丹麦学者的一项研究表明，早期妊娠阶段女性应用克拉霉素可升高其流产风险，但未升高后代先天畸形患病率。论文于2013年1月2日在线发表于《公共科学图书馆·综合》（PLoS ONE）。

　　此项研究利用丹麦生殖数据库确认所有分娩女性，并利用丹麦医院登记系统确认伴流产或人工流产记录的所有女性。处方资料从丹麦处方登记库中获取。主要转归为克拉霉素应用者和非应用者的流产和后代严重先天畸形例数。

　　结果显示，共有931,504例妊娠女性被纳入研究，其中活产、流产和人工流产例数分别为705,837、77,553和148,114例。在401例于妊娠前三个月接受克拉霉素治疗的女性中，40例（10.0%）出现流产；在活产婴儿中则有9例（3.6%）伴先天畸形。应用克拉霉素后流产的危险比（HR）为1.56。应用青霉素或红霉素未升高流产风险。应用克拉霉素后后代先天畸形患病率未出现升高（OR 1.03）。

　　Clarithromycin in Early Pregnancy and the Risk of Miscarriage and Malformation: A Register Based Nationwide Cohort Study

　　Background

　　The antibiotic clarithromycin has been associated with fetal loss in animals and a study has found a doubling in the frequency of miscarriages among women using clarithromycin in pregnancy. The aim of the study was to investigate whether clarithromycin use in early pregnancy was associated with an increased risk for miscarriages and major malformations.

　　Methods

　　We conducted a nationwide cohort study including all women in Denmark with a known conception between 1997 and 2007. The Fertility Database was used to identify all women giving birth and the National Hospital Register was used to identify all women with a record of miscarriage or induced abortion. Presc**tion data was obtained from the National Presc**tion Register. The primary outcome was the number of miscarriages and offspring with major congenital malformations among users of clarithromycin compared to non-users.

　　Results

　　We identified 931 504 pregnancies (705 837 live births, 77 553 miscarriages, and 148 114 induced abortions). 401 women redeemed a presc**tion of clarithromycin in the first trimester of which 40 (10.0%) experienced a miscarriage and among the live born nine (3.6%) had offspring with malformations. The hazard ratio (HR) of having a miscarriage after exposure to clarithromycin was 1.56 (CI95% 1.14–2.13). There was no increased hazard of having a miscarriage when being exposed to penicillin or erythromycin. There was no increased prevalence (OR=1.03 (CI95% 0.52–2.00)) of having offspring with malformations after exposure to clarithromycin.

　　Conclusions

　　We found an increased hazard of miscarriage but no increased prevalance of having offspring with malformations among women redeeming a presc**tion of clarithromycin in early pregnancy. This is supported by previous studies in animals and humans. However, further research is required to explore the possible effect of treatment indication on the associations found.

　　原始来源：http://www.cmt.com.cn/subjectDetail/1/19/128647.html