Here’s the link to the article. First, it’s important to note that there are some weaknesses to the study, in that it relied on the mothers’ recollection 6 weeks to 2 years after the birth which may cause problems in two ways: first, that some women may have misremembered (e.g., they may have thought the drug they were given for their bladder infection was an antibiotic, when it wasn’t; or they actually did take an antibiotic when they thought it was something else), and secondly, about a third of the women couldn’t remember what the antibiotic was that they had taken. [Why didn’t they check their records? It should be in both the prescribing physician’s file as well as in the pharmacy’s computers. Seems a simple and easy thing to do, but I digress…] Secondly, it’s important to note that it’s possible that the increase in birth defects was not due to the drug, but to some underlying condition (perhaps the bladder infection itself, or something else which made the woman more likely to get a bladder infection in the first place — who knows?). Thirdly, since the risk is rare, this is not a call to let a sick woman get sicker and sicker and sicker. After all, if she dies or has a miscarriage from a massive, untreated infection, that’s not very good for the baby, either!
Birth defects linked to sulfa drugs included rare brain and heart problems, and shortened limbs. Those linked to nitrofurantoins included heart problems and cleft palate. The drugs seemed to double or triple the risk, depending on the defect.”These defects are rare. Even with a threefold increase in risk, the risk for the individual is still quite low,” Crider said.
The good news is that penicillins seem to be the safest, and they are the most commonly prescribed drugs. Penicillins include Amoxil (amoxicillin); sulfa drugs include Bactrim (sulfamethoxazole and trimethoprim, if I’m remembering correctly); nitrofurantoins include Macrobid.
It’s important to remember that antibiotics don’t work with viruses, so taking these drugs does not actually help if you’ve got a viral infection; and then you’re just exposed to the risk (however minimal) without any corresponding benefit. These drugs actually predate the FDA, and their safety has been more assumed than proven. [If there were massive risks, this would have been discovered by now, because probably billions of people have taken these medicines since the 1930s, so the assumption is a pretty safe bet.] Yet, pregnancy is a tricky situation — with embryonic development being so sensitive a part of the development of the child, nobody wants another Thalidomide type of event! But it’s not exactly ethical to give pregnant women drugs just to see what happens to their babies, like the Nazis did. So there is a fine line.
When I worked at the pharmacy, I witnessed first-hand the great and royal run-around from doctors who were all unwilling to be the one to say, “Yes, this is fine to take during pregnancy.” I remember one “pass the buck” incident, in which a pregnant woman went to her GP for a cold or something, and he told her that her OB would have to prescribe something for her since she was pregnant. We called the OB, and he said that he didn’t know what to prescribe for a cold — he was an obstetrician, after all, and wanted the pharmacist to recommend something. The pharmacist didn’t want to be the one to “prescribe” something, because that was out of his purview. Undoubtedly, part of the reason for everyone’s hesitance was not wanting to be sued for prescribing something, even if it was done with the best of intentions, and the best knowledge available at the time.