A new study suggests a particular type of antibiotics prescribed to women during the first trimester of pregnancy could increase the risk of major birth defects.

Macrolide antibiotics are prescribed for use against a variety of serious infections including methicillin-resistant Staphylococcus aureus (MRSA), Chlamydia, and Legionella.  You might know these antibiotics better by names that include azithromycin (Zithromax) and erythromycin.

A study from the University College London (UCL) published in the BMJ explored the use of macrolide antibiotics and the occurrence of conditions including cerebral palsy, epilepsy, and autism spectrum disorders. Compared to the use of other antibiotics, macrolides were found to increase the risk of birth defects.

What was the research about?

This large study evaluated data from the Clinical Practice Research Datalink (CPRD).  Data included information on 104,605 children who were born between 1990 and 2016 of moms who were prescribed one of the macrolide antibiotics between the fourth week of pregnancy through delivery.  Two control groups involved 82,314 children whose mothers were prescribed penicillin or macrolide therapy before conception, and another 53,735 children who were siblings of research cohort.

Study authors assessed what they termed “major malformations” involving the heart or genitals along with four neurodevelopmental disorders.  Lead author at UCL, Heng Fan, said “this work builds on previous evidence of rare but serious adverse outcomes of macrolide use, especially for unborn babies.”

Findings of the study include:

  • Unborn children of women prescribed macrolides during the first three months of pregnancy were at increased risk for major malformations, especially cardiovascular problems.
  • There were higher rates of genital malformations in babies exposed to macrolides than those whose mothers were treated with penicillins.
  • The number of children diagnosed with the malformations was significantly higher than those whose mothers were prescribed only penicillins.

This important information can guide healthcare providers in their advice and treatment of newly pregnant women.  Study author Ruth Gilbert notes, “Our findings suggest it would be better to avoid macrolides during pregnancy if alternative antibiotics can be used.”  With that, Dr. Gilbert also noted the importance of sound medical treatment during pregnancy and the real risk to unborn children if infections are left untreated.

If pregnant, speak with your physician about the risks and benefits of different types of antibiotic treatments if needed during your pregnancy.  If you suffered substandard medical care and you or your baby was injured, speak with our experienced injury attorney.

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