Abstract: Regarding the risk of antibiotic therapy during pregnancy, any medication given to the mother should be according to the indications due to the risk of possible side effects. Antibiotics are one of the most important groups of these medications to be considered. Along with direct antibiotic-induced side effects, indirect pathways also affect the fetus through the maternal changes. According to the data, different cytokines including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) are involved in both term and preterm parturition. These cytokines could trigger expression of different substances such as prostaglandins (PGs), their receptors, and PGs synthetizing molecules with already proven roles in parturition. Moreover, IL-1, IL-6, and TNF-α knocked-out mice have delayed parturition and lower levels of PGs compared to the wild types. The earlier-mentioned cytokines are able to induce matrix metalloproteinases and are also involved in parturition. Certain antibiotics have been shown capable of inducing inflammation cascade directly. Both in-vivo and in-vitro studies in human have also demonstrated this inflammation as elevated levels of inflammatory cytokines especially IL-1, IL-6, and TNF-α. This increase has been observed both in the presence and the absence of lipopolysaccharide (LPS). Moreover, antibiotics can induce endotoxemia in healthy cases which finally leads to the pro-inflammatory cytokine release. Regarding the role of mentioned pro-inflammatory cytokines in both term and preterm parturition, it seems that non-indicated use of antibiotics during pregnancy may increase the risk of preterm labor.

Keywords: preterm labor, antibiotic, inflammation, interleukin-1, interleukin-6, tumor necrosis factor-α


中文翻译：

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抗生素，炎症和早产：遗漏结论。

摘要：关于怀孕期间使用抗生素治疗的风险，由于可能的副作用，给予母亲的任何药物均应根据适应症进行治疗。抗生素是要考虑的最重要的药物之一。除直接的抗生素诱导的副作用外，间接途径也通过母体变化影响胎儿。根据数据，足月分娩和早产都涉及不同的细胞因子，包括白介素-1β（IL-1β），IL-6和肿瘤坏死因子-α（TNF-α）。这些细胞因子可能触发不同物质的表达，例如前列腺素（PGs），它们的受体和PGs，这些分子合成了已经在分娩中发挥作用的分子。此外，IL-1，IL-6，与野生型相比，被淘汰的TNF-α和TNF-α小鼠延迟了生育并降低了PGs的水平。前面提到的细胞因子能够诱导基质金属蛋白酶，也参与分娩。已经显示某些抗生素能够直接诱导炎症级联。人体的体内和体外研究均已证明这种炎症是炎症细胞因子尤其是IL-1，IL-6和TNF-α水平升高的结果。在存在和不存在脂多糖（LPS）的情况下都可以观察到这种增加。此外，在健康情况下，抗生素可以诱导内毒素血症，最终导致促炎性细胞因子释放。关于提及的促炎细胞因子在足月和早产中的作用，

关键词：早产，抗生素，炎症，白介素-1，白介素-6，肿瘤坏死因子-α