Related Experiment Video
Updated: May 11, 2026
08:50
A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
Published on: June 24, 2020
Fetal safety of macrolides
Anat Bahat Dinur1, Gideon Koren, Ilan Matok
1Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Antimicrobial Agents and Chemotherapy
|May 8, 2013
Summary
Macrolide antibiotic use during pregnancy showed no increased risk for major fetal malformations in the first trimester. Third-trimester exposure also did not significantly increase risks for infant conditions like pyloric stenosis.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Pediatrics
Background:
- Macrolide antibiotics are frequently prescribed during pregnancy for bacterial infections.
- Previous studies on macrolide fetal safety have yielded conflicting results, with some suggesting associations with cardiovascular malformations, pyloric stenosis, and intussusception.
- Concerns over potential risks have led to cautious prescribing of macrolides in some regions.
Purpose of the Study:
- To investigate the fetal safety of macrolide antibiotics.
- To determine if first-trimester exposure is associated with major malformations.
- To assess third-trimester exposure risks for neonatal conditions like pyloric stenosis and intussusception.
Main Methods:
- A large administrative database of drug dispensing and pregnancy outcomes in Southern Israel was utilized.
- Data from 1999-2009 linked medication dispensing records with maternal and infant hospitalization records, including medical pregnancy terminations.
- Confounding factors such as maternal age, ethnicity, diabetes, parity, and year of birth/termination were controlled for.
Main Results:
- First-trimester macrolide exposure (n=1,033) was not associated with an increased risk of major malformations (OR, 1.08; 95% CI, 0.84-1.38).
- Third-trimester macrolide exposure (n=959) showed no association with perinatal mortality, low birth weight, low Apgar score, or preterm delivery.
- No significant associations were found between third-trimester macrolide exposure and the development of pyloric stenosis or intussusception in infants.
Conclusions:
- Macrolide antibiotic use in the first trimester of pregnancy does not appear to increase the risk of major fetal malformations.
- Third-trimester macrolide exposure is unlikely to pose a clinically significant increased risk for neonatal conditions such as pyloric stenosis or intussusception.
- The findings support the safety of macrolide antibiotics during pregnancy when indicated for bacterial infections.
Related Concept Videos
01:07Teratogenicity
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
01:23Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by anesthetizing...
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by anesthetizing...
01:25Mechanism of Antibiotic Resistance in MRSA
Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...