Tetracycline-induced hepatotoxicity and hepatorenal failure have been reported in pregnant women given tetracycline [1-3]

Results of The Collaborative Perinatal Project found no increase in the incidence of major malformations among 341 mother-child pairs exposed during the first trimester to tetracycline. However, the findings of the study suggested a possible association with minor defects (inguinal hernia, hypoplasia of a limb, and hypospadias)[4].

A surveillance study of Michigan Medicaid recipients reported that data on 1004 newborns exposed to tetracycline during the first trimester did not support an association between tetracycline and major malformations, specifically cardiovascular defects, oral clefts, spina bifida, polydactyly, limb reduction defects, and hypospadias [5].

Tetracycline exposure after the fourth month of pregnancy may result in brownish staining of the deciduous teeth. When administered near term the permanent teeth may also be a stained [6].

BREAST FEEDING:  The American Academy of Pediatrics has classified tetracycline  as a medication "usually compatible with breast feeding" [7]. The WHO Working Group on Human Lactation considered the risk to the infant to be slight when tetracycline is used for less than 10 days [8].

NEONATAL SIDE EFFECTS: Oral tetracycline given to premature infants has been associated with decreased growth of the  fibula . The effect was reversible after the drug was discontinued [9].

SEARCH LITERATURE

1. Pride GL, et al. Disseminated intravascular coagulation associated with tetracycline-induced hepatorenal failure during pregnancy. Am J Obstet Gynecol. 1973;115:585-6. available. MEDLINE
2. Allen ES, et al.Hepatic toxicity of tetracycline in pregnancy.Am J Obstet Gynecol. 1966;95:12-8. MEDLINE
3. Whalley PJ, et al. Disposition of tetracycline by pregnant women with acute pyelonephritis.Obstet Gynecol. 1970;36:821-6. MEDLINE
4. Heinonen OP et al: Birth Defects and Drugs in Pregnancy Littleton, Publishing Sciences Group, 1977, pp 472-486.
5. Briggs GG,Freeman RK, Yaffe SJ, Drugs in Pregnancy and Lactation 6th edition,Baltimore, MD: Williams & Wilkins,2002 p 1325.
6. Shepard TH. Catalog of Teratogenic Agents pp 1309. 9th ed.Baltimore, MD: Johns Hopkins University Press, 1998 .p2553
7.  Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Review.
8.The WHO Working Group, Bennet PN (ed).: Drugs and Human Lactation. Elsevier, Amsterdam, New York, Oxford, 1988.
9. Cohlan SQ et al.Growth inhibition of prematures receiving tetracycline. Am J Dis Child 1963;105:453-461.

Created: 11/27/2002
Last Update: 11/30/2003