Trimethoprim use in early pregnancy and the risk of miscarriage: a register-based nationwide cohort study
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Trimethoprim use in early pregnancy and the risk of miscarriage : a register-based nationwide cohort study. / Andersen, J T; Petersen, M; Jimenez-Solem, E; Broedbaek, K; Andersen, Elisabeth Anne Wreford; Andersen, N L; Afzal, Shoaib; Torp-Pedersen, C; Keiding, Niels; Poulsen, H E.
In: Epidemiology and Infection, Vol. 141, No. 8, 2013, p. 1749-1755.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Trimethoprim use in early pregnancy and the risk of miscarriage
T2 - a register-based nationwide cohort study
AU - Andersen, J T
AU - Petersen, M
AU - Jimenez-Solem, E
AU - Broedbaek, K
AU - Andersen, Elisabeth Anne Wreford
AU - Andersen, N L
AU - Afzal, Shoaib
AU - Torp-Pedersen, C
AU - Keiding, Niels
AU - Poulsen, H E
PY - 2013
Y1 - 2013
N2 - SUMMARY The antibiotic trimethoprim acts as a folate antagonist. Since trophoblasts are very sensitive to drugs that interfere with the folic acid cycle and thereby inhibit DNA synthesis, use of trimethoprim during the first trimester could be associated with miscarriage. A nationwide cohort study including all women in Denmark with a registered pregnancy between 1997 and 2005 was conducted. We used nationwide registers to identify all women giving birth, having a record of miscarriage or induced abortion. Data on exposure to trimethoprim were obtained from the National Prescription Register. Cox proportional hazard regression analysis with exposure to trimethoprim as a time-dependent variable was used to estimate the risk of miscarriage. The adjusted hazard ratio of having a miscarriage after exposure to trimethoprim in the first trimester compared to non-exposure was 2·04 (95% confidence interval 1·43-2·91). Our results indicate that trimethoprim exposure in the first trimester is associated with a doubling of the hazard of miscarriage.
AB - SUMMARY The antibiotic trimethoprim acts as a folate antagonist. Since trophoblasts are very sensitive to drugs that interfere with the folic acid cycle and thereby inhibit DNA synthesis, use of trimethoprim during the first trimester could be associated with miscarriage. A nationwide cohort study including all women in Denmark with a registered pregnancy between 1997 and 2005 was conducted. We used nationwide registers to identify all women giving birth, having a record of miscarriage or induced abortion. Data on exposure to trimethoprim were obtained from the National Prescription Register. Cox proportional hazard regression analysis with exposure to trimethoprim as a time-dependent variable was used to estimate the risk of miscarriage. The adjusted hazard ratio of having a miscarriage after exposure to trimethoprim in the first trimester compared to non-exposure was 2·04 (95% confidence interval 1·43-2·91). Our results indicate that trimethoprim exposure in the first trimester is associated with a doubling of the hazard of miscarriage.
KW - Faculty of Health and Medical Sciences
KW - Antibiotics
KW - birth defects
KW - epidemiology
KW - pregnancy
U2 - 10.1017/S0950268812002178
DO - 10.1017/S0950268812002178
M3 - Journal article
C2 - 23010291
VL - 141
SP - 1749
EP - 1755
JO - Epidemiology and Infection
JF - Epidemiology and Infection
SN - 0950-2688
IS - 8
ER -
ID: 122545779