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RCOG statement on the use of antibiotics in pregnancy and the relative risk of neurological disorders

News 26 February 2015

A paper published in PLOS ONE (Public Library of Science) today suggests that the use of certain antibiotics (macrolides) in pregnancy are associated with an increased risk of cerebral palsy and/or epilepsy in childhood. However, the absolute risk was noted as being low.

Erythromycin is a macrolide and is used to treat chlamydia and syphilis during pregnancy. Its use has not been shown to be harmful when used in pregnancy.

Erythromycin is also the preferred antibiotic to use in pregnant women with preterm premature rupture of membranes who are allergic to penicillin. 

The Royal College of Obstetricians and Gynaecologists (RCOG) notes the findings of this study and would like to emphasise that this research, on the whole, demonstrates that there is no association between overall antibiotic prescribing to treat maternal infection with a risk of the child developing cerebral palsy and/or epilepsy.

Infections in pregnancy can result in very poor maternal and neonatal outcomes and the use of antibiotics have been proven to be safe. Current NICE guidelines state that the use of prescription medicines in pregnancy should be limited and used when medically-indicated. Women who are concerned about the possible side effects of antibiotics or any form of medication should speak to their midwife, obstetrician or GP for advice.

Professor Alan Cameron, RCOG Vice President for Clinical Quality, says:

“We welcome any new research which sheds light on the safety of antibiotics in pregnancy. The secondary analysis in this paper has shown a small increase in cerebral palsy and/or epilepsy with prenatal use of macrolides but it does not consider the severity of the maternal infection which, in turn, has an effect on the outcome.

“This level of evidence does not warrant a change in current clinical guidelines. Doctors should continue to prescribe erythromycin during pregnancy where indicated.”


For further information, please contact the RCOG Media and PR team on +44 20 7772 6300 or email


RCOG Green-top guideline Preterm Prelabour Rupture of Membranes.

RCOG Scientific Impact Paper Preterm Labour, Antibiotics, and Cerebral Palsy

NICE Antenatal Care guideline.