TY  - JOUR
T1  - Antibacterial medication use during pregnancy and risk of birth defects: National birth defects prevention study
AU  - Crider KS, Cleves MA, Reefhuis J, Berry RJ, Hobbs CA, Hu DJ
Y1  - 2009/11/01
N1  - 10.1001/archpediatrics.2009.188
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 978
EP  - 985
VL  - 163
IS  - 11
N2  - Objective 
    To estimate the association between antibacterial medications and selected birth defects.Design, Setting, and Participants 
    Population-based, multisite, case-control study of women who had pregnancies affected by 1 of more than 30 eligible major birth defects identified via birth defect surveillance programs in 10 states (n = 13 155) and control women randomly selected from the same geographical regions (n = 4941).Main Exposure 
    Reported maternal use of antibacterials (1 month before pregnancy through the end of the first trimester).Main Outcome Measure 
    Odds ratios (ORs) measuring the association between antibacterial use and selected birth defects adjusted for potential confounders.Results 
    The reported use of antibacterials increased during pregnancy, peaking during the third month. Sulfonamides were associated with anencephaly (adjusted OR [AOR] = 3.4; 95% confidence interval [CI], 1.3-8.8), hypoplastic left heart syndrome (AOR = 3.2; 95% CI, 1.3-7.6), coarctation of the aorta (AOR = 2.7; 95% CI, 1.3-5.6), choanal atresia (AOR = 8.0; 95% CI, 2.7-23.5), transverse limb deficiency (AOR = 2.5; 95% CI, 1.0-5.9), and diaphragmatic hernia (AOR = 2.4; 95% CI, 1.1-5.4). Nitrofurantoins were associated with anophthalmia or microphthalmos (AOR = 3.7; 95% CI, 1.1-12.2), hypoplastic left heart syndrome (AOR = 4.2; 95% CI, 1.9-9.1), atrial septal defects (AOR = 1.9; 95% CI, 1.1-3.4), and cleft lip with cleft palate (AOR = 2.1; 95% CI, 1.2-3.9). Other antibacterial agents that showed associations included erythromycins (2 defects), penicillins (1 defect), cephalosporins (1 defect), and quinolones (1 defect).Conclusions 
    Reassuringly, penicillins, erythromycins, and cephalosporins, although used commonly by pregnant women, were not associated with many birth defects. Sulfonamides and nitrofurantoins were associated with several birth defects, indicating a need for additional scrutiny.
SN  - 1072-4710
M3  - doi: 10.1001/archpediatrics.2009.188
UR  - http://dx.doi.org/10.1001/archpediatrics.2009.188
ER  -