ArticleBJOG : an international journal of obstetrics and gynaecology2026
Exposure to Systemic Antimicrobials During Pregnancy and Risk of Miscarriage: A Population-Based Registry Study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Exposure to Systemic Antimicrobials During Pregnancy and Risk of Miscarriage: A Population-Based Registry Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Article
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Authors and funding
4 authors.
Funding
Abstract
objectiveTo estimate miscarriage risk following gestational antimicrobial exposure while addressing biases that have affected previous studies.
designPopulation-based cohort study.
settingLinkage of four nationwide registries: Medical Birth Registry of Norway (MBRN), Norwegian Prescribed Drug Registry (NorPD), Norwegian Patient Registry (NPR) and Norwegian Control and Payment of Health Reimbursements Database (KUHR). POPULATION OR SAMPLE: A total of 704 082 pregnancies (2009-2018), with 91 836 (13.0%) exposed to systemic antimicrobials in early pregnancy.
methodsTime-stratified Cox regression models with overlap weights were used, considering time-varying exposures and a 14-day lag to prevent reverse causation. Elective terminations were right-censored to address competing risks, with adjustment for common infections and probabilistic bias analysis for confounding by indication.
main outcome measuresMiscarriage and gestational age at miscarriage, captured from NPR, KUHR and MBRN, using the UiO pregnancy algorithm.
resultsNitrofurantoin, pivmecillinam and amoxicillin were not associated with increased miscarriage risk. Metronidazole (HR = 2.00; 95% CI: 1.82-2.21), ciprofloxacin (HR = 1.89; 95% CI: 1.62-2.20), cephalexin (HR = 1.87; 95% CI: 1.57-2.22), fluconazole (HR = 1.61; 95% CI: 1.45-1.78), trimethoprim-sulfas (HR = 1.49; 95% CI: 1.36-1.63) and others showed associations with miscarriage. Probabilistic bias analysis indicated that associations for common antimicrobials may be driven by the underlying infections.
conclusionsNitrofurantoin, pivmecillinam and amoxicillin did not increase miscarriage risk, but other less commonly used antimicrobials may carry higher risks. By addressing key biases, this study provided a more reliable assessment of miscarriage risks associated with antimicrobial use in early pregnancy.
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