Fever and antibiotic use in maternal urinary tract infections during pregnancy and risk of congenital heart defects: Findings from the National Birth Defects Prevention Study

Details

• Alternative Title:
  Birth Defects Res
• Personal Author:
  Patel, Jenil ; Politis, Maria D. ; Howley, Meredith M. ; Browne, Marilyn L. ; Bolin, Elijah H. ; Ailes, Elizabeth C. ; Johnson, Candice Y. ; Magann, Everett ; Nembhard, Wendy N.
• Corporate Authors:
  The National Birth Defects Prevention Study
• Description:
  Background:
  
  Previous studies report an association between prenatal maternal urinary tract infections (UTI) and specific congenital heart defects (CHDs); however, the role of fever and antibiotic use on this association is poorly understood. Using data from the National Birth Defects Prevention Study, we examined whether the relationship between maternal UTIs during the periconceptional period and occurrence of CHDs is modified by the presence of fever due to UTI and corresponding antibiotic use among 11,704 CHD case infants and 11,636 live-born control infants.
  
  Methods:
  
  Information on UTIs, fever associated with UTI and antibiotic use (sulfonamides, nitrofurantoin, cephalosporins, penicillin, macrolides, and quinolones) during pregnancy were obtained using a computer-assisted telephone interview. Using unconditional multivariable logistic regression, we calculated adjusted odds ratios (ORs) to determine the association between maternal UTIs and subtypes of CHDs. Analyses were stratified by the presence of fever and medication use associated with UTI.
  
  Results:
  
  The prevalence of UTIs during the periconceptional period was 7.6% in control mothers, and 8.7% in case mothers. In the absence of fever, UTI was associated with secundum atrial septal defects (ASD) (OR 1.3; 95% confidence interval [CI] 1.1–1.5) and in the absence of antibiotics, UTI was associated with conotruncal defects as a group and for four specific CHDs. When fever and UTI occurred concomitantly, no significantly elevated odds ratios were noticed for any subtypes of CHD. Among women with UTIs who used antibiotics, an elevated but statistically non-significant estimate was observed for secundum ASD (OR 1.4; 95% CI 1.0–2.0).
  
  Conclusion:
  
  Findings in the present study suggest that fever due to UTI and corresponding maternal antibiotic use do not substantially modify the association between maternal UTIs and specific CHDs in offspring. Further studies with larger sample sizes are warranted to guide clinical management of UTIs during the periconceptional period.
  
  
• Subjects:
  Anti-Bacterial Agents Case-Control Studies Female Heart Defects, Congenital Humans Infant Pregnancy Risk Factors Urinary Tract Infections
• Keywords:
  CHDs Congenital Heart Defects Fever Maternal Infections Pregnancy UTI
• Source:
  Birth Defects Res. 116(1):e2281
• Pubmed ID:
  38093546
• Pubmed Central ID:
  PMC11071646
• Document Type:
  Journal Article
• Funding:
  FOA #DD09-001/CC/CDC HHSUnited States/ ; U01 DD001304/DD/NCBDD CDC HHSUnited States/ ; U01 DD001285/DD/NCBDD CDC HHSUnited States/ ; FOA #DD13-003/CC/CDC HHSUnited States/ ; U01 DD001227/DD/NCBDD CDC HHSUnited States/ ; PA #96043/CC/CDC HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; T42 OH008421/OH/NIOSH CDC HHSUnited States/ ; EP-D-18-001/EPA/EPAUnited States/ ; U01 DD001032/DD/NCBDD CDC HHSUnited States/ ; PA #02081/CC/CDC HHSUnited States/ ; U01 DD001306/DD/NCBDD CDC HHSUnited States/ ; NOFO #DD18-001/CC/CDC HHSUnited States/ ; U01 DD001229/DD/NCBDD CDC HHSUnited States/ ; CDP 13-003/HX/HSRD VAUnited States/
• Volume:
  116
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c6b085050bbf13ec93cf25e1b3af977773a7e9b987c7f1c62dd729efc0fc8cba6fb615c66355c349a3430ef959e333d7f9c4ecf57b1070acaaa1321bb4961d18
• Download URL:
  https://stacks.cdc.gov/view/cdc/155544/cdc_155544_DS1.pdf
• File Type:
  [PDF - 145.06 KB ]