Quinolone Use during the First Trimester of Pregnancy and the Risk of Atopic Dermatitis, Asthma, and Allergies of Offspring during 2011 to 2020

Background: Many pregnant women receive antibiotic treatment for infections. We investigated the association between quinolone use in the first trimester of pregnancy and the risk of adverse health outcomes for the child in Korea.

Materials and methods: This nationwide, population-based cohort study used data on mother-child pairs from the National Health Insurance claims database. This study cohort included 2,177,765 pregnancies from January 1, 2011, to December 31, 2020, and 87,456 women were prescribed quinolones during pregnancy. After propensity score matching, the final number of study subjects was 84,365 for both quinolone and non-antibiotic users. We examined the subjects' exposure to quinolone antibiotics. The main outcome measures were absolute and relative risks of atopic dermatitis, asthma, and allergies. We adjusted for potential confounders.

Results: Quinolones were prescribed at least once during the first trimester in 4.01% of pregnancies. Quinolone users had significantly higher absolute risks than non-antibiotic users for atopic dermatitis, asthma, and allergies, with significantly elevated risk ratios (RRs) for these conditions (atopic dermatitis: RR, 1.09; 95% confidence interval [CI], 1.08-1.11, asthma: RR, 1.04; 95% CI, 1.03-1.05, and allergies: RR, 1.10; 95% CI, 1.08-1.13).

Conclusion: We found that quinolone exposure during the first trimester of pregnancy increased the risk of atopic dermatitis, asthma, and allergies. This study could provide physicians with useful information when selecting antibiotics for pregnant women.