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. 2013 Aug;141(8):1749-55.
doi: 10.1017/S0950268812002178. Epub 2012 Sep 25.

Trimethoprim use in early pregnancy and the risk of miscarriage: a register-based nationwide cohort study

J T Andersen  1 , M Petersen, E Jimenez-Solem, K Broedbaek, E W Andersen, N L Andersen, S Afzal, C Torp-Pedersen, N Keiding, H E Poulsen
Affiliations

Trimethoprim use in early pregnancy and the risk of miscarriage: a register-based nationwide cohort study

J T Andersen et al. Epidemiol Infect. 2013 Aug.

Abstract

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.

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Figures

Fig. 1.
Fig. 1.
Hazard ratio for miscarriage following trimethoprim exposure in three different parts of the first trimester.
See this image and copyright information in PMC

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