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Antibiotics You Should Avoid While Pregnant

Photograph by Twenty20

Being sick while pregnant is literally the WORST. Aside from already being tired, possibly cranky from the hormone overload and uncomfortable, you also can't take some of the typical over-the-counter or prescription remedies you would while not pregnant because they could affect your baby. But is it really that big of a deal?

Yes. As it turns out, there's a link between certain antibiotics taken during pregnancy and major congenital malformations (MCM)—aka birth defects—which is why your doctor is likely to take much more care in which medicine to prescribe when you're sick and pregnant.

A recent study published by the British Journal of Clinical Pharmacology looked at the link between fetal exposure to antibiotics and the risk of major birth defects. Canadian researchers followed nearly 140,000 mothers who had babies born in Quebec between 1998 and 2008. They assessed moms' use of antibiotics during the first trimester and then identified birth defects for the newborns throughout their first year of life.

Once other variables that could increase the risks for birth defects were adjusted for, researchers found that organ-specific defects were linked to exposure to clindamycin (prescribed for skin and vaginal infections), doxycycline (used to treat acne, urinary tract, intestinal and eye infections, and other types of bacterial infections), quinolones (broad-spectrum antibiotics such as Cipro and Levaquin), macrolides (erythromycin and azythromycin—the infamous Z-Pack that you've used to cure a sinus infection—to name a few) and phenoxymethylpenicillin (sometimes called penicillin V, and used to treat strep, ear infections and cellulitis) during gestation.

For example, doxycycline use during pregnancy can increase the risk of baby's circulatory system malformation, cardiac malformations, ventricular defects (a hole between the heart's two lower chambers) and atrial septal defects (a hole between the two upper chambers).

Other birth defects were associated with quinolone, moxifloxacin, ofloxacin, macrolides, erythromycin and phenoxymethylpenicillin.

The good news? There was no link to birth defects associated with amoxicillin, cephalosporins (a broad-spectrum antibiotic class) and nitrofurantoin (used to treat UTIs).

The takeaway from the study is not that antibiotics shouldn’t be used to treat infections during pregnancy, but that some antibiotics are safer than others and that should definitely be taken into consideration when prescribing to expectant mothers. If you have an infection, it can't just go untreated.

"Infections during pregnancy are frequent and should be treated; however, our study highlights safer options for the treatment of infections, more specifically urinary tract infections or pulmonary infections, at least during the first trimester of pregnancy," said the study's senior author, Dr. Anick Bérard.

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