 2025.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2025Guideline
- Can the use of azithromycin during labour reduce the incidence of infection among puerperae and newborns? A systematic review and meta-analysis of randomized controlled trials.BMC pregnancy and childbirth · 2024Pooled it
- 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
- Associations between use of macrolide antibiotics during pregnancy and adverse child outcomes: A systematic review and meta-analysis.PloS one · 2019Pooled it
- A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy.BMC pregnancy and childbirth · 2018Pooled it
- Pregnancy Outcomes Following Exposure to Quinolone Antibiotics - a Systematic-Review and Meta-Analysis.Pharmaceutical research · 2018Pooled it
- Efficacy of lactoferrin in preventing recurrent urinary tract infections in pregnant Egyptian women: a randomized controlled trial.BMC urology · 2025Trial
- A Prospective, Open-label, Randomized Trial of Doxycycline Versus Azithromycin for the Treatment of Uncomplicated Murine Typhus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Trial
- Risk of Permanent Dental Staining Following Exposure to Newer-Generation Tetracycline Derivatives in Children: A Systematic Review and Meta-Analysis.Children (Basel, Switzerland) · 2026Review
- Exposure to Systemic Antimicrobials During Pregnancy and Risk of Miscarriage: A Population-Based Registry Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Prenatal Azithromycin Exposure and Risk of Neurodevelopmental Disorders in Children.JAMA network open · 2026Article
- The relationship between first trimester maternal diet and early pregnancy loss: a retrospective case-control study.BMC pregnancy and childbirth · 2026Article
- Article
- Risk assessment of drug-associated miscarriage using XGBoost and SHAP explainability: a real-world pharmacovigilance analysis based on the FAERS database.Frontiers in pharmacology · 2026Article
- Expanding treatment options for syphilis during pregnancy: a review of alternatives to penicillin.Frontiers in global women's health · 2026Review
- A review of antibiotic safety in pregnancy-2025 update.Pharmacotherapy · 2025Review
- Immunopathogenesis and immunotherapy of diabetes-associated periodontitis.Clinical oral investigations · 2025Review
- First Trimester Tetracycline Exposure and Risk of Major Congenital Malformations.JAMA network open · 2024Article
- Comprehensive Overview of Methods of Pregnancy Termination in Macaques and Marmosets.Veterinary sciences · 2024Review
- Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough antibiotics are widely used during pregnancy, evidence regarding their fetal safety remains limited. Our aim was to quantify the association between antibiotic exposure during pregnancy and risk of spontaneous abortion.
methodsWe conducted a nested case-control study within the Quebec Pregnancy Cohort (1998-2009). We excluded planned abortions and pregnancies exposed to fetotoxic drugs. Spontaneous abortion was defined as having a diagnosis or procedure related to spontaneous abortion before the 20th week of pregnancy. The index date was defined as the calendar date of the spontaneous abortion. Ten controls per case were randomly selected and matched by gestational age and year of pregnancy. Use of antibiotics was defined by filled prescriptions between the first day of gestation and the index date and was compared with (a) non-exposure and (b) exposure to penicillins or cephalosporins. We studied type of antibiotics separately using the same comparator groups.
resultsAfter adjustment for potential confounders, use of azithromycin (adjusted odds ratio [OR] 1.65, 95% confidence interval [CI] 1.34-2.02; 110 exposed cases), clarithromycin (adjusted OR 2.35, 95% CI 1.90-2.91; 111 exposed cases), metronidazole (adjusted OR 1.70, 95% CI 1.27-2.26; 53 exposed cases), sulfonamides (adjusted OR 2.01, 95% CI 1.36-2.97; 30 exposed cases), tetracyclines (adjusted OR 2.59, 95% CI 1.97-3.41; 67 exposed cases) and quinolones (adjusted OR 2.72, 95% CI 2.27-3.27; 160 exposed cases) was associated with an increased risk of spontaneous abortion. Similar results were found when we used penicillins or cephalosporins as the comparator group.
interpretationAfter adjustment for potential confounders, use of macro-lides (excluding erythromycin), quinolones, tetracyclines, sulfonamides and metronidazole during early pregnancy was associated with an increased risk of spontaneous abortion. Our findings may be of use to policy-makers to update guidelines for the treatment of infections during pregnancy.
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