Antibiotics and Pregnancy: Safe or Not Safe?

While in utero, babies receive oxygen, blood, and nutrients through the placenta. Many substances that a woman ingests, including medications, can cross the placenta and potentially affect the fetus. As such, a lot of women avoid taking anything that could potentially affect the health and safety of their baby, including medications and drugs.

After developing a bacterial infection of some kind, many pregnant women wonder whether it is safe for them to take antibiotics or whether they would be better off riding it out.

When it comes to antibiotics and pregnancy, the good news is that some are considered safe – but others should be avoided due to the potential risk they pose for an unborn baby. Here, we’ve taken a closer look at what is ‘safe’ and what is not.
 
As a leading group of gynaecologists in women’s health, the dedicated team at Create Health is committed to delivering exceptional care across obstetrics, gynaecology, fertility, and other complementary health services in Melbourne– all while removing the clinical attitude and creating a positive and inviting space for our patients. Book an appointment today for personalised pregnancy and antenatal care.

Reasons to Take Antibiotics During Pregnancy

Certain infections, if left untreated, may be dangerous to the health of a pregnant woman and her unborn baby. They may also pose a higher risk for miscarriage, preterm labour, stillbirth, newborn death, and/or problems with the baby’s organs.

Some of the common reasons that a pregnant woman is given antibiotics include:

• Positive Group B Streptococcus (GBS) Swab
  In the lead-up to your due date, your gynaecologist will swab you for GBS. This bacterium can be found in the body and easily passed onto a baby during birth. It has the potential to cause meningitis, pneumonia, or sepsis. If you test positive for or are suspected to have GBS, you will be given an IV antibiotic (usually penicillin) during labour.
• Premature Water Breakage
  If a woman’s water breaks before her pregnancy has reached full term (especially before 34 weeks gestation), she may be treated with antibiotics to help prevent any infections from reaching the baby before it’s delivered.

Other reasons that a doctor may prescribe antibiotics, even during pregnancy, include a urinary tract infection (UTI), gallbladder infection, placenta and amniotic fluid infection, kidney infection, bacterial vaginosis, listeria, and syphilis.

What Antibiotics Are ‘Safe’ in Pregnancy?

While no medication is completely without risks, antibiotics generally considered safe to take during pregnancy include:

• Penicillin (such as amoxicillin and ampicillin)
• Macrolides (such as erythromycin and azithromycin)
• Cephalosporins (such as cephalexin)
• Metronidazole (an antibiotic used to treat certain vaginal infection such as bacterial vaginosis)

Some antibiotics may need to be prescribed even though there are safety concerns for using them during pregnancy. These include nitrofurantoin, trimethoprim, and sulfamethoxazole. These antibiotics are commonly used to treat UTIs, which are common during pregnancy and may cause complications if left untreated.

What Antibiotics Are Unsafe in Pregnancy?

Some antibiotics are avoided altogether during pregnancy due to the risks they pose to the unborn baby. These include:

• Tetracycline (such as minocycline, oxytetracycline, and doxycycline), typically used to address acne and respiratory infections
• Streptomycin, used for tuberculosis
• Ciprofloxacin, used to manage UTIs

These antibiotics have been associated with fetal side effects, such as discoloured teeth, hearing loss, or abnormal bone development, based on human and animal studies.

Taking Antibiotics Safely in Pregnancy

You should always follow your doctor’s instructions when taking antibiotics, particularly during pregnancy.

Your gynaecologist will consider a range of factors before prescribing antibiotics to ensure that they’re necessary for your gestation and pose minimal risk to you and your unborn child. Most gynaecologists will:

• Use extra caution when prescribing antibiotics in the first trimester but will proceed if the benefits outweigh the risks.
• Confirm the type of injections with appropriate tests.
• Prescribe the lowest effective dose.
• Prescribe antibiotics for the shortest necessary duration.
• Use only one type of antibiotic
• Only prescribe antibiotics when absolutely necessary

Pregnant women with a minor infection that doesn’t require antibiotics should consult their doctor about safe over-the-counter alternatives.

Antibiotics and Pregnancy: The Takeaway

So, are antibiotics safe during pregnancy? The answer is that it really depends on the specifics of the situation.

In many cases, the risk of a child being exposed to an untreated infection is higher than the risk of being exposed to antibiotics. It’s important to speak to your doctor about any concerns so that you can work together to keep both you and your baby safe.

The obstetricians and gynaecologists at Create Health are committed to equipping patients with all the information needed to make informed decisions about their health. If you are pregnant and suspect that you need antibiotics, book an appointment with us today to discuss all your options.

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