The safety of quinolones and fluoroquinolones in pregnancy: a meta-analysis

E. Yefet, N. Schwartz, B. Chazan, R. Salim, S. Romano, Z. Nachum

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background: Quinolones were contraindicated during pregnancy because of concerns regarding fetal malformations and carcinogenesis in animals. The literature is conflicting regarding their safety in humans. Objectives: To conduct a meta-analysis evaluating the risk for fetal malformations and pregnancy complications following exposure to quinolones during pregnancy. Search strategy: We searched Embase, PubMed, Medline, the Cochrane database,, and Dart Databases. We added articles found through the references of included articles. Selection criteria: Relevant English citations using the terms quinolone/s, fluoroquinolone/s, and pregnancy in humans. Exclusion criteria were case reports, reviews, and articles without data regarding the study outcomes. Data collection and analysis: Two authors performed the database search, assessment of eligibility, and abstraction of data from included studies. Disagreement was settled by consensus among all authors. The pooled odds ratios (with 95% CIs) were estimated. The Cochrane's Q-test of heterogeneity and I² were used for the measurement of heterogeneity. A total of 256 papers were retrieved, 13 of which met the inclusion criteria and were then analysed. Main results: No association was found between quinolones and fetal malformations (pooled odds ratio, OR 1.08; 95% CI 0.96–1.21), preterm delivery (pooled OR 0.97; 95% CI 0.75–1.24), stillbirth (pooled OR 1.11; 95% CI 0.34–3.6), or miscarriage (pooled OR 1.78; 95% CI 0.93–3.38). Conclusions: Quinolones are not associated with unfavourable pregnancy outcomes; however, larger studies are needed before safety is established. Until then, it is suggested that quinolones should not be used as a first-line therapy during the first trimester. Tweetable abstract: Quinolones were associated with favourable pregnancy outcomes; caution should be taken in the first trimester.

Original languageEnglish
Pages (from-to)1069-1076
Number of pages8
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Issue number9
StatePublished - Aug 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 Royal College of Obstetricians and Gynaecologists


  • fetal malformations
  • miscarriages
  • pregnancy
  • quinolones
  • stillbirth
  • terminations of pregnancy


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