A recent systematic review and meta-analysis published in Lancet eClinical Medicine has raised significant concerns about the impact of preconception antibiotic use on maternal health and pregnancy outcomes. The study, involving over 1.2 million participants across 155 studies, underscores the potential risks of antibiotic exposure before conception, including negative effects on fertility, increased miscarriage rates, and a higher risk of congenital anomalies.
The findings reveal that certain classes of antibiotics can have detrimental effects on reproductive health. Women who were exposed to macrolides before conception showed a 35% reduction in fecundability ratios (FR: 0.65), indicating a major decline in their ability to conceive. The use of macrolides also doubled the risk of infertility (Odds Ratio [OR]: 2.35), highlighting a significant threat to female reproductive health. These results suggest that macrolides and sulfonamides, in particular, may severely impair fertility.
On the other hand, beta-lactams, a different class of antibiotics, were found to have a protective effect, reducing the odds of infertility by 64% (OR: 0.36). This suggests that the reproductive impact of antibiotics varies depending on the type, with beta-lactams posing a lesser risk. Quinolones also appeared to have a marginally lower impact, with a slight reduction in infertility risk (OR: 0.87), indicating they may pose less of a threat compared to other antibiotics.
One of the more concerning findings of the study was the association between trimethoprim use and an 85% increased risk of congenital malformations (OR: 1.85), raising serious concerns about its safety during the preconception period.
Overall, antibiotic exposure was linked to a 34% increased risk of miscarriage (Relative Risk [RR]: 1.34), further underscoring the potential dangers of using antibiotics before pregnancy.
The study highlights the need for caution when prescribing and using antibiotics in the preconception phase. While some antibiotics, like beta-lactams and quinolones, appear to have minimal impact on fertility and pregnancy outcomes, others—particularly macrolides, sulfonamides, and trimethoprim—are associated with significant reproductive risks.
The findings call for more clinical and mechanistic research to understand the underlying biological effects of these antibiotics on fertility and pregnancy outcomes. Additionally, awareness campaigns and stricter prescribing protocols for antibiotics during the preconception period are essential to mitigate risks and improve pregnancy success rates.
The preconception period is a critical window for influencing maternal and fetal health, and thoughtful, informed antibiotic use is essential for safeguarding reproductive health and ensuring the well-being of future generations.
Related topics:
Which 5 HRTs Are Best for Fibroids?
