(Date of issue: January 2016. Version: 3)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
What are they?
The cephalosporins (cefaclor, cefadroxil, cefalexin, cefixime, cefotaxime, cefpodoxime, cefradine, ceftazidime, ceftriaxone and cefuroxime) are a family of antibiotics that are used in the treatment of respiratory tract infections, middle ear infections, skin and soft tissue infections, urinary tract infections, sexually transmitted infections, septicaemia (an infection of the blood), meningitis, peritonitis (an infection of the tissue that lines the inside of the abdomen) and endocarditis (an infection of the heart). Cephalosporins may also be used to prevent an infection from developing after a person has had an operation.
Is it safe to take cephalosporins in pregnancy?
There is no yes or no answer to this question. When deciding whether to take a cephalosporin during pregnancy it is important to weigh up how necessary a cephalosporin is to your health against any possible risks to you or your baby, some of which might depend on how many weeks pregnant you are.
It is important to appropriately treat infections in pregnancy. Some infections can be serious and/or can lead to premature labour and other pregnancy complications. Cephalosporins are generally regarded as suitable for use in pregnancy. Your doctor is the best person to help you decide what is right for you and your baby.
This leaflet summarises the scientific studies relating to the effects of cephalosporin on a baby in the womb.
What if I have already taken a cephalosporin during pregnancy?
If you have taken any medicines it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and to make sure that you are taking the lowest dose that works.
Can taking cephalosporins in pregnancy cause my baby to be born with birth defects?
A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.
Studies of over 6,500 babies born to women who took a cephalosporin in early pregnancy have, provided no strong evidence that use of a cephalosporin increases the risk of the baby having a birth defect overall. When the rates of specific birth defects were investigated, three studies suggested that heart defects might be linked to exposure to cephalosporins in the womb. However, possible problems with the way that the information was collected and analysed in some of these studies mean that more research is required to confirm this.
Can taking cephalosporins in pregnancy cause miscarriage?
A very small study of around 100 women taking the cephalosporin cefuroxime in early pregnancy provided no evidence that their risk of miscarriage was increased. However, much more research is required to confirm this finding and studies of other specific cephalosporins are also needed.
Can taking cephalosporins in pregnancy cause stillbirth?
No studies have investigated whether rates of stillbirth are increased in women who use cephalosporins in pregnancy.
Can taking cephalosporins in pregnancy cause preterm birth or my baby to be small at birth (low birth weight)?
A single small study of around 100 women taking the cephalosporin cefuroxime in early pregnancy provided no evidence of a link with preterm birth or low birth weight in the baby. Much more research is required to confirm these findings and studies of other specific cephalosporins are also needed.
Can taking cephalosporins in pregnancy cause learning and behavioural problems in the child?
A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.
Around 170 babies and children who were exposed to a cephalosporin in the womb have been assessed to see if they were reaching developmental milestones as expected. There is currently no evidence of a link between using a cephalosporin in pregnancy and delayed development in babies and children. However, scientific studies into other aspects of development, and also the rates of behavioural and learning problems in children exposed to cephalosporins in the womb are required to rule out any effects.
Will my baby need extra monitoring?
Most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects as part of their routine antenatal care. Taking a cephalosporin in pregnancy is not expected to cause problems that would require extra monitoring of your baby. However, women who have had a serious infection during pregnancy might be more closely monitored to ensure that their baby is growing and developing as expected.
Are there any risks to my baby if the father has taken a cephalosporin?
No studies have specifically investigated whether cephalosporins taken by the father can harm the baby through effects on the sperm, however most experts agree that this is very unlikely. More research on the effects of medicine use in men around the time of conception is needed.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.