Common antibiotics linked to increased risk of birth defects: Study

WION Web Team New Delhi, India Feb 20, 2020, 12.11 PM(IST)

The official from the United Nations' food agency issued the warning on the sidelines of an international meeting in Bangkok focused on antimicrobial resistance (AMR). Photograph:( Zee News Network )

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An increased risk of birth defects in the children of women who were prescribed macrolides during the first three months of pregnancy compared to mothers who were prescribed penicillin.

Consumption of some common antibiotics during the first trimester of pregnancy has been linked with higher risks of birth defects, according to a new study.

The study was published in the medical British Medical Journal on Wednesday.

Also read: World's rivers loaded with antibiotics waste

An increased risk of birth defects was found in children of women who were prescribed macrolides during the first three months of pregnancy compared to mothers who were prescribed penicillin.

Macrolide antibiotics include erythromycin, clarithromycin and azithromycin are used to treat infections, such as pneumonia, bronchitis and urinary, skin and sexually transmitted diseases. It is often prescribed for patients who are allergic to penicillin.

Also read: In India, 64% of antibiotics unapproved: British Journal

The study cohort included 1,04,605 children born from 1990 to 2016 whose mothers were prescribed one macrolide monotherapy or one penicillin monotherapy from the fourth gestational week to delivery.

It assessed the association between macrolide antibiotics prescribing during pregnancy and major malformations, cerebral palsy, epilepsy, attention deficit hyperactivity disorder, and autism spectrum disorder in children.

Also read: Southeast Asia a 'hotspot' for antibiotic abuse, says Food and Agriculture Organization official

The researchers observed that major malformations were recorded in 186 of 8632 children whose mothers were prescribed macrolides and 1666 of 95 973 children whose mothers were prescribed penicillins during pregnancy. 

Macrolide prescribing in any trimester was associated with an increased risk of genital malformations. Erythromycin in the first trimester was associated with an increased risk of any major malformation.

Prescribing macrolide antibiotics during the first trimester of pregnancy was associated with an increased risk of major malformation and specifically cardiovascular malformations compared with penicillin antibiotics. 

Macrolide prescribing in any trimester was associated with an increased risk of genital malformations. 

The findings show that macrolides should be used with caution during pregnancy and if feasible alternative antibiotics should be prescribed until further research is available.

Interestingly, India leads in increasing antibiotic consumption. 

According to Proceedings of the National Academy of Sciences of the United States, India’s antibiotics consumption increased by 103 per cent from 2000 to 2015, the highest in low and middle-income countries.