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

• Personal Author:
  Ailes EC ; Bolin EH ; Browne ML ; Howley MM ; Johnson CY ; Magann E ; Nembhard WN ; Patel J ; Politis MD
• Corporate Authors:
  National Birth Defects Prevention Network
• 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. [Description provided by NIOSH]
• Subjects:
  Anti-Bacterial Agents Occupational Health Pregnancy Safety
• Keywords:
  Antibiotics Author Keywords: CHDs Birth Defects Body Temperature Congenital Effects Congenital Heart Defects Fever Hyperthermia Maternal Infections Prenatal Exposure UTI

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• ISSN:
  2472-1727
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Arkansas ; Georgia ; New York ; North Carolina ; OSHA Region 2 ; OSHA Region 4 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  116
• Issue:
  1
• NIOSHTIC Number:
  nn:20069472
• Citation:
  Birth Defects Res 2024 Jan; 116(1):e2281
• Contact Point Address:
  Wendy N. Nembhard, Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #820, Little Rock, AR 72205-7199, USA
• Email:
  wnnembhard@uams.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of Texas Health Science Center, Houston
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Birth Defects Research
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f6bbef7a6fd1d8b35627185b54d9d2c7bc61783726556b5bd1697e01968b85268cbb97042b345d85973a831c03ea255aba3e64069f83b4df3a389853c64f7913
• Download URL:
  https://stacks.cdc.gov/view/cdc/207909/cdc_207909_DS1.pdf
• File Type:
  [PDF - 1.62 MB ]