title: Exposure to anti-infective drugs during pregnancy and the risk of small-for-gestational-age newborns: a case-control study.
abstract: OBJECTIVE
  To determine the association between anti-infective exposure during the last two trimesters of pregnancy and the risk of small-for-gestational-age (SGA) newborns.
  
  
  METHODS
  Case-control study within the Québec Pregnancy Registry.
  
  
  METHODS
  Province of Québec, Canada.
  
  
  METHODS
  Analyses were performed on prospectively collected data of 63,338 pregnant women that met eligibility criteria for the study (8192 cases and 55,146 controls).
  
  
  METHODS
  Unconditional logistic regression models were used to quantify the association between exposure to anti-infective drugs and the risk of SGA.
  
  
  METHODS
  A case of SGA was defined as a pregnancy resulting in a baby that weighs below the tenth percentile, adjusted for gestational age and gender, according to the Canadian gender-specific reference curves. A control was defined as a pregnancy resulting in a baby that weighs greater or equal to the tenth percentile, adjusted for gestational age and gender.
  
  
  RESULTS
  Exposure to all combined anti-infective drugs was not associated with the risk of SGA (OR 0.97; 95% CI 0.91-1.04). The use of sulfamethoxazole/trimethoprim was associated with SGA (OR 1.61; 95% CI 1.16-2.23), whereas the use of urinary anti-infective drugs decreased the risk (OR 0.80; 95% CI 0.65-0.97).
  
  
  CONCLUSIONS
  Exposure to sulfamethoxazole/trimethoprim during the last two trimesters of pregnancy was associated with SGA. Further research is needed to address the use of other therapeutic alternatives in the management of infections that predispose infants being born SGA in pregnant women with other risk factors for this condition.
authors.affiliation: Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Santos
authors.forename: O
authors.initials: O
authors.lastname: Sheehy
authors.forename: S
authors.initials: S
authors.lastname: Perreault
authors.forename: E
authors.initials: E
authors.lastname: Ferreira
authors.forename: A
authors.initials: A
authors.lastname: Berard
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination