One of the most important phases of a woman’s life is during pregnancy, after all, it’s the time when she shows her capacity for propagating the human race! It’s also a time when she is accorded special care and attention. Not surprisingly treatment of women with azithromycin when pregnant also takes place and in this article we shall discuss how important this medication is to the health and safety of or both mother and baby during pregnancy and at birth.
Grouping of Antibiotic Drugs – Macrolides
Our journey begins with and introduction and knowledge of a group of antibiotics called macrolides that include an impressive list of six brands that comprise azithromycin, clarithromycin, erythromycin, spiramycin and telithromhycin. While they are named differently, the use of these antibiotics on women during early pregnancy have all proven positive.
This means that treatment of women by any one of these antibiotics during pregnancy is safe and should raise no alarm for causing birth defects or miscarriage.
Birth Defects
Medical experts say that the first 12 weeks is crucial for the proper formation of a baby’s body and internal organs in the womb. It’s also critical because at this point some medicines have been known to cause complications during births.
- A study of 4,000 babies showed that even though their mothers were given doses of azithromycin, clarithromycin and erythromycin, it didn’t show that more of their babies had birth defects than the babies of the mothers who weren’t given similar doses of the macrolides.
- Four of these studies showed also that no link existed between taking a macrolide antibiotic during pregnancy and the incident of a heart defect in a baby.
- Six studies involving 35,000 women who had taken macrolide treatment during early pregnancy showed no evidence to suggest any links between the treatment and birth defects in the baby generally.
- Five of these studies showed no links between the treatment and heart defects in the baby.
- Four studies involving 1,700 women who took azithromycin in early pregnancy showed no links between the dosages and birth defects in the baby in general.
- Three of these studies showed there was no links between the treatment and heart defects.
- Four studies that involved 1,600 women who took clarithromycin during early pregnancy showed no links between the dosages and birth defects in the baby generally speaking
- One of these studies found there was no evidence to show that clarithromycin, exposed in the womb, could cause defects in a baby’s limbs or external genitals.
Miscarriages
Given that the 12 weeks period is crucial for the proper formation of a baby’s body and internal organs and that some medicines actually caused birth defects in this area, other studies were carried out as shown below:
- Even though one single study found there was a possible link between miscarriage and the taking of macrolide during early pregnancy, three additional studies involving 700 pregnant women who took macrolides found the absence of such a link.
- Two studies involving 8,000 women taking azithromycin in early pregnancy had differing outcomes. One found there was no link between taking the drug and miscarriage and the other found there was a higher chance of women taking the medication of having a miscarriage but that the higher chance of having a miscarriage was because of more acute infections in the mothers.
In view of the above discrepancies and doubts from the second group of studies, more studies need to be carried out on the use of clarithromycin, azithromycin, spiramycin and telithromycin during early pregnancy before accurate conclusions can be drawn.
What about Stillbirths and Preterm Births?
A stillbirth has been defined as the birth of a dead fetus after about the 28th week of pregnancy. To answer this question reference is made to a minor study which has been carried out. This study showed there was no evidence to indicate that there was a link between taking clarithromycin during pregnancy and stillbirth.
Preterm births is similar to premature births which is more generally used. For this subject, three studies were done involving a total of 500 women who used macrolides during early pregnancy. All three studies couldn’t find a link between taking macrolides and premature births. More studies are needed.
What about low birth weight?
A total of four studies were done to determine if there was a link between taking macrolides and low birth weight of babies as shown below:
- The studies involved 600 women who took macrolides during pregnancy found no link between reduced birth weight in the baby and taking macrolides.
- One study done on azithromycin gave a similar finding but
- More research is needed specifically to the incidence of low birth weight (<2,500g) needed
- More research is also needed for information on the other macrolides.
What about learning or behavioral issues in the child?
The development of a baby’s brain is active right up to the time of birth. This means that the taking of certain medicines at any point during this period may have a lasting effect on the learning and behavioral patterns of the child.
Studies investigating the question of babies exposed to macrolides in the womb showing greater risk of learning and behavioral disorders as compared to children not exposed to antibiotics have produced different findings.
However, the studies were not focused on women taking antibiotics who went into labour at the right time but were studies on women taking antibiotics who went into premature labour and premature births have been linked with higher risks of learning and behavioral issues in children.
This suggests that study results have been caused by the prematurity of the baby or infections in the mother that may have caused premature labor instead of macrolide treatment. More research on the subject is needed.
Taking Medicines in Pregnancy and While Breastfeeding
Pregnancy
Most medicines taken by the mother will pass through the placenta and reach the baby sometimes benefiting or harming its normal growth. The stage of pregnancy and the medicine taken will determine how a baby may be affected.
To reduce risks on your child, you should discuss the affects that you have from taking medicines with your doctor before you become pregnant. Usually there is enough information available on the use of medicines during pregnancy which will make it easier for you and your doctor to make the right decision for you and your baby.
It’s of utmost importance for yourself and your baby that you discuss any decision to begin, cease, resume or change prescription before or during pregnancy, with your doctor. It would also help if you keep a record of all the medication you took during pregnancy.
Breastfeeding
You need to bear in mind these two growth stages of your baby:
- If the baby is exposed to azithromycin during the first 90 days after delivery, it has a threefold chance of developing infantile, hypertrophic pyloric stenosis or the narrowing of the digestive system.
- Doses of 500 mg orally given to infants every 12 hours would receive a dose of 0.1 mg/kg/day and would be stable in 3 days.
Conclusion
Taking Azithromycin when pregnant is not a novel undertaking and in fact may become the cure for pregnant women before and during pregnancy once more studies have been conducted to prove the efficacy of azithromycin and other macrolide drugs. It’s important to remember that new medicines are constantly being developed and it may be that with studies and trials, a time will come when new antibiotics will be developed to deal with more bacterial created diseases.
