Exposure to trimethoprim/sulfamethoxazole but not other {FDA} category C and D anti-infectives is associated with increased risks of preterm birth and low birth weight

摘要

SummaryObjective To examine the association between trimethoprim/sulfamethoxazole, other {US} Food and Drug Administration (FDA) C and D anti-infectives, and non anti-infective {FDA} C, D, and X drugs used during pregnancy with preterm birth and low birth weight. Methods We carried out a retrospective cohort study based on a 50% random sample of women who gave birth in the Canadian province of Saskatchewan from 1997 to 2000. The association between trimethoprim/sulfamethoxazole, other {FDA} C and D anti-infectives (fluconazole, clarithromycin, doxycycline, and tetracycline), and non anti-infective {FDA} C, D, and X drugs used during pregnancy with preterm birth and low birth weight was evaluated using multiple logistic regression, with adjusted odds ratios (aORs) and 95% confidence intervals (CIs) as association measures. Results A total of 17?939 women were included in the final analysis. Trimethoprim/sulfamethoxazole was associated with significantly increased risks for preterm birth (aOR 1.51, 95% {CI} 1.10, 2.08) and low birth weight (aOR 1.67, 95% {CI} 1.14, 2.46). Exposure to non anti-infective {FDA} category C, D and X drugs was also associated with increased risks for preterm birth (aOR 1.17, 95% {CI} 1.09, 1.31) and low birth weight (aOR 1.14, 95% {CI} 0.92, 1.42), but to a lesser degree. Other {FDA} C and D anti-infectives were not (statistically) significantly associated with increased risks for preterm birth (aOR 0.93, 95% {CI} 0.49, 1.77) or low birth weight (aOR 0.65, 95% {CI} 0.27, 1.60). Conclusions Among {FDA} C, D and X drugs, trimethoprim/sulfamethoxazole, a folic acid antagonist, has the strongest association with preterm birth and low birth weight.