Antibiotics and Your Third Trimester

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Doctors would generally say that a pregnant mom should not take medication without prescription, for fear of the side effects of the drugs on the growing foetus. More so, where medication like antibiotics are involved, it is strongly advised that pregnant moms consider the type of drugs, and use it/them only as prescribed by their doctors. Self-medication often has far reaching effects during pregnancy, and is strongly advised against.

An encounter with a doctor friend, whom I had met during my service year, was what opened my eyes to the dangers of antibiotics especially during the last trimester of pregnancy. It had been sort of a mini reunion meeting at the home of another friend, who was in her third trimester. We had agreed on her home, to save her the stress of jumping around in Lagos traffic in her condition.

While catching up with each other over the happenings in our lives over the last few years; who’d had another baby, who was having what and such, our host brought out her medicine bag, as in a bag filled with supplements and prescription slips, and proceeded to pop her pills. The doctor amongst us took the bag, when she was done, just for curiosity’s sake, and when she saw an antibiotic medication there, she nearly threw a fit, as she asked why she was taking antibiotic so late in her pregnancy and where was the prescription for it.

The prescription was provided and then the lecture started. Didn’t she know that antibiotics this late in her pregnancy could cause her baby to have asthma? Why did the doctor not prescribe another type of antibiotic, and what dosage was she on, how long was she supposed to take it? The questions went on?

By the time asthma had been mentioned, our pregnant mama was already showing signs of worry, and rightly so. There is no mother who would hear that the medication she took could affect her baby, and not worry. It’s natural. Besides, this friend is a practising gynaecologist, so she knew what she was talking about.

Well, the doctor who had caused the worry was the one who went about comforting our pregnant woman, with statistics from studies and even the cases she had seen and managed. But I was intrigued by this piece of information and I wanted to know, why she was taking the antibiotics. Well, she had an infection that was not going away, after she had taken immune boosters, so her doctor prescribed antibiotics to help get rid of the infection.

Well, when I dug into the antibiotic palaver, I was almost paranoid with worry, as I revisited my pregnancy days and realised that I had taken antibiotics the first time I was pregnant, also because of an infection. I even added 2+2 and got 100, with regards some symptoms my older son exhibited when he was born; he could not breathe on his own for close to seven days, and needed to be on oxygen 24/7. As for other conditions, like asthma, thankfully, that was not his portion and he is seven now.

According to one of the stories, which my doctor friend told, taking antibiotics at any time during pregnancy is not really a good idea and especially during the third trimester, since the baby is almost ready to come into the world, and the birth canal is the first point of contact, an obvious residual area for whatever antibiotics a pregnant mom had taken. Usage of antibiotics late in pregnancy could decimate the population of the good bacteria, therefore predisposing the baby to catching some unwanted bacteria.

She said, she had a patient like that once, who had gone to a pharmacy to buy antibiotics, instead of coming to the hospital to see the doctor about her complaints. It was during her next antenatal clinic that she had come with the antibiotics to show the doctor, that she had been taking them, but her symptoms had only grown worse. She said she was so shocked at the harm the woman was putting her baby and herself through by that act, that she took her to see their consultant, who was an older woman, perhaps, she would be better able to explain the consequences of her actions to her, as she did not believe her. In the end, she did not need antibiotics, all she needed was something to boost her immunity, to be able to fight the infection. So, she was asked to stop the medication and never try a repeat performance.

A week later, that woman went into labour and she gave birth to a baby boy, but the first three months of the baby’s life were challenging, in that he was in and out of the hospital, on account of the fact that he was always gasping for breath. He would sleep and become unresponsive, feeding was an issue. He needed to be monitored 24/7 but after the first three months of his life, he recovered and reached milestones for a child his age. Although, his condition never got complicated beyond the wheezing, while he was under their care at the hospital, it could have.

According to a research into 13-thousand pregnancies, researchers found links between birth defects and two common antibiotics – sulfanomides and nitrofurantoins – commonly used for urinary tract infections.
“Any study shows the relationship from one to the other,” says Dr. Mark Sheffield a neonatologist. “It can’t show a cause and effect. Serious bacterial infections are a problem in pregnancy, and, if left untreated, can cause problems. So, could the infection or the combination of the drugs and the infection together cause some of these birth defects? Yes. But, we see increased risk with these two classes than we did with other common antibiotics like penicillin, amoxicillin, ampicillin or cephalosporin, which didn’t see an increased risk.”

Another study found that by the European Lung Foundation finds that antibiotic use during the third trimester of pregnancy could increase your baby’s chances of developing a childhood wheeze—but scientists aren’t exactly sure why.
“In recent years, prenatal and early life exposure to several common medicines, such as [acetaminophen] and antibiotics have been linked to asthma-like conditions in children. These exposures during early life are most likely explained by reverse causation, i.e. patients with asthmatic symptoms may receive antibiotics or paracetamol more frequently, either by misprescription or for treatment of comorbidities,” explains Maja Popovic, Ph.D., lead author of the study. “It was unclear whether already reported positive associations between exposure to antibiotics in utero and asthmatic symptoms reflect the true relationship or whether some other factors such as maternal infections might underlie this association.”

When it’s okay to take them
Doctors admit that usage of antibiotic during pregnancy is not strictly forbidden. “Our findings should not discourage antibiotic use when there is a real medical indication,” Dr. Popovic clarified. “At this point it is important to remind ourselves that when antibiotics are really needed they do more good than harm and they should be prescribed for pregnant women even in the third trimester if appropriate indication exists. However, they should be used for the shortest effective duration.”

Food or thought!

 

 Join the conversation with any of our TTC and Pregnancy Groups here

Photo credits:

1. http://www.mamashealth.com/

2. http://arquivo.geledes.org.br/

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