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Tetracycline and Pregnancy
The information below will help you determine if your prenatal exposure to tetracycline represents an
increased fetal risk. With every pregnancy, all women have a 3 to 5 percent chance to have a baby with
a birth defect.
What is tetracycline?
discoloration (graying) of the "baby" teeth. The
discoloration of the baby teeth is due to
Tetracycline is an antibiotic used to treat
calcification (hardening) of the teeth, which
conditions including acne and respiratory
starts at about four months. This problem
infections. It belongs to a group of antibiotics
appears to be only cosmetic, and does not
that includes minocycline, oxytetracycline,
appear to affect the development of the enamel
doxycycline, and other related antibiotics. In
or the chance of getting cavities. We do not
general, the concerns stated in this fact sheet
know what percentage of exposed babies will
apply to tetracycline and these related
have discoloration of the teeth. For this reason,
antibiotics. Tetracycline is usually taken orally.
the use of tetracycline should be avoided after
four months of pregnancy unless there is a
special condition requiring the doctor to
I am taking tetracycline during the first month
prescribe this type of antibiotic.
of my pregnancy. Is there a risk for birth
defects?
I have heard that tetracycline also affects the
Researchers have studied the outcome
bones of developing babies, in addition to the
of pregnancies when women took tetracycline
teeth. Is this true?
during the first trimester (the first 12 weeks),
which is the period when all the body organs
Tetracycline appears to affect the
are forming. These studies have not shown an
calcification (hardening) of the bones and teeth,
increased risk for major birth defects in children
and it also appears to cause reduced growth of
exposed to tetracycline in the first trimester of
some bones while the baby is being exposed to
pregnancy.
the medication. Yet, while the tooth
discoloration is permanent, the bone growth
There may be a small increased risk for
seems to return to normal after the tetracycline
minor birth defects such as an inguinal hernia,
exposure ends.
but the number of reports is too small to be sure
this risk exists. Once you know that you are
pregnant, it is a good idea to talk to your health
I am 14 weeks pregnant and I am taking
care provider about continuing the use of
tetracycline. If I stop taking it now, how long
tetracycline for the remainder of your
will tetracycline stay in my body?
pregnancy.
It takes less than 5 days for tetracycline
to be cleared from the body of most people. If
Is there a risk for other problems if I take
you stop taking the medication now, your baby
tetracycline at any time during pregnancy?
will not be exposed to tetracycline after one
week. As with any medication, you should
Yes. If you take tetracycline after the
speak with your health care provider before you
fourth month of pregnancy, there is a risk for
stop taking tetracycline.
What if I am taking one of the other
medications in this group such as minocycline,
November 2000
oxytetracycline, or doxycycline instead of
Copyright by OTIS,
tetracycline? Does that still put my baby at
Reproduced by permission.
risk?
Since these antibiotics are similar to
tetracycline, it is possible that they could also
affect a baby's teeth and bones in the same way
if taken in the second and third trimesters of
References:
pregnancy. There are some reports of babies
Briggs et al. Drugs in Pregnancy and Lactation,
with dental discoloration after similar
5th Ed. Williams and Wilkins (1998).
exposures, and for that reason, it is best to use
Cohlan, SQ et al. (1961) "Effect of tetracycline
the same precautions with these related
on bone growth in the premature infant." Antimicrobial
medications.
Agents Chemotherapy. 1961: 340-7.
Committee on Drugs, American Academy of
Pediatrics (1994). "The transfer of drugs and other
I am pregnant and I often get upper
chemicals into human breast milk." Pediatrics. 93: 137-
respiratory infections for which my doctor
150.
prescribes tetracycline. If I get one of these
Egerman, et al. (1992). "The tetracyclines."
infections after I am five months pregnant,
Obstet Gynecol Clin NA. 19(3): 551-61.
Genot, MT et al. (1970). "Effect of
what should I do?
administration of tetracycline on teeth." J Oral Med. 25:
75-9.
Talk to your doctor about your concerns
Kline et al. (1964). "Transplacental effect of
regarding tetracycline. Your doctor may
tetracycline on teeth." JAMA. 188: 178.
consider a different medication to treat your
Kutscher et al. (1966). "Discoloration of
deciduous teeth induced by administration of tetracycline
infection.
antepartum." Am J Obstet Gynecol. 96: 291-2.
The WHO Working Group, Bennet, PN (Ed):
Drugs and Human Lactation. Elsevier, New York,
I am breast feeding and thinking about taking
(1988).
tetracycline. Can it still affect my baby?
Gilman, AG et al. (Eds). Goodman and Gilman's
The Pharmacological Basis of Therapeutics, 7th Ed.,
Macmillan, New York, (1985).
In a baby, the bones and teeth continue
O'Rahilly, R, and Mueller, F. Human
to harden until one year of age. Therefore, if a
Embryology & Teratology. Wiley-Liss, New York,
baby is exposed to tetracycline in breast milk,
(1992).
theoretically it could cause tooth discoloration
and delayed bone growth. Yet, since only very
low levels of tetracycline are secreted into the
breast milk, no problems have been reported in
nursing babies.
In fact, the American Academy of
Pediatrics has approved tetracycline for use
during breastfeeding. Also, the WHO Working
Group on Human Lactation states that when the
antibiotic is used for seven to 10 days while
nursing, the risk to the infant appears to be low.
If you have any concerns about breastfeeding
while taking these types of antibiotics, talk to
your health care provider.