What pregnant women should know about antibiotics use

A Senior Registrar in Obstetrics and Gynaecology at the Alex Ekwueme University Teaching Hospital, Abakaliki, Ebonyi State, Dr. Amuche Nwafor, has counselled pregnant women to desist from going to patent medicine dealers to buy antibiotics when they have urinary tract infection, cough and catarrh or other ailments.

The gynaecologist warned that the use of antibiotics in pregnancy without a doctor’s prescription has a devastating impact and can cause deformities and jaundice in babies.

Nwafor, during an interview with PUNCH HealthWise, said it is cheaper and safer for pregnant women to visit the hospital when they are sick rather than patronising patent medicine dealers.

The physician says that maternal health experts discourage use of antibiotics in pregnancy because not all of them are safe.

She said, “Generally, we discourage drug use in pregnancy as much as possible. We only use antibiotics in pregnancy when it is extremely necessary. There are some antibiotics that are not safe during pregnancy. Some of them will affect the foetus negatively. Antibiotics can cause deformity in the baby. It can also affect the bone.

“There are, however, some that are safe. But the problem is that some pregnant women, when they are sick, go to the chemist to buy drugs, not minding the impact on their unborn baby.

“Doctors don’t just give antibiotics. Even when they want to give, they give the ones that are safe.

“Some antibiotics can affect the bone marrow also. Others can cause jaundice, brain damage and also affect the skin.”

The gynaecologist also noted that antibiotics can cause miscarriages.

In a 2020 study published in BMJ journal, the researchers state that children of mothers who were prescribed macrolide antibiotics during early pregnancy are at an increased risk of major birth defects, particularly heart defects, compared with children of mothers whose doctors prescribed penicillin for.

The researchers say these findings show that macrolides should be used with caution during pregnancy and if feasible, alternative antibiotics should be prescribed until further research is available.

Macrolide antibiotics (including erythromycin, clarithromycin, and azithromycin) are – widely used to treat common bacterial infections. They are often used as alternatives for patients with penicillin allergy.

Researchers analysed data from 104,605 children born in the UK from 1990 to 2016 with a median follow up of 5.8 years after birth. A further 82,314 children whose mothers were prescribed macrolides or penicillins before pregnancy, and 53,735 children who were siblings of children in the study group acted as negative control cohorts.

The researchers say major malformations were recorded in 186 of 8,632 children whose mothers were prescribed macrolides at any point during pregnancy and 1,666 of 95,973 children whose mothers were prescribed penicillins during pregnancy.

Also, some studies have shown that taking antibiotics during pregnancy can cause miscarriage.

According to an online news portal, WebMD, taking certain types of antibiotics during pregnancy may boost the risk of miscarriage.

Nwafor advised pregnant women to register early for antenatal care and to always take their complaints to their physician rather than engage in self-medication.

“Once women notice that they are pregnant, they should register for antenatal care in a health facility that has skilled birth attendants. In such facilities, you have professionals who have been trained on drug safety and therefore, know the types of drugs that are safe for pregnant women. They know the drugs to give to women during pregnancy.

“Pregnant women are prone to urinary tract infection; they can have difficulty with urination. They can have coughs and catarrh and all sorts of symptoms just like non-pregnant persons. But, most times, because they feel that coming to the hospital is more expensive, most of them when they are sick, they go to the chemist to buy drugs where they feel are cheaper.

“But it is not true. When you book at a facility, you already have a card with them. Once you are sick, you walk into the facility to see the doctor. Many diseases have similar symptoms, so it is dangerous for pregnant women to be taking drugs without the doctor’s prescription,” she explained.

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