Table 2.
Association of preconception antibiotics with pregnancy, miscarriage, and birth defects in the included studies.
| Author Year | N in exposed/case | N non-exposed/control | FR/OR/RR/P | 95% CI/IQR | Conclusion |
|---|---|---|---|---|---|
| A. Pregnancy | |||||
| Harrison et al., 197524 | 30 | 58 | P (16%, 14% and 16%) | NR | No significant benefit in increasing the conception rate |
| Schaumburg, 198936 | 597 | 3833 | OR 1.34 To Delay | 1.0, 1.8 | A slightly increased risk of prolonged time to pregnancy |
| Grodstein et al., 199233 | 593 | 3833 | RR 1 | 0.7, 1.4 | No significant effect to prolong time to pregnancy |
| Peikrishvili et al., 200437 | 130 | 145 | P (36.9% and 36.5%) | NA | Implantation rate per transfer was similar in the two groups |
| Brook et al., 200632 | 178 | 172 | RR 1.01 | 0.81, 1.24 | Has no impact on clinical pregnancy rates |
| Cicinelli et al., 201832 | 53 | 42 | OR 14.48 | 4.50, 46.55 | Showed higher pregnancy rate and live birth rate |
| Eskew et al., 202037 | 12 | 14 | Median time to conception (25 and 18) | IQR (18, 48) and (8, 32) | Failure to achieve clinical pregnancy in the azithromycin group |
| Crowe et al., 20216 | 1432 | 8092 | FR 0.98 | 0.89, 1.07 | No significant difference between the two groups in terms of reduced fecundability |
| Shao 202328 | 302 | 302 | OR 1.29 | 0.78, 2.15 | Has no significant association with fecundability |
| Mikkelsen et al., 202321 | 1130 | 8332 | FR 0.86 | 0.76,0.99 | Antibiotics were associated with decreased fecundability compared with no-users |
| Duan et al., 202338 | 338 | 7962 | OR 0.83 | 0.66, 1.03 | No statistical difference in the occurrence of clinical pregnancy |
| B. Spontaneous miscarriage | |||||
| Peikrishvili et al., 200435 | 130 | 145 | P (33.3% and 20.8%) | NA (P-value = 0.15) | Antibiotic prescription for IVF cases didn’t cause significant pregnancy loss |
| Crowe et al., 20226 | 1537 | 6353 | HR 1.06 | 0.88, 1.28 | Not appreciably associated with SAB |
| Duan et al., 202338 | 338 | 7962 | OR: 1.49 | 1.01, 2.19 | Antibiotics increase the risk of SAB |
| Gelder et al., 202339 | 585 | 7305 | RR 1.34 | 1.11, 1.79 | Preconception antibiotics exposure increases the risk of SAB |
| C. Birth defects | |||||
| Andersen, TJ et al., 201340 | 402 | 520,865 | OR 2.01 | 1.45, 2.78 | Exposure to trimethoprim during the 12 weeks before conception increased the risk of heart and limb defects |
| Sun Y et al., 201431 | NR | NR | 1.66 | 1.10, 2.53 | Trimethoprim is a potential teratogen when used 3 months before pregnancy |
N: Sample size in the study; OR: Odds ratio; RR: Relative risk; FR: Fecundability ratio; p: Proportion; CI: Confidence interval; IQR: Interquartile range; NR: Not reported; NA: Not applicable; HR: Hazard ratio; IVF: In vitro fertilization, SAB: Spontaneous abortion; RCT: Randomized controlled trial.