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Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides

Henrik Toft Sørensen1, Mette Vinther Skriver, Lars Pedersen

  • 1Department of Clinical Epidemiology, Aarhus University Hospital and Aalborg Hospital, Aarhus, Denmark. hts@soci.au.dk

Scandinavian Journal of Infectious Diseases
|April 16, 2003
PubMed

Insights

Macrolide antibiotics transmitted via breast milk may increase the risk of infantile hypertrophic pyloric stenosis in newborns. This finding highlights potential risks associated with breastfeeding after maternal macrolide exposure.

Area of Science:

  • Neonatal health
  • Pharmacology
  • Pediatric gastroenterology

Background:

  • A previous case report suggested a link between erythromycin in breast milk and infantile hypertrophic pyloric stenosis (IHPS).
  • Macrolide antibiotics are commonly prescribed and can be transmitted to infants through breast milk.

Purpose of the Study:

  • To investigate the association between maternal macrolide use during breastfeeding and the risk of infantile hypertrophic pyloric stenosis (IHPS) in neonates.

Main Methods:

  • A population-based cohort study utilizing Danish prescription, birth, and hospital discharge registries.
  • Included 1166 women prescribed macrolides from birth to 90 days postpartum and 34,690-41,778 control women.
  • Analyzed odds ratios for IHPS based on postnatal macrolide exposure, stratified by infant gender.

Main Results:

  • Macrolide use during breastfeeding was associated with an increased risk of IHPS.
  • Odds ratios ranged from 2.3 to 3.0 for different postnatal exposure periods.
  • Gender-specific analysis showed a significantly higher risk in girls (OR 10.3) compared to boys (OR 2.0).

Conclusions:

  • Maternal macrolide use while breastfeeding elevates the risk of infantile hypertrophic pyloric stenosis in neonates.
  • The association appears stronger in female infants.
  • This study underscores the importance of considering antibiotic exposure risks during breastfeeding.

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