Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study
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 Prescr...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2022-08, Vol.129 (9), p.1503-1511 |
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| creator | Noergaard, Mia Gotfredsen, Ditte Resendal Sørensen, Anne Mette Skov Andersen, Jon Trærup |
| description | 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
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.
Tweetable
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes. |
| doi_str_mv | 10.1111/1471-0528.17083 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2614757185</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2614757185</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4123-56bcf3fed38a9da2cdaebdc694d97abcf286a0b1af7b5040138a3d29cfb7a0413</originalsourceid><addsrcrecordid>eNqFkDtPwzAURi0EoqUwsyFLLCxp7ThPtlLeqtQFxGg5tkNTJXawE9r8e9ymdGDhLr669_iTfQC4xGiMXU1wEGMPhX4yxjFKyBEYHibHux55iPjJAJxZu0IIRz4ip2BAgjQMUoSG4GNW1Ebnpd4wXigoN7W2rZGQKQGZ-JbGSlgb-amY4h3UbcN1Je0tnMJ7pgq7hIo1hVbrQkjI9VKbBtqmFd05OMlZaeXF_hyB98eHt9mzN188vcymc48H2CdeGGU8J7kUJGGpYD4XTGaCR2kg0pi5nZ9EDGWY5XEWogBhxxHhpzzPYoYCTEbgps91v_hqpW1oVVguy5IpqVtL_chJCGOchA69_oOudGuUe52jkjiMSLyjJj3FjbbWyJzWpqiY6ShGdOucbg3TrWG6c-5uXO1z26yS4sD_SnZA2APropTdf3n07nXRB_8ATYCMPw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2687563785</pqid></control><display><type>article</type><title>Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Noergaard, Mia ; Gotfredsen, Ditte Resendal ; Sørensen, Anne Mette Skov ; Andersen, Jon Trærup</creator><creatorcontrib>Noergaard, Mia ; Gotfredsen, Ditte Resendal ; Sørensen, Anne Mette Skov ; Andersen, Jon Trærup</creatorcontrib><description>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
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.
Tweetable
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.</description><identifier>ISSN: 1470-0328</identifier><identifier>ISSN: 1471-0528</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.17083</identifier><identifier>PMID: 34954900</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Abortion ; Abortion, Spontaneous - chemically induced ; Abortion, Spontaneous - epidemiology ; Antibiotics ; Birth defects ; Ciprofloxacin ; Ciprofloxacin - adverse effects ; Clinical outcomes ; Cohort analysis ; Cohort Studies ; Denmark - epidemiology ; early exposure ; Female ; Fetuses ; Human exposure ; Humans ; major malformation ; Miscarriage ; Pregnancy ; Pregnancy Trimester, First ; Sensitivity analysis ; Statistical analysis ; Stillbirth</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2022-08, Vol.129 (9), p.1503-1511</ispartof><rights>2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4123-56bcf3fed38a9da2cdaebdc694d97abcf286a0b1af7b5040138a3d29cfb7a0413</citedby><cites>FETCH-LOGICAL-c4123-56bcf3fed38a9da2cdaebdc694d97abcf286a0b1af7b5040138a3d29cfb7a0413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.17083$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.17083$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>315,782,786,1419,27931,27932,45581,45582</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34954900$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Noergaard, Mia</creatorcontrib><creatorcontrib>Gotfredsen, Ditte Resendal</creatorcontrib><creatorcontrib>Sørensen, Anne Mette Skov</creatorcontrib><creatorcontrib>Andersen, Jon Trærup</creatorcontrib><title>Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>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
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.
