Hey y’all, just wanted to give you additional information on a topic I hit on a couple months ago.

The initial post, “Is Nitrofurantoin Safe to Use During Pregnancy?” was viewed by a blog follower in New Zealand who is currently pregnant and was prescribed nitrofurantoin (Yup, that’s right, GPA.com has traveled across the world…wicked exciting to me!).

The soon-to-be mom was concerned for her baby’s safety, so she e-mailed the following message:

Hi im 34 weeks pregnant and my midwife have me on 4 x 50mg a day for 7 days as i have a uti and im very worried about the effects i will have on my babies development and wellbeing. My midwife said its very safe and that my baby will be fine but as this is my first pregnancy im worried as i dont know anyone close that has had uti  antibiotics during pregnancy and feel scared as i dont want to harm my baby in any way. Am feeling a bit scared as its not 100% sure. What do you think.

My response was:

Hi Jane Doe (or whatever name you’d like to insert!),

I definitely understand your concern about taking medications during your pregnancy, especially since it’s your first time through such an experience!

You have the right idea…best to to avoid taking any medications, but sometimes the benefits outweigh the risks.

I’m not sure if you’re familiar with the U.S. Food and Drug Administration (FDA), as I believe you live in another country (New Zealand? based on your e-mail address), but they have setup categories for the use of medications in pregnancy.

The categories include A, B, C, D, and X, with A being the safest category on down to X being extremely dangerous.    Nitrofurantoin falls into category B: Animal studies have shown no evidence of risk to the fetus, but there are not enough studies in humans to come to the same conclusion OR animal studies have shown risk BUT there are adequate studies in humans showing no risk to the fetus.

The fact that nitrofurantoin is a category B based on the FDA guidelines would make give me great comfort if I were in your situation!

If you were at full term (between 38 to 42 weeks) or could go into labor at any moment, there is concern that your newborn could experience what’s called hemolytic anemia (not enough red blood cells in the blood).

I know that sounds scary, but this hemolytic anemia was reported in mothers with G-6PD deficiency (a rare condition that you’d probably know if you had), which can also occur in the fetus.

The best news about this chance of hemolytic anemia is that it is extremely rare….the risk is 0.0004%!   A comprehensive review of available studies on treatment of UTIs in pregnancy has shown nitrofurantoin (and other antibiotics) to be very effective and complications to be rare.

With all of this being said, I agree with your midwife, and if I were in your place, I would take the nitrofurantoin.  To me, the risk of not treating the infection outweighs the risk that nitrofurantoin poses to the fetus, especially because the infection can become worse and lead to undesirable outcomes.

I hope I have been of at least some help and that you can use this information as a way to help you decide what’s best for your situation.

Have a great night (or in your case, day!) and thanks for getting in touch,

Cate

END OF RESPONSE!

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