ArticleBMJ (Clinical research ed.)2020
Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: population based cohort study.
Article in BMJ (Clinical research ed.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03948620 (Associations Between Macrolide Antibiotics Prescribed During Pregnancy and Adverse Child Outcomes), which is not on this map. Cited by 39 papers, 6 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.
Associations Between Macrolide Antibiotics Prescribed During Pregnancy and Adverse Child Outcomes
Who cites it
39 citing papers in PubMed, 6 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- The Association between Prenatal Antibiotic Use and the Risk of Autism Spectrum Disorders among Children: An Updated Meta-Analysis.Current pediatric reviews · 2026Pooled it
- Does early pregnancy exposure to macrolide antibiotics lead to major birth defects? A systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- 2023 Korean sexually transmitted infections guidelines for non-gonococcal bacterial infection (chlamydia, syphilis, etc.) by the Korean Association of Urogenital Tract Infection and Inflammation.Investigative and clinical urology · 2024Guideline
- Prenatal exposure to antibiotics and risk of neurodevelopmental disorders in offspring: A systematic review and meta-analysis.Frontiers in neurology · 2022Pooled it
- Antibiotic exposure and childhood attention-deficit/hyperactivity disorder: systematic review and meta-analysis.Psychopharmacology · 2021Pooled it
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- Trial
- Agent, Dose and Duration: The Unanswered Questions Behind Latency Antibiotic Therapy for Preterm Prelabour Rupture of Membranes.Antibiotics (Basel, Switzerland) · 2026Review
- Prenatal Azithromycin Exposure and Risk of Neurodevelopmental Disorders in Children.JAMA network open · 2026Article
- Explainable machine learning model for identifying key risk factors in congenital heart disease prediction using questionnaire data: a retrospective case-control study.BMC medical informatics and decision making · 2026Article
- The Impact of Chlamydia Treatment During Pregnancy on Birth Defects in New York State.Birth defects research · 2026Article
- Real-world antibiotic utilization during pregnancy in Italy: a multiregional retrospective population-based study.BMC pregnancy and childbirth · 2025Article
- A review of antibiotic safety in pregnancy-2025 update.Pharmacotherapy · 2025Review
- First-trimester exposure to macrolides and risk of major congenital malformations compared with amoxicillin: A French nationwide cohort study.PLoS medicine · 2025Article
- Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Advancing the safe motherhood initiative: A qualitative and sentiment analysis of local physician's perspectives on antibiotic self-medication during pregnancy in a low- and middle-income country.PLOS global public health · 2025Article
- Scrub typhus in pregnancy: A 10-year multicenter study in resource-limited settings in China.PLoS neglected tropical diseases · 2025Article
- Quinolone Use during the First Trimester of Pregnancy and the Risk of Atopic Dermatitis, Asthma, and Allergies of Offspring during 2011 to 2020.Infection & chemotherapy · 2024Article
- Prenatal Environmental Antibiotic Exposure and Autism Spectrum Disorder Symptoms in Children at 3 Years of Age: Findings from the Ma'anshan Birth Cohort Study.Environment & health (Washington, D.C.) · 2024Article
- PeRinatal, neOnatal, and Maternal OuTcomEs with azithromycin prophylaxis in pregnancy and labour (PROMOTE-PROPHYLAXIS): systematic review and meta-analysis.EClinicalMedicine · 2024Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo assess the association between macrolide antibiotics prescribing during pregnancy and major malformations, cerebral palsy, epilepsy, attention deficit hyperactivity disorder, and autism spectrum disorder in children.
designPopulation based cohort study.
settingThe UK Clinical Practice Research Datalink.
participantsThe study cohort included 104 605 children born from 1990 to 2016 whose mothers were prescribed one macrolide monotherapy (erythromycin, clarithromycin, or azithromycin) or one penicillin monotherapy from the fourth gestational week to delivery. Two negative control cohorts consisted of 82 314 children whose mothers were prescribed macrolides or penicillins before conception, and 53 735 children who were siblings of the children in the study cohort.
main outcome measuresRisks of any major malformations and system specific major malformations (nervous, cardiovascular, gastrointestinal, genital, and urinary) after macrolide or penicillin prescribing during the first trimester (four to 13 gestational weeks), second to third trimester (14 gestational weeks to birth), or any trimester of pregnancy. Additionally, risks of cerebral palsy, epilepsy, attention deficit hyperactivity disorder, and autism spectrum disorder.
resultsMajor malformations were recorded in 186 of 8632 children (21.55 per 1000) whose mothers were prescribed macrolides and 1666 of 95 973 children (17.36 per 1000) whose mothers were prescribed penicillins during pregnancy. Macrolide prescribing during the first trimester was associated with an increased risk of any major malformation compared with penicillin (27.65
conclusionsPrescribing macrolide antibiotics during the first trimester of pregnancy was associated with an increased risk of any major malformation and specifically cardiovascular malformations compared with penicillin antibiotics. Macrolide prescribing in any trimester was associated with an increased risk of genital malformations. These findings show that macrolides should be used with caution during pregnancy and if feasible alternative antibiotics should be prescribed until further research is available.
trial registrationClinicalTrials.gov NCT03948620.
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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.