Evidence map›Paper›PMID 40844697›Full record

ArticleInfection2025

Doxycycline safety during pregnancy: a large population-based cohort of pregnancies.

Itamar Ben Shitrit, Daphna Idan, Ariel Avraham Hasidim, Tal Michael, Amalia Levy, Gali Pariente, Eitan Lunenfeld, Sharon Daniel

Erratum issuedAbstract read
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In one paragraph

Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Itamar Ben Shitrit *Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 8410501, Israel.
Daphna Idan *Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 8410501, Israel.
Ariel Avraham HasidimDepartment of Pediatrics A, Schneider Children's Medical Center of Israel, Petah Tikva, 94903, Israel.
Tal MichaelDepartment of Epidemiology, Biostatistics, and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben- Gurion University of the Negev, Beer-Sheva, Israel.
Amalia LevyDepartment of Epidemiology, Biostatistics, and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben- Gurion University of the Negev, Beer-Sheva, Israel.
Gali ParienteDepartment of Obstetrics and Gynecology, Faculty of Health Sciences, Ben-Gurion University of the Negev and Soroka University Medical Center, Beer-Sheva, Israel.
Eitan LunenfeldAdelson School of Medicine, Ariel University, Ariel, Israel.
Sharon DanielDepartment of Epidemiology, Biostatistics, and Community Health Sciences, School of Public Health, Faculty of Health Sciences, Ben- Gurion University of the Negev, Beer-Sheva, Israel. daniels07@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDoxycycline is frequently prescribed during pregnancy, yet evidence on fetal safety is inconsistent and often excludes non-live births. We assessed whether exposure during the first or third trimester is associated with major congenital malformations or late-pregnancy adverse outcomes in a population-based cohort that also included stillbirths and terminations.

methodsUsing data from Clalit Health Services Southern district, we identified 265,686 pregnancies in women aged 15-45 years (from 1998 to 2017). Pharmacy records classified doxycycline dispensation in the first trimester (≤ 13 weeks) or third trimester (≥ 27 weeks). Crude and adjusted negative-binomial models estimated relative risks (RRs) for total and organ-specific major congenital malformations diagnosed up to age 1 year and for perinatal mortality, preterm birth, low/very-low birthweight, and low Apgar scores. Sensitivity analyses explored dose-response relations and propensity-score-matched cohorts.

resultsAmong 2,696 first-trimester exposures, major malformations occurred in 7.7% versus 7.0% of 262,990 unexposed pregnancies (SMD = 0.03, p = 0.17). No association with major malformations was observed in both crude (Crude Relative Risk (RR) = 1.10; 95% CI 0.96-1.27) and adjusted (Adjusted RR = 1.07; 95% CI 0.93-1.23) analyses, nor by organ-specific sub-groups. Third-trimester exposure (n = 112) was linked to a higher risk of very-low birthweight, while other late-pregnancy outcomes were comparable to unexposed pregnancies.

conclusionFirst-trimester doxycycline use was not associated with increased major congenital malformation risk, and most late-pregnancy outcomes were unaffected. These findings support the relative safety of doxycycline when clinically indicated during pregnancy.

Indexed as

Anti-Bacterial AgentsDoxycyclineAdolescentAdultCohort StudiesFemaleHumansInfant, NewbornMiddle AgedPregnancyPregnancy OutcomePregnancy Trimester, FirstYoung AdultAnti-Bacterial AgentsDoxycyclineCongenital malformationsDoxycyclineFetal safetyFirst trimester infectionPrenatal drug exposureThird trimester infection

Identifiers

PMID40844697
PMCPMC12675617

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Registered trials

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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.