Journal
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
Volume 15, Issue 5, Pages E336-E341Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ijid.2011.01.007
Keywords
Trimethoprim/sulfamethoxazole; Anti-infectives; Preterm birth; Low birth weight; Folic acid antagonist; Pregnancy
Categories
Funding
- Ontario Ministry of Health and Long-Term Care [2008-007]
- Canadian Institutes for Health Research (CIHR) Ontario Women's Health Council
- CIHR
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Objective: 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. (C) 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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