Table 2.
Maternal exposure to macrolide antibiotics and risk of congenital heart defects or pyloric stenosis
| Non-malformed controls (N=6952), N (%) | Cases of CHD (N=4132) | Cases of PS (N=735) | |||
|---|---|---|---|---|---|
| N (%) | OR (95% CI) d | N (%) | OR (95% CI) d | ||
| Any Macrolides | |||||
| No exposure during pregnancy | 6655 (95.7) | 3948 (95.5) | 1.0 (Ref) | 693 (94.3) | 1.0 (Ref) |
| Exposure in the 1st trimester a | 70 (1.0) | 46 (1.1) | 0.9 (0.6–1.3) | 12 (1.6) | 1.3 (0.6–2.8) |
| Exposure in the 2nd trimester a | 74 (1.1) | 47 (1.1) | 1.1 (0.7–1.7) | 7 (1.0) | 1.3 (0.5–3.0) |
| Exposure in the 3rd trimester a,c | 71 (1.0) | 47 (1.1) | 1.0 (0.6–1.6) | 11 (1.5) | 1.3 (0.6–2.9) |
| Erythromycin | |||||
| No exposure during pregnancy | 6828 (98.2) | 4064 (98.4) | 1.0 (Ref) | 717 (97.6) | 1.0 (Ref) |
| Exposure in the 1st trimester a | 28 (0.4) | 18 (0.4) | 1.3 (0.6–2.6) | 4 (0.5) | 0.9 (0.3–3.0) |
| Exposure in the 2nd trimester a | 27 (0.4) | 15 (0.4) | 0.9 (0.4–2.0) | 4 (0.5) | 1.5 (0.4–4.8) |
| Exposure in the 3rd trimester a,c | 20 (0.3) | 15 (0.4) | 1.1 (0.5–2.6) | 5 (0.7) | 1.5 (0.5–5.1) |
| Non-erythromycin macrolides | |||||
| No exposure during pregnancy | 6773 (97.4) | 4013 (97.1) | 1.0 (Ref) | 711 (96.7) | 1.0 (Ref) |
| Exposure in the 1st trimester b | 43 (0.6) | 29 (0.7) | 0.7 (0.4–1.3) | 8 (1.1) | 1.7 (0.6–4.6) |
| Exposure in the 2nd trimester b | 48 (0.7) | 32 (0.8) | 1.2 (0.7–2.0) | 3 (0.4) | - |
| Exposure in the 3rd trimester b,c | 51 (0.7) | 32 (0.8) | 1.0 (0.6–1.7) | 7 (1.0) | 1.5 (0.6–3.8) |
Ref: reference group, OR: odds ratio, CI: confidence interval
ORs comparing likely exposure to erythromycin in the window of interest with no exposure to erythromycin during pregnancy based on an algorithm previously published 14
ORs comparing likely exposure to non-erythromycin macrolides in the window of interest with no exposure to non-erythromycin macrolides during pregnancy based on an algorithm previously published 14
Excluding preterm deliveries, stillbirths and terminated abortions did not change the estimates materially
ORs adjusted for region of participants’ residences and calendar year when they were ascertained, maternal age, race, education level, pre-pregnancy BMI, family history of congenital malfomarions, diabetes mellitus, first trimester cigarette smoking, peri-conceptional folic acid supplement, multiple pregnancy, urinary tract, respiratory, or vaginal/yeast infection, sexually transmitted disease, and other kinds of infection, and/or febrile events that occurred in the first trimester