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Medical Video: What is Cerebral Palsy?
The results of a recent study show that women who use macrolide antibiotics are slightly more likely to give birth to children with both conditions (or one of them), compared to women who use penicillin.
But no relationship was found between taking antibiotics during pregnancy, and cerebral palsy (a condition that causes movement abnormalities) or seizures. The results of the research conducted are not yet reliable. There can be other factors, such as the type and severity of the infection.
This study does not prove that macrolides cause cerebral palsy or seizures. Infection in pregnancy may be a factor that increases the risk of this condition, not the treatment itself. There is no treatment that is 100% risk free. That is, people must use the best evidence to make decisions between the benefits and risks of diverse choices.
Many experts will agree that the benefits of treating bacterial infections in pregnancy far outweigh the potential risk of antibiotics. If the infection does not go away, the infection can spread to the baby, or more seriously, miscarriages or stillbirths.
Where did this guess come from?
This is a retrospective group study at University College London and Farr Institute of Health Informatics Research, London, which involved 195,909 women to find out whether antibiotics used during pregnancy were associated with a higher risk of cerebral palsy or seizures in their children.
Group research is often used to find out whether certain events are related to certain health outcomes. The advantage of this type of study is that it can follow large groups of people over a long period of time, but cannot prove cause and effect.
The researchers say that antibiotics are one of the most commonly prescribed drugs during pregnancy.
However, it is said that randomized controlled trial (RCT) found in certain antibiotics for women who have given birth prematurely is associated with an increased risk of cerebral palsy or seizures in 7-year-old children.
The two antibiotics used in previous experiments were erythromycin, macrolide, and co-amoxiclay, a type of penicillin.
The researchers used data on 195,909 women who had enrolled in general surgery before pregnancy and had given birth to a baby at or after 37 weeks.
For women with multiple pregnancies (around one quarter of a group), one pregnancy was randomly selected for analysis. Women with children who are born prematurely are not included, because premature babies are more at risk of developing cerebral palsy and seizures.
They looked at whether women had been treated with any oral antibiotic during pregnancy, and if so, recorded the antibiotic class, the amount of drug consumption, and timings treatment during pregnancy.
Children are supervised until they are 7 years old to be diagnosed with cerebral palsy or any seizure, as recorded in the primary child care record.
The researcher analyzed the data with standard statistical methods. They adjusted the results to see risk factors with a wide range.
This includes the age of the mother during childbirth; pregnancy complications; chronic conditions such as obesity; treatment of chronic medical conditions during pregnancy; smoking and drinking alcohol; less socializing; and infections that have the potential to cause fetal brain damage.
Research result
In total there were 64,623 (33%) women prescribed antibiotics in pregnancy, and 1,170 (0.60%) children had records with indications of having cerebral palsy or seizures, or both.
When the researchers adjusted the results, they found that:
- There is no connection between antibiotics with cerebral palsy and seizures
- Compared to penicillin, macrolide antibiotics are associated with a 78% increased risk of cerebral palsy or seizures
- Children whose mothers receive more than 3 prescriptions for antibiotics during pregnancy have a 40% risk compared to mothers who do not get a prescription
The researchers say that the findings indicate that prescription macrolide in pregnancy is associated with an increased risk of cerebral palsy or childhood seizures.
They speculate why macrolides might be associated with danger. For example, that if a woman stops taking medication because of side effects, an infection that is partially treated might prolong the fetal brain's exposure to inflammation.
However, they added that there is growing evidence that using macrolide during pregnancy is dangerous, and this drug may have certain adverse effects on the fetus.
Conclusion
The findings from this large study indicate that antibiotic use in pregnancy is not associated with an increased risk of cerebral palsy or seizures. Increased risk of macrolide compared to penicillin is unreliable.
A direct comparison between women who use each type of antibiotic is inaccurate because it does not take into account the potential for dangerous factors, including:
- The type and severity of the infection, which may have affected the baby, rather than antibiotics
- Does the woman consume antibiotics or is this just an antibiotic side effect that is stopped too early. If antibiotics are not spent, the infection may not be fully cured, and can harm the baby.
- Other non-measurable factors that affect the type of antibiotics given, such as medication or other health conditions
In addition, macrolide analysis is carried out based on a small number of women, so the results also occur by chance.
It is important to emphasize that doctors will only prescribe antibiotics in pregnancy if they think there is a clear clinical need, where the mother and baby are potentially infected. The risk of any pregnancy due to antibiotics may be far exceeded by the benefits of treatment.
