Antibiotic use during pregnancy: how bad is it?

Area of Science:

• Microbiome research
• Maternal-fetal medicine
• Antibiotic stewardship

Background:

• The human microbiome is vital for health, with alterations (dysbiosis) linked to disease.
• Pregnancy involves significant microbiome changes essential for maternal and child health.
• Current clinical practice often overlooks microbiome implications in pregnancy antibiotic use.

Discussion:

• Antibiotics are frequently prescribed during pregnancy, despite potential negative impacts on microbial communities.
• Antibiotic treatment can cause persistent perturbations in the maternal and fetoplacental microbiomes.
• Use of antibiotics in pregnancy should be limited to necessary cases, employing narrow-spectrum agents.

Key Insights:

• Pregnancy-associated microbiome shifts are critical for immune and metabolic development.
• Antibiotics administered during pregnancy may have unintended consequences for the developing microbiome.
• Evidence suggests microbial ecosystems may not fully recover post-antibiotic treatment.

Outlook:

• Future clinical interest will likely focus on microbiome modulation during pregnancy.
• Probiotics and fecal microbiota transplantation are emerging as potential therapeutic strategies.
• Further research is needed to optimize antibiotic use and explore microbiome-based interventions in pregnancy.