Maternal antibiotic exposure and fetal outcomes: is there evidence for teratogenicity?

Aim: During pregnancy, untreated infections may be associated with low birth weight, preterm birth, and spontaneous abortion. Thus, use of antibiotics are commonly seen in pregnancy. In this study, we aimed to evaluate the possible teratogenic risks related to the maternally exposed antibiotics during pregnancy. Material and Methods: Data from pregnant women, who used antibiotics for several infectious diseases between 2014 and 2018, and admitted to our Teratology Information Service for drug analysis, were collected. Data concerning their medication, concomitant drugs and co-morbidities were documented. The possible teratogenic risks related to the drugs were evaluated. A follow-up was conducted with the women after delivery to obtain whether any major or minor congenital malformations occurred in the infants.Results: The maternal use of doxycycline between 3-6th weeks, and acyclovir between 1-2nd weeks of pregnancy resulted in elective termination. The maternal use of cefazoline between 3-4th weeks of pregnancy, and the use of amoxicillin-clavulanate between 3-6th weeks of gestation resulted in spontaneous abortion. In the outcome of one pregnancy, the concomitant exposure of miconazole, metronidazole, ciprofloxacin, ornidazole and isoconazole in the first two weeks of pregnancy resulted in hypothyroidism in the infant. Conclusions: Antibiotics presented no major teratogenic effects. However, their use in pregnancy should be used only when indicated. Pregnant women should have access to the information and specific advice on the use of medications with proven safety in pregnancy through counseling with the Teratology Information Services.