The safety of quinolones-A meta-analysis of pregnancy outcomes

Objective: We conducted a meta-analysis of all published data in order to evaluate the risk for birth defects, stillbirths, preterm births and low birth weight following exposure to quinolones in the first trimester of pregnancy. Study design: Medline, Embase, Scopus, Biological Abstracts and Proquest Thesis Dissertation databases were searched. Other papers and abstracts were located from the retrieved articles' references, meeting booklets, internet web sites and books on teratology. Results: Five studies met the inclusion criteria. The summary odds ratio for all the included studies was 1.05 (95% CI 0.90-1.22) for major malformations, 2.6 (95% CI 0.36-18.67) for stillbirths, 1.15 (95% CI 0.69-1.91) for preterm births and 0.73 (95% CI 0.30-1.79) for low birth weight. In an additional analysis including only fluoroquinolones (nalidixic acid was removed), the summary odds ratio for major malformations remained non-significant (1.11, 95% CI 0.57-2.15). Conclusions: The use of quinolones during the first trimester of pregnancy does not appear to represent an increased risk for major malformations recognized after birth, stillbirths, preterm births or low birth weight.