Abstract
Several epidemiological studies have found an association between maternal antibiotics use during pregnancy and increased risk of certain cancer types, although conclusions differ between studies. We examined this association in a cohort study including 262 116 mother‐child pairs of Manitoba births between 1996 and 2013. Maternal antibiotics use during prepregnancy (6 months prior to pregnancy) and pregnancy periods was assessed. Children's cancer incidence was tracked up to the end of the follow‐up period (December 2015). We calculated incidence rate and used Cox regression to estimate adjusted hazard ratios (HRs). Antibiotics use during pregnancy was not associated with overall cancer (HR = 1.1, 95% confidence interval 0.9‐1.4), leukemias (1.3, 0.9‐1.8), or acute lymphocytic leukemia (1.1, 0.7‐1.6). The association between antibiotics use and overall cancer risk differed by trimester: 1.5 (1.1‐1.9) in the first, 0.8 (0.6‐1.0) in the second, and 1.1 (0.8‐1.5) in the third trimester. Further research is necessary to confirm the association between first‐trimester exposure and cancer risk after a better controlling of confounding factors.
Highlights
Prescription drug use during pregnancy is common and increasing
The incidence rate of overall cancer was 14 per 100 000 person‐years for children under 20 years exposed to antibiotics during pregnancy and 13 [11,12,13,14,15] for those who were not, resulting in a crude incidence rate ratios (IRRs) of 1.1 (0.9‐1.4)
For all cancers as well as leukemias and acute lymphocytic leukemia (ALL), the IRR was higher for use in the first trimester, 1.4 (1.0‐1.8) compared to 0.8 (0.6‐1.1) and 1.1 (0.8‐1.4) for the second and third trimester, respectively
Summary
Prescription drug use during pregnancy is common and increasing. Around 60% of pregnant women in British Columbia of Canada received at least one prescription in 2002 (a median of two prescriptions); this proportion increased to 66% by 2011 (the median number of prescriptions rose to 3). A quarter of pregnant women received prescriptions across all trimesters. Similar increasing trends were reported in other countries. Antibiotics are the most commonly used medications by pregnant women, but pregnant women and children are often excluded from clinical trials due to safety concerns.Many drugs and/or their metabolites can cross the placenta barrier, causing in utero exposures. Postmarketing surveillance typically focuses on pregnancy outcomes (eg, fetal loss, preterm birth) and birth defects and rarely on the long‐term effects (eg, cancer and chronic diseases) in offspring. Prescription drug use during pregnancy is common and increasing. Around 60% of pregnant women in British Columbia of Canada received at least one prescription in 2002 (a median of two prescriptions); this proportion increased to 66% by 2011 (the median number of prescriptions rose to 3).. A quarter of pregnant women received prescriptions across all trimesters.. Similar increasing trends were reported in other countries.. Antibiotics are the most commonly used medications by pregnant women, but pregnant women and children are often excluded from clinical trials due to safety concerns. Many drugs and/or their metabolites can cross the placenta barrier, causing in utero exposures.. Postmarketing surveillance typically focuses on pregnancy outcomes (eg, fetal loss, preterm birth) and birth defects and rarely on the long‐term effects (eg, cancer and chronic diseases) in offspring
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