WHITE PLAINS, N.Y., OCT. 22, 2001 -- Pregnancy and possible anthrax exposure are too important for self-medication, the March of Dimes said today in a statement posted on its Web site. The foundation strongly urges pregnant women to consult their physicians about potential diagnosis and treatment for anthrax exposure before taking any prescription or non-prescription drug because of the potential harm to the fetus from some of these medications.
"Anthrax exposure is highly unlikely to cause direct harm to an unborn baby," says Nancy Green, M.D., associate medical director of the March of Dimes. "It’s different from the more familiar infections such as rubella (German measles) that cause only mild problems for the mother but can damage the fetus. We hope this information will reassure pregnant women who are more worried about their unborn babies than about themselves."
She says pregnant women and those with babies or young children should take the same precautions recommended by the U.S. Centers for Disease Control and Prevention for the general population.
However, Dr. Green says, pregnant women should understand that there are some special considerations when prescribing antibiotics for a pregnant woman who may have been exposed to anthrax. Similar considerations apply to children under age 9 years. She says a trained physician who is familiar with the circumstances of the potential exposure or the nature of an illness must weigh the risks against the benefits of treatment in each individual case.
Among the medications currently on the market:
- Penicillin and amoxicillin have excellent safety records for use in pregnancy, and are effective against anthrax.
- Women allergic to penicillin can take other effective antibiotics such as erythromycin.
- The oral antibiotic ciprofloxacin (Cipro™) has been recommended as the first drug of choice for adults who may have been infected with anthrax that is resistant to penicillin. However, Cipro has been reported to damage cartilage in young animals and possibly in humans. If the inhaled form of anthrax is suspected, the CDC recommends Cipro even for pregnant women and children until the effectiveness of penicillin can be determined. Once it is shown that penicillin would work, treatment with Cipro should be stopped and penicillin begun.
- Tetracycline and doxycycline are also generally effective against anthrax. However, these antibiotics can permanently stain a baby’s or young child’s teeth; they may also cause some delay in bone growth.
- Certain herbal and dietary supplements are promoted by their manufacturers as being good for the immune system, but these cannot protect against anthrax and are not known to be safe in pregnancy or childhood.
- Anthrax vaccine is not available to the general public. Moreover, there have been no studies to assess the safety of the vaccine in pregnant women or children.
What positive steps can pregnant women take? Many of the symptoms of anthrax are similar to those of influenza (the "flu"). In order to avoid masking the symptoms and to help prevent getting the flu, Dr. Green says, pregnant women should get a flu shot, preferably in the second or third trimester – unless they are allergic to eggs.
The March of Dimes is a national voluntary health agency whose mission is to improve the health of babies by preventing birth defects and infant mortality. Founded in 1938, the March of Dimes funds programs of research, community services, education, and advocacy to save babies. For more information call 1-888-MODIMES.
