Macrolide and lincosamide antibiotic exposure in the first trimester of pregnancy and risk of congenital anomaly: A European case-control study
Por:
Leke, A, Dolk, H, Loane, M, Casson, K, Nelen, V, Barisic, I, Garne, E, Rissman, A, O'Mahony, M, Neville, A, Pierini, A, Bergman, J, Klungsoyr, K, Materna-Kiryluk, A, Bielenska, A, Carbonell, C, Addor, M and Tucker, D
Publicada:
1 mar 2021
Ahead of Print:
1 ene 2021
Categoría:
Toxicology
Resumen:
This study investigated the risk of congenital heart defects (CHD) and other congenital anomalies (CA) associated with first trimester use of macrolide antibiotics (mainly erythromycin, spiramycin, clarithromycin and azithromycin) and lincosamides (clindamycin) using a case-malformed control design.
Data included 145,936 babies with a CA diagnosis (livebirths, stillbirths and terminations of pregnancy for CA) from 15 population-based EUROCAT registries in 13 European countries, covering 9 million births 1995-2012. Cases were babies with CHD, anencephaly, orofacial clefts, genital and limb reduction anomalies associated with antibiotic exposure in the literature. Controls were babies with other CA or genetic conditions. Main outcomes were odds ratios adjusted (AOR) for maternal age and registry, with 95 % Confidence Intervals (95 %CI).
Macrolide and lincosamide exposure was recorded for 307 and 28 cases, 72 and 4 non-genetic controls, 57 and 7 genetic controls, respectively. AOR for CHD was not significantly raised (AOR 0.94, 95 %CI: 0.70-1.26 vs non genetic controls; AOR 1.01, 95 %CI: 0.73-1.41 vs genetic controls), nor significantly raised for any specific macrolide. The risk of atrioventricular septal defect was significantly raised with exposure to any macrolide (AOR 2.98; 95 %CI: 1.48-6.01), erythromycin (AOR 3.68, 95 %CI: 1.28-10.61), and azithromycin (AOR 4.50, 95 %CI: 1.30-15.58). Erythromycin, clarithromycin, azithromycin, and clindamycin were associated with an increased risk of at least one other CA. Further research is needed on the risk of specific CA associated with macrolide and lincosamide use in the first trimester, particularly relevant for the potential use of azithromycin in the treatment of COVID-19.
Filiaciones:
Leke, A:
Ulster Univ, Ctr Maternal Fetal & Infant Res, Inst Nursing & Hlth Res, Shore Rd, Newtownabbey BT37 0QB, Antrim, North Ireland
Dolk, H:
Ulster Univ, Ctr Maternal Fetal & Infant Res, Inst Nursing & Hlth Res, Shore Rd, Newtownabbey BT37 0QB, Antrim, North Ireland
Loane, M:
Ulster Univ, Ctr Maternal Fetal & Infant Res, Inst Nursing & Hlth Res, Shore Rd, Newtownabbey BT37 0QB, Antrim, North Ireland
Casson, K:
Ulster Univ, Ctr Maternal Fetal & Infant Res, Inst Nursing & Hlth Res, Shore Rd, Newtownabbey BT37 0QB, Antrim, North Ireland
Nelen, V:
Provinciaal Inst Hyg, Antwerp, Belgium
Barisic, I:
Univ Zagreb, Childrens Hosp Zagreb, Ctr Excellence Reprod & Regenerat Med, Med Sch, Zagreb, Croatia
Garne, E:
Lillebaelt Skovvangen, Paediat Dept Hosp, Kolding, Denmark
Rissman, A:
Otto von Guericke Univ, Malformat Monitoring Ctr Saxony Anhalt, Med Fac, Magdeburg, Germany
O'Mahony, M:
St Finbarrs Hosp, Med Dept Publ Hlth, Douglas Rd, Cork, Ireland
Neville, A:
Univ Ferrara, Ctr Clin & Epidemiol Res, Emila Romagna Registry Birth Defect, IMER Registry,Azienda Osped Univ Ferrara, Ferrara, Italy
Pierini, A:
Fdn Toscana Gabriele Monasterio, Tuscany Registry Congenital Defects, CNR Inst Clin Physiol, Pisa, Italy
Bergman, J:
Univ Groningen, Univ Med Ctr Groningen, Dept Med Genet, Groningen, Netherlands
Klungsoyr, K:
Med Birth Registry Norway, Bergen, Norway
Materna-Kiryluk, A:
Poznan Univ Med Sci, Dept Med Genet, Polish Registry Congenital Malformat, Poznan, Poland
Bielenska, A:
Poznan Univ Med Sci, Dept Med Genet, 8 Rokietnicka St, PL-60806 Poznan, Poland
:
Fdn Promot Hlth & Biomed Res Valencian Reg, Rare Dis Res Unit, Valencia, Spain
Addor, M:
Registre Vaudois Malformat EUROCAT, Dept Woman Mother Child, Lausanne, Switzerland
Tucker, D:
Singleton Hosp, Congenital Anomaly Register & Informat Serv, Level 3 West Wing,Sketty Lane, Swansea, W Glam, Wales
Green Submitted, Green Published
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