Use of Common UTI Antibiotic in First-Trimester linked to Birth Defects: JAMA
Researchers have found in a new study involving over 70,000 pregnancies in the U.S. that using trimethoprim-sulfamethoxazole (TMP-SMX) during the first trimester is associated with a higher risk of congenital malformations. The malformations include especially cardiac defects and cleft lip/palate, compared to beta-lactam antibiotics. In contrast, nitrofurantoin, another commonly used UTI antibiotic, showed no increased risk of birth defects. The study has been published in JAMA Network Open by Sarah S. and colleagues.
The research used data from the Merative MarketScan Commercial Database for the 2006-2022 period. It comprised 71,604 pregnant women aged 15-49 years who were commercially insured and treated for UTI in the first trimester. The participants were matched with their liveborn offspring, and congenital malformations were monitored through diagnosis codes up to 365 days post-delivery. The analysis was done by comparing results across participants exposed to the four primary groups of antibiotics: nitrofurantoin (59.2%), TMP-SMX (4.9%), fluoroquinolones (5.1%), and β-lactams (30.8%). Risk ratios (RRs) and risk differences for overall and certain malformations were estimated using log-binomial regression models, with propensity score weights.
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