Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study
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Objective: To examine the association between maternal exposure to ciprofloxacin and the risk of miscarriage and major malformations. Design: A nationwide register-based cohort study. Setting: Data were obtained from the Medical Birth Registry, the National Hospital Registry, the Danish National Prescription Registry and Statistics Denmark. Population: Data were collected in the period between 1997 and 2016 and included all registered pregnancies that ended in an elective termination, miscarriage, stillbirth or a live birth. Exposure was defined as redeeming one or more prescriptions of ciprofloxacin. Methods: Miscarriage was defined as a diagnosis given before 22 weeks without any medical intervention. Major malformations were classified according to EUROCAT 1.4. We matched ciprofloxacin-exposed pregnancies to unexposed pregnancies on the propensity score in a ratio 1:4. To estimate the hazard ratio (HR) of miscarriage a Cox proportional hazard regression model was used. A log binomial model was used to estimate the relative risk ratio (RR) of major malformations. Main outcome measures: HR of miscarriage and the RR of major malformations. Results: A total of 1 650 649 pregnancies were identified. Of these, 10 250 (2050 ciprofloxacin-exposed) and 6100 (1220 ciprofloxacin-exposed) were included in the miscarriage and major malformation analysis, respectively. The HR of miscarriage was 0.99 (95% confidence interval [CI] 0.84–1.17). For major malformation, the RR was 1.01 (95% CI 0.72–1.40). For the organ-specific major malformations and the sensitivity analyses, no significant increased risks were identified. Conclusion: We demonstrated no association between miscarriage and maternal ciprofloxacin exposure within the first 22 weeks of pregnancy, or between major malformations and maternal exposure during the first trimester. Tweetable abstract: No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.
Original language | English |
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Journal | BJOG: An International Journal of Obstetrics and Gynaecology |
Volume | 129 |
Issue number | 9 |
Pages (from-to) | 1503-1511 |
ISSN | 1470-0328 |
DOIs | |
Publication status | Published - 2022 |
Bibliographical note
Funding Information:
MN was supported by a grant from P. Carl Petersens Fond, reference number: 19133.
Publisher Copyright:
© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
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