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Cohort study
Balancing competing risks: perinatal exposure to macrolides increases the risk of infantile hypertrophic pyloric stenosis
  1. Margaret A Honein,
  2. Janet D Cragan
  1. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to : Dr Margaret A Honein, Centers for Disease Control and Prevention, Mailstop E-86, 1600 Clifton Road, Atlanta, GA 30333, USA; mhonein{at}

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Infantile hypertrophic pyloric stenosis (IHPS) is a potentially life-threatening condition for which surgical treatment yields excellent patient outcomes.1 However, the aetiology of IHPS remains elusive. Prior studies have implicated early neonatal exposure to erythromycin as a strong risk factor for IHPS, but it is less clear whether maternal use in late pregnancy or while breastfeeding also poses a risk.2 Perinatal exposure to macrolide antibiotics is not uncommon. About 1% of pregnant women report use in the third trimester, and while no macrolides are licensed by the US Food and Drug Administration for use in infants less …

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  • Competing interests None.

  • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

  • Provenance and peer review Commissioned; internally peer reviewed.