University of Florida cohort study links early-pregnancy doxycycline use to higher risk of pregnancy loss
A retrospective study of insurance claims found that doxycycline for respiratory infections or acne in the first trimester was associated with more pregnancy losses than alternative treatments.
Researchers from the University of Florida and colleagues report that doxycycline use for respiratory tract infections or acne in early pregnancy was associated with an increased risk of pregnancy loss. The result comes from a retrospective, active-comparator cohort study published in Annals of Internal Medicine and summarized by eurekalert.org eurekalert.org
eurekalert.orgeurekalert.orgOpen source ↗. The corresponding author is Almut G. Winterstein, PharmD, PhD. Doxycycline is a commonly used antibiotic prescribed for a variety of infections, including skin and respiratory tract infections.
Data and study design
The team analyzed insurance claims data from commercial and Medicaid databases. The sample included 218,234 pregnancies in women with respiratory tract infections and 6,636 pregnancies in women with acne. The aim was to assess whether taking doxycycline during early pregnancy was associated with pregnancy loss.
The authors compared women who filled prescriptions for doxycycline during the first trimester with similar women who received alternative treatments. For respiratory tract infections, the comparators were amoxicillin and macrolide. For acne, the comparator was topical clindamycin. This is an observational design, so the findings describe an association.
Results in two indications
In both insurance claims databases, women with respiratory tract infections who used doxycycline had a higher risk of pregnancy loss than the comparison group eurekalert.org
eurekalert.orgeurekalert.orgOpen source ↗. Among patients with acne, risk was higher in pregnancies with doxycycline exposure in the commercial claims database, but not in Medicaid.
The authors note that doxycycline is frequently used by women of childbearing age. In their view, the findings underscore the importance of clinicians and patients weighing the benefits and risks when considering treatment with doxycycline. They also state that the results provide additional data to inform clinical recommendations for the treatment and postexposure prophylaxis of infections during pregnancy.
The summary of the study does not report effect sizes or confidence intervals; these are given in the full article in Annals of Internal Medicine.
