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ACHRI, CDC Research in Archives of Pediatric and Adolescent Medicine Ties Certain Antibiotics to Increased Risk of Birth Defects

Publication Date: Friday, November 20, 2009

LITTLE ROCK, AR. (Nov. 20, 2009) – Research by scientists at the Arkansas Children’s Hospital Research Institute (ACHRI) and the Centers for Disease Control and Prevention (CDC) has shown that the use of most antibiotics during pregnancy does not increase a mother’s risk of delivering an infant with birth defects, though there are exceptions. Their work is published this month in Archives of Pediatric and Adolescent Medicine.

The researchers studied data on more than 18,000 infants born between 1997 and 2003 to find whether there was a relationship between birth defects and a mother’s use of antibacterial medications early in her pregnancy. While they found that common classes of antibiotics like penicillins, erythromycins and cephalosporins were associated with relatively few birth defects, other types of antibiotics were linked to an increased risk.

Sulfonamides were associated with a higher chance of defects among the heart, limbs, nervous system and diaphragm, while nitrofurantoins were tied to problems with the infants’ eyes, hearts, lips and palates. In their manuscript, the researchers recommend the need for further research to confirm these findings, though previous studies have supported the sulfonamides conclusion.

“Ultimately, the data show that it’s essential for pregnant women to consult with their physician for appropriate treatment of bacterial infections,” said Charlotte Hobbs, MD, PhD, director of the Arkansas Center for Birth Defects Research and Prevention at ACHRI and one of the study’s authors. She also is a professor in the Department of Pediatrics at the University of Arkansas for Medical Sciences (UAMS) College of Medicine and section chief of Birth Defects Research.“We also know that as new evidence becomes available from scientific studies, new guidelines and standards of care may be developed that require physicians to modify current prescribing patterns.”

Physicians do need to prescribe antibiotics to treat bacterial infections in pregnant women, Hobbs said, and for some women with specific infections, sulfonamides and nitrofurantoins will continue to be the best choice of antibiotics.
“Findings from our study will need to be replicated and reviewed by professional associations such as the American College of Obstetrics and Gynecology who will decide whether changes in prescribing patterns are warranted,” Hobbs said.
Women have used the common antibiotics that demonstrated little risk during pregnancy for many years without adverse effect. But, as the ACHRI and CDC scientists indicate in Archives of Pediatric and Adolescent Medicine, the growing problem of antibacterial resistance worldwide has led to the use of newer antibiotics which have not been tested to gauge their safety if taken during pregnancy.

The scientists also found that antibiotic use during pregnancy isn’t unusual. Their data indicated that women’s use of antibiotics increased when they were pregnant, peaking during the third month after conception.

The research drew on extensive data from the National Birth Defects Prevention Study (NBDPS), which was funded by the CDC. This ongoing, population-based initiative is among the largest case-control studies ever conducted on the causes of birth defects.

Women in the antibiotics study took the medications examined between one month before conception and the third month of pregnancy. The study looked at the occurrences of 30 major birth defects tracked by the NBDPS in 10 states. It examined data on 13,000 women who had infants with birth defects and on 5,000 control cases.

The study’s lead author is Krista Crider, PhD, a geneticist with the National Center on Birth Defects and Developmental Disabilities, part of the U.S. Centers for Disease Control and Prevention.

Arkansas Children’s Hospital is the only pediatric medical center in Arkansas and one of the largest in the United States serving children from birth to age 21. The campus spans 28 city blocks and houses 316 beds, a staff of approximately 500 physicians, 80 residents in pediatrics and pediatric specialties and more than 4,000 employees. The private, nonprofit healthcare facility boasts an internationally renowned reputation for medical breakthroughs and intensive treatments, unique surgical procedures and forward-thinking medical research - all dedicated to fulfilling our mission of enhancing, sustaining and restoring children's health and development. ACH recently ranked No. 85 on FORTUNE 100 Best Companies to Work For®. For more information, visit www.archildrens.org.

ACHRI provides a research environment on the ACH campus to meet the needs of the UAMS faculty. Research scientists at ACHRI conduct clinical, basic science, and health services research for the purpose of treating illnesses, preventing disease and improving the health of children everywhere.

UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a new 540,000-square-foot hospital, six centers of excellence and a statewide network of regional centers. UAMS has 2,652 students and 733 medical residents. Its centers of excellence include the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Institute for Research and Therapy, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute and the Donald W. Reynolds Institute on Aging. It is the state’s largest public employer with more than 10,000 employees, including nearly 1,150 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. Visit www.uams.edu or www.uamshealth.com.

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