Antibiotic use during pregnancy: a retrospective study of prescription patterns and birth outcomes at an antenatal clinic in rural Ghana

Abstract

BackgroundBabies are increasingly being exposed to antibiotics intrapartum in the bid to reduce neonatal and maternal deaths. Intrapartum antibiotic exposure, including even those considered safe in pregnancy, have been associated with childhood obesity and compromised immunity. Data on the extent of antibiotic use, safety and its impact on birth outcomes and neonatal health in Sub-Saharan Africa is very limited. This study sought to ascertain the extent of antibiotic use in pregnancy and its effects on birth outcomes in a rural hospital in Ghana.MethodsThe study was a retrospective randomized study of mothers who delivered babies in a rural hospital between 2011 and 2015 in Ghana. A total of 412 mother/baby records out of 2100 pre-selected met the inclusion criteria of the study. Indicators of neonatal health used were birthweight, Apgar score, incidence of birth defects.ResultsSixty five percent of pregnant women were administered antibiotics at some stage during pregnancy. Beta Lactam antibiotics accounted for more than 67% of all antibiotics prescribed. There was a statistically significant association between antibiotic exposure and pregnancy factors such as stage of pregnancy, parity and mode of delivery but not with socio-economic status of the mother. Intrapartum antibiotic exposure did not significantly affect the birthweight, incidence of congenital birth defect and mean Apgar scores. After adjusting for method of delivery, however, perinatal antibiotic use (24 h to delivery) was associated with lower mean Apgar scores. Birth weight was affected significantly by maternal socio-economic factors such as age and marital status.ConclusionSixty five percent of women attending the antenatal clinic received antibiotics. Intrapartum antibiotics did not affect early markers of neonatal health such as birthweight, congenital birth defect and mean Apgar scores. However, antibiotic use less than 24 h to delivery was associated with a decrease in mean APGAR score.

Patterns of Infections and Antimicrobial Drugs’ Prescribing among Pregnant Women in Saudi Arabia

“…This is also in agreement with the findings of the Ganian study where beta lactam antibiotics i.e. cephalosporins and penicillins also represented the majority of antibiotics used in an antenatal clinic in rural Ghana (13) and as reported in another study conducted in a hospital in Western Nepal (12) . According to FDA risk categorization, penicillins and cephalosporins are considered safe option in pregnancy.…”

“…Forty-eight percent of pregnant women in our study have received antimicrobial medication during their pregnancies. This is higher than the prevalence of anti-infective use reported in a study conducted in 2012 in Quebec Canada (11) , however, it was less than the documented antibiotic use in a recent study conducted in an antenatal clinic in rural Ghana (13) .…”

“…The most commonly prescribed antibiotics were categorized under classes B, C and D according to FDA risk classification system. The study results have shown that 3.5% of antibacterial prescriptions were filled without proper diagnosis or justification (13) .…”

Prescription pattern of antimicrobials in pregnant women attending antenatal clinic in a tertiary care hospital in Telangana, India

“…A similar finding was reported in the studies done in South India and Africa. 11,12 It is a known fact that gravid uterus exerts pressure over urinary bladder resulting in retention of urine leading to UTIs. [12][13][14] Betalactams constituted two-fifths of the antimicrobials prescribed followed by Nitrofuranes and Nitroimidazoles similar to the study reports from South India and Africa.…”

Várandósság és gyógyszerek

“…Az FDA C (ADEC B3) kategóriába tartozó cla ri thro my cin állatkíséretekben teratogénnek bizonyult, ezért alkalmazását érdemes mellőzni [23]. Bár általánosságban elmondható, hogy a makrolidok alkalmazása biztonságos, a motilin receptorokat közvetlenül indukálva gas trointestinális diszkomfort érzést okozhatnak [20], ami tovább fokozhatja a várandósság során előforduló emésztőrendszeri panaszokat.…”