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Seguridad de la doxiciclina durante el embarazo: una gran cohorte de embarazos basada en la población
Itamar Ben Shitrit1,2, Daphna Idan1,2, Ariel Avraham Hassidim3,4
1Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 8410501, Israel.
Infection
|August 22, 2025
Resumen
El uso de doxiciclina en el primer trimestre de embarazo no está relacionado con defectos congénitos graves. Si bien la exposición en el tercer trimestre mostró un mayor riesgo de peso al nacer muy bajo, la seguridad fetal en general parece favorable cuando la doxiciclina es médicamente necesaria.
Área de la Ciencia:
- Obstetricia y ginecología
- Farmacología
- Medicina fetal
Sus antecedentes:
- La doxiciclina se prescribe comúnmente durante el embarazo, pero sus datos de seguridad fetal son inconsistentes.
- Los estudios existentes a menudo excluyen los nacimientos no vivos, lo que limita las evaluaciones integrales de seguridad.
Objetivo del estudio:
- Evaluar la asociación entre la exposición a la doxiciclina en el primer o tercer trimestre y las malformaciones congénitas importantes.
- Evaluar el vínculo entre la exposición a la doxiciclina y los resultados adversos del embarazo tardío, incluidos los partos muertos y las interrupciones.
Principales métodos:
- Un estudio de cohorte basado en la población de 265,686 embarazos de 1998-2017.
- La exposición a la doxiciclina se identificó a través de registros farmacéuticos para el primer (≤13 semanas) y tercer (≥27 semanas) trimestres.
- Los modelos binomiales negativos estimaron los riesgos relativos de malformaciones y resultados perinatales; los análisis de sensibilidad incluyeron la correspondencia dosis-respuesta y propensión-puntuación.
Principales resultados:
- La exposición a la doxiciclina en el primer trimestre (n=2, 696) no mostró una asociación significativa con malformaciones congénitas importantes (RR ajustado=1, 07; IC del 95% 0, 93-1, 23).
- No se observó un aumento del riesgo de malformaciones específicas de órganos o de la mayoría de los resultados del embarazo tardío.
- La exposición en el tercer trimestre (n=112) se asoció con un mayor riesgo de peso al nacer muy bajo.
Conclusiones:
- El uso de doxiciclina durante el primer trimestre de embarazo no está asociado con un mayor riesgo de malformaciones congénitas importantes.
- La exposición a la doxiciclina no afectó a la mayoría de los resultados adversos a finales del embarazo.
- Estos hallazgos sugieren que la doxiciclina puede considerarse relativamente segura cuando está clínicamente indicada durante el embarazo.
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