Tweetable
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.</description><subject>Abortion</subject><subject>Abortion, Spontaneous - chemically induced</subject><subject>Abortion, Spontaneous - epidemiology</subject><subject>Antibiotics</subject><subject>Birth defects</subject><subject>Ciprofloxacin</subject><subject>Ciprofloxacin - adverse effects</subject><subject>Clinical outcomes</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Denmark - epidemiology</subject><subject>early exposure</subject><subject>Female</subject><subject>Fetuses</subject><subject>Human exposure</subject><subject>Humans</subject><subject>major malformation</subject><subject>Miscarriage</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, First</subject><subject>Sensitivity analysis</subject><subject>Statistical analysis</subject><subject>Stillbirth</subject><issn>1470-0328</issn><issn>1471-0528</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNqFkDtPwzAURi0EoqUwsyFLLCxp7ThPtlLeqtQFxGg5tkNTJXawE9r8e9ymdGDhLr669_iTfQC4xGiMXU1wEGMPhX4yxjFKyBEYHibHux55iPjJAJxZu0IIRz4ip2BAgjQMUoSG4GNW1Ebnpd4wXigoN7W2rZGQKQGZ-JbGSlgb-amY4h3UbcN1Je0tnMJ7pgq7hIo1hVbrQkjI9VKbBtqmFd05OMlZaeXF_hyB98eHt9mzN188vcymc48H2CdeGGU8J7kUJGGpYD4XTGaCR2kg0pi5nZ9EDGWY5XEWogBhxxHhpzzPYoYCTEbgps91v_hqpW1oVVguy5IpqVtL_chJCGOchA69_oOudGuUe52jkjiMSLyjJj3FjbbWyJzWpqiY6ShGdOucbg3TrWG6c-5uXO1z26yS4sD_SnZA2APropTdf3n07nXRB_8ATYCMPw</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Noergaard, Mia</creator><creator>Gotfredsen, Ditte Resendal</creator><creator>Sørensen, Anne Mette Skov</creator><creator>Andersen, Jon Trærup</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>202208</creationdate><title>Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study</title><author>Noergaard, Mia ; Gotfredsen, Ditte Resendal ; Sørensen, Anne Mette Skov ; Andersen, Jon Trærup</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4123-56bcf3fed38a9da2cdaebdc694d97abcf286a0b1af7b5040138a3d29cfb7a0413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abortion</topic><topic>Abortion, Spontaneous - chemically induced</topic><topic>Abortion, Spontaneous - epidemiology</topic><topic>Antibiotics</topic><topic>Birth defects</topic><topic>Ciprofloxacin</topic><topic>Ciprofloxacin - adverse effects</topic><topic>Clinical outcomes</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Denmark - epidemiology</topic><topic>early exposure</topic><topic>Female</topic><topic>Fetuses</topic><topic>Human exposure</topic><topic>Humans</topic><topic>major malformation</topic><topic>Miscarriage</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, First</topic><topic>Sensitivity analysis</topic><topic>Statistical analysis</topic><topic>Stillbirth</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Noergaard, Mia</creatorcontrib><creatorcontrib>Gotfredsen, Ditte Resendal</creatorcontrib><creatorcontrib>Sørensen, Anne Mette Skov</creatorcontrib><creatorcontrib>Andersen, Jon Trærup</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Noergaard, Mia</au><au>Gotfredsen, Ditte Resendal</au><au>Sørensen, Anne Mette Skov</au><au>Andersen, Jon Trærup</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2022-08</date><risdate>2022</risdate><volume>129</volume><issue>9</issue><spage>1503</spage><epage>1511</epage><pages>1503-1511</pages><issn>1470-0328</issn><issn>1471-0528</issn><eissn>1471-0528</eissn><abstract>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
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.
Tweetable
No association between maternal ciprofloxacin exposure and adverse pregnancy outcomes.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34954900</pmid><doi>10.1111/1471-0528.17083</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1470-0328 |
| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2022-08, Vol.129 (9), p.1503-1511 |
| issn | 1470-0328 1471-0528 1471-0528 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2614757185 |
| source | MEDLINE; Access via Wiley Online Library |
| subjects | Abortion Abortion, Spontaneous - chemically induced Abortion, Spontaneous - epidemiology Antibiotics Birth defects Ciprofloxacin Ciprofloxacin - adverse effects Clinical outcomes Cohort analysis Cohort Studies Denmark - epidemiology early exposure Female Fetuses Human exposure Humans major malformation Miscarriage Pregnancy Pregnancy Trimester, First Sensitivity analysis Statistical analysis Stillbirth |
| title | Ciprofloxacin exposure and adverse pregnancy outcomes: A Danish nationwide cohort study |
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