Antibiotic in pregnancy: what is the risk of these drugs for the health of the fetus?
The antibiotic in pregnancy is a type of drug that must be taken with great caution, for the health of the mother, but above all so that the fetus does not run any risk of malformations or developing chronic inflammatory bowel diseases. However, the antibiotic in pregnancy can be necessary: a pregnant woman is in equal danger of contracting bacterial infections, and a higher than average risk of contracting urinary tract infections. Let's find out together everything you need to know about taking antibiotic drugs during pregnancy.
What are the most dangerous bacterial infections in pregnancy for the baby?
During pregnancy, the expectant mother can contract bacterial infections: this poses a risk to the fetus, since the bacterium could cross the placenta and infect the baby, or infect him while passing through the birth canal. The consequence of this is an increase in the danger of spontaneous abortion, especially in the first trimester, when the baby is most vulnerable. Therefore, in order to safeguard the health of both, it will be necessary to fight pathogens, but without the future child running any danger in growth due to the drugs taken.
Some infections are particularly dangerous for the baby. This is the case, for example, of Listeria monocytogenes, a bacterium which is part of the intestinal flora of various mammals and which causes listeriosis. To avoid it, you must be careful not to eat raw fruit and vegetables during pregnancy if not well washed, raw or undercooked dog, unpasteurized milk and derivatives: these are foods that can be easily contaminated by this bacterium and pose a serious danger to the health of the child, with a high possibility of miscarriage or meningitis (if contracted in the birth canal).
Streptococcus agalactiae can also be very dangerous for the newborn, which can lead to serious consequences (even lethality) if contracted at the moment of birth. Between the 35th and 37th week of pregnancy, not surprisingly, a swab is performed to check its presence: in case you have streptococcus it will be essential to resort to therapy!
Equally risky are infections caused by Chlamydia trachomatis and Troponema pallidum, which can involve the first premature birth, pneumonia and conjunctivitis in the baby, the second even death in utero.
Finally, it is mainly urinary tract infections that most affect pregnant women and can pose risks to both the health of the mother and that of the child: risk of spontaneous abortion, pre-term birth and gestosis. Also in these cases it will be important to carry out urine tests as early as the first trimester to check that there are no urinary tract infections or, if necessary, treat them with targeted antibiotic therapy.
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Antibiotic in pregnancy: the risks
If antibiotics taken during pregnancy cross the placenta to the fetus, they could affect the development of the future baby. If in the first week of pregnancy the danger is that of a spontaneous abortion, in the following weeks of the first trimester these drugs would be very dangerous for its future development, with the risk of malformations to the central nervous system and beyond.
In addition, taking antibiotics during pregnancy could also lead to chronic inflammatory bowel disease in the child, obesity, Crohn's disease and ulcerative colitis.
Antibiotic in pregnancy and chronic inflammatory bowel disease in children
According to a study conducted by Swedish researchers, indirect "contact" with antibiotic drugs during pregnancy increases the risk of developing inflammatory bowel disease twice in the first years of life. Antibiotics, in fact, modify the intestinal microbiota, which has the task of regulating the metabolism and the immune system. The alteration induced by contact with the drug would lead to the development of an imbalance in these fundamental functions.
The alteration of the microbiota of the newborn due to the mother's intake of antibiotics during pregnancy would have an important role in the onset of chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis.
Antibiotics in pregnancy: which to choose for the health of mother and baby?
How to behave, then, if during pregnancy you contract an "infection that requires" antibiotics? First of all it is important to begin an antibiotic therapy under medical supervision only and only that no other type of treatment has been sufficient. In short, it is necessary to resort to this type of drug only if strictly necessary. To be avoided completely (always if possible) in the first trimester of pregnancy.
It will then be necessary to choose a safe drug and take it in the lowest possible dose with proven effectiveness. If in the first trimester a wrong drug or an inadequate dose could lead to a high risk of malformations for the fetus (which is forming its organs in those weeks of pregnancy), in the second and third trimester the danger is more reduced, but always here I'm.
Classification of antibiotics that can be taken with less risk during pregnancy
As for antibiotics that are considered safe in pregnancy, the best are penicillins, because they cross the placenta, but only in very low concentrations. To these belongs amoxicillin, contained for example in the drugs Augmentin and Zimox, considered safe to use during pregnancy. Amoxicillin is often used together with clavulanic acid to increase its ability to act. The fact remains that amoxicillin and clavulanic acid - although safer than other drugs - they should not be taken if it is possible to avoid them in any way!
Cephalosporins, erythromycin and fosfomycin do not appear to cause fetal damage or spontaneous abortion. Aminoglycosides, clarithromycin and vancomycin are not recommended during pregnancy.
The drugs that are at the highest risk for the fetus are tetracyclines (which can cause severe damage to the central nervous system and bone tissues) and co-trimoxazole, which increases the possibility of problems with the cardiovascular and urinary systems. In cases of extreme and absolute necessity, however, even this kind of drug can be prescribed: always trust your doctor for every decision and leave the DIY alone!
For more information on the subject, you can consult the website of the Veronesi Foundation.
