Urinary tract infections are not uncommon during pregnancy. However, a new CDC report states over 40 percent of women are receiving unsafe antibiotics during their first trimester.
Urinary tract infections (UTIs) are relatively common in pregnancy, affecting up to 10 percent of all expectant mothers. In fact, the American Pregnancy Association lists UTIs as the most common medical complication associated with pregnancy.
In addition to being incredibly uncomfortable, urinary tract infections can lead to several health hazards for both mom and baby. Asymptomatic bacteriuria, or the presence of bacteria in the urine without symptoms, has been linked to low birth rate, prematurity, and in rare cases, newborn death. Further, untreated UTI’s can lead to maternal kidney infections.
The primary treatment for UTIs, pregnant or not, are antibiotics. However, in 2011 the American College of Obstetrics and Gynecologists (ACOG), warned against the use of two specific antibiotics in the first three months of pregnancy: Macrobid and Bactrim.
Macrobid belongs to a group of drugs called nitrofuran antibiotics and is used to stop the growth of bacteria. Bactrim, chemically referred to as sulfamethoxazole, is a pregnancy category C medication, meaning it has shown harm in animal studies. Both drugs have been associated with congenital birth defects, including brain and heart defects, as well as cleft lips and palates.
In 2017, ACOG reiterated their recommendations, stating that sulfonamides and nitrofurantoin should be avoided in the first trimester unless there are no other alternatives.
However, a new report from the Centers for Disease Control (CDC) estimates that more than 40 percent of pregnant women diagnosed with UTIs in their first trimester are being prescribed these potentially dangerous drugs. According to the CDC, approximately 3 in 10 women with a diagnosis of a UTI during early pregnancy filled a prescription for Macrobid and about 1 in 10 filled a prescription for Bactrim.
For the study, the CDC analyzed records of nearly 483,000 pregnant women in 2014 who had employer-sponsored health insurance. Among the pregnancies, 7.2% of women had an outpatient UTI diagnosis during the first 90 days of gestation. Of the women diagnosed with a UTI, close to 70% filled an antibiotic prescription for their UTI.
The CDC report comes at a time when women and healthcare providers are voicing concern about the safety of medications during pregnancy. As a result, the CDC has initiated the “Treating for Two” campaign which aims to improve the health of women and babies by identifying the safest treatment options for common health conditions during pregnancy.