Metronidazole Appears Not to Be a Human Teratogen: Review of Literature

Metronidazole is used to treat trichomoniasis, bacterial vaginosis, and other diseases. As is the case with many drugs, physicians often hesitate to use it during pregnancy, particularly in the first trimester. A review of the nearly four decades' worth of published literature on metronidazole use in pregnant women indicates that it is not teratogenic, regardless of the trimester in which it is used. On the other hand, a number of published studies indicate that bacterial vaginosis and trichomoniasis are associated with preterm birth and low birth weight. Treatment of these conditions with metronidazole during pregnancy may decrease the incidence of preterm birth and low birth weight, thus potentially decreasing the complications that can result from prematurity.

[1]  M. Krohn,et al.  Trichomonas vaginalis Associated With Low Birth Weight and Preterm Delivery , 1997, Sexually transmitted diseases.

[2]  Mary Frances Cotch,et al.  Association between Bacterial Vaginosis and Preterm Delivery of a Low-Birth-Weight Infant , 1995 .

[3]  J. Hauth,et al.  Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis , 1995, The New England journal of medicine.

[4]  T. Einarson,et al.  Safety of metronidazole in pregnancy: a meta-analysis. , 1995, American journal of obstetrics and gynecology.

[5]  John A. Albritton,et al.  Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double-blind study. , 1994, American journal of obstetrics and gynecology.

[6]  W. Ray,et al.  Prenatal Use of Metronidazole and Birth Defects: No Association , 1993, Obstetrics and gynecology.

[7]  O. Ylikorkala,et al.  Bacterial vaginosis in early pregnancy and pregnancy outcome , 1992, Obstetrics and gynecology.

[8]  M. Krohn,et al.  Bacterial Vaginosis as a Risk Factor for Post- Cesarean Endometritis , 1990, Obstetrics and gynecology.

[9]  N. Kiviat,et al.  A case‐control study of chorioamnionic infection and histologic chorioamnionitis in prematurity , 1989, The New England journal of medicine.

[10]  K. Holmes,et al.  Relationships of Vaginal Lactobacillus species, Cervical Chlamydia trachomatis, and Bacterial Vaginosis to Preterm Birth , 1988, Obstetrics and gynecology.

[11]  A. Gupta,et al.  Hepatic abscess during pregnancy , 1988 .

[12]  C. Baum,et al.  Pregnancy outcomes after first-trimester vaginitis drug therapy. , 1987, Obstetrics and gynecology.

[13]  D. Sweet Registry of toxic effects of chemical substances , 1987 .

[14]  K. Holmes,et al.  Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. , 1986, JAMA.

[15]  L. Keith,et al.  The possible role of Trichomonas vaginalis as a "vector" for the spread of other pathogens. , 1986, International journal of fertility.

[16]  L. Tompkins,et al.  Polymicrobial early postpartum endometritis with facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis: treatment with piperacillin or cefoxitin. , 1986, The Journal of infectious diseases.

[17]  K. Holmes,et al.  Preterm labor associated with subclinical amniotic fluid infection and with bacterial vaginosis. , 1986, Obstetrics and gynecology.

[18]  J. Feldman,et al.  Risk factors for prematurity and premature rupture of membranes: a prospective study of the vaginal flora in pregnancy. , 1984, American journal of obstetrics and gynecology.

[19]  P. Hardy,et al.  PREVALENCE OF SIX SEXUALLY TRANSMITTED DISEASE AGENTS AMONG PREGNANT INNER-CITY ADOLESCENTS AND PREGNANCY OUTCOME , 1984, The Lancet.

[20]  L. Heisterberg Placental transfer of metronidazole in the first trimester of pregnancy. , 1984, Journal of perinatal medicine.

[21]  I. Damjanov,et al.  The transplacental effects of ethanol and metronidazole in Swiss Webster mice. , 1983, Toxicology letters.

[22]  H. Minkoff Prematurity: Infection as an Etiologic Factor , 1983, Obstetrics and gynecology.

[23]  Ross Sm,et al.  Trichomonas infection in pregnancy--does it affect perinatal outcome? , 1983 .

[24]  S. Tischler Infectious Diseases in Obstetrics and Gynecology , 1983 .

[25]  S. Ross,et al.  Trichomonas infection in pregnancy--does it affect perinatal outcome? , 1983, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[26]  Giuseppe Attardi,et al.  Midline facial defect as a teratogenic effect of metronidazole. , 1982 .

[27]  J. Cantú,et al.  Midline facial defect as a teratogenic effect of metronidazole. , 1982, Birth defects original article series.

[28]  E. Hook Human teratogenic and mutagenic markers in monitoring about point sources of pollution. , 1981, Environmental research.

[29]  G. Friedman Cancer after metronidazole. , 1980, The New England journal of medicine.

[30]  J. Haas Cancer after metronidazole. , 1980, The New England journal of medicine.

[31]  P. Shubik,et al.  Experimental induction of hepatomas, mammary tumors, and other tumors with metronidazole in noninbred Sas:MRC(WI)BR rats. , 1979, Journal of the National Cancer Institute.

[32]  Isabel Morgan Metronidazole Treatment in Pregnancy , 1978, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[33]  S. Shapiro,et al.  Birth defects and drugs in pregnancy , 1977 .

[34]  A. Berget,et al.  [Metronidazole and pregnancy]. , 1972, Ugeskrift for laeger.

[35]  P. Shubik,et al.  Induction of lung tumors and malignant lymphomas in mice by metronidazole. , 1972, Journal of the National Cancer Institute.

[36]  R. Sands Pregnancy, trichomoniasis, and metronidazole. A novel dose schedule. , 1966, American journal of obstetrics and gynecology.

[37]  W. F. Peterson,et al.  Metronidazole in pregnancy. , 1966, American journal of obstetrics and gynecology.

[38]  S. C. Robinson,et al.  Trichomonas vaginalis. V. Further observations on metronidazole (Flagyl) (including infant follow-up). , 1965, American journal of obstetrics and gynecology.

[39]  R. T. Parker,et al.  Metronidazole in the Treatment of Vaginal Trichomoniasis: Hematologic, Neurologic, and Long-Term Clinical Evaluations , 1965, Southern medical journal.

[40]  G. Perl Metronidazole Treatment of Trichomoniasis in Pregnancy , 1965, Obstetrics and gynecology.

[41]  Pereyra Aj,et al.  UROGENITAL TRICHOMONIASIS; TREATMENT WITH METRONIDAZOLE IN 2002 INCARCERATED WOMEN. , 1964 .

[42]  A. J. Pereyra,et al.  Urogenital Trichomoniasis: Treatment with Metronidazole in 2002 Incarcerated Women , 1964, Obstetrics and gynecology.

[43]  H. L. Gardner,et al.  CLINICAL AND LABORATORY EFFECTS OF METRONIDAZOLE. , 1964, American journal of obstetrics and gynecology.

[44]  Doyle Jc,et al.  TREATMENT OF TRICHOMONIASIS WITH METRONIDAZOLE. A STUDY OF 99 FEMALE PATIENTS. , 1964 .

[45]  M. Scott-Gray METRONIDAZOLE IN OBSTETRIC PRACTICE , 1964, The Journal of obstetrics and gynaecology of the British Commonwealth.

[46]  E. Kotcher,et al.  THE EFFECT OF METRONIDAZOLE ON VAGINAL MICROBIOLOGY AND MATERNAL AND NEONATAL HEMATOLOGY. , 1964, American journal of obstetrics and gynecology.

[47]  G. Csonka Long-term Aspect of Treatment with Metronidazole (Flagyl) in Trichomonal Vaginitis* , 1963, The British journal of venereal diseases.

[48]  Andrews Mc,et al.  SYSTEMIC TREATMENT OF TRICHOMONAS VAGINITIS. , 1963 .

[49]  M. Andrews,et al.  Systemic Treatment of Trichomonas Vaginitis , 1963, Southern medical journal.

[50]  Whitelaw Mj,et al.  RESULTS OF TREATMENT OF TRICHOMONIASIS WITH METRONIDAZOLE (FLAGYL) IN PRIVATE AND CLINIC PATIENTS. , 1963 .

[51]  J. Gunn,et al.  Trichomoniasis and metronidazole. , 1963, American journal of obstetrics and gynecology.

[52]  S. E. Monroe Trichomoniasis. Clinical trial of metronidazole (Flagyl). , 1963, California medicine.

[53]  F. A. Lyon,et al.  Trichomonal vaginitis treated with metronidazole. , 1963, American journal of obstetrics and gynecology.

[54]  M. J. Whitelaw,et al.  RESULTS OF TREATMENT OF TRICHOMONIASIS WITH METRONIDAZOLE (FLAGYL) IN PRIVATE AND CLINIC PATIENTS. , 1963, Western journal of surgery, obstetrics, and gynecology.

[55]  Williams Bf Metronidazole in the treatment of trichomonal infections. A clinical study. , 1962 .

[56]  J. R. Boyd,et al.  The treatment of trichomoniasis with metronidazole , 1962 .

[57]  H. Kleinman,et al.  Use of metronidazole in the treatment of trichomoniasis. , 1962, American journal of obstetrics and gynecology.

[58]  H. Ragazzoni,et al.  Flagyl in Treatment of “Trichomonas vaginalis” Vaginitis , 1962, Obstetrics and gynecology.

[59]  R. Jennison,et al.  Metronidazole Treatment of Trichomoniasis in the Female , 1962, British medical journal.

[60]  D. Johnston,et al.  Observations on vaginal trichomoniasis. II. Treatment with metronidazone. , 1961, Canadian Medical Association journal.

[61]  M. S. Gray TRICHOMONAS VAGINALIS IN PREGNANCY THE RESULTS OF METRONIDAZOLE THERAPY ON THE MOTHER AND CHILD , 1961, The Journal of obstetrics and gynaecology of the British Empire.

[62]  King Aj Metronidazole in the treatment of trichomonal infections. , 1960 .

[63]  M. Moffett,et al.  Treatment of Trichomoniasis with Metronidazole , 1960, British medical journal.

[64]  A. King Metronidazole in the treatment of trichomonal infections. , 1960, The Practitioner